title: A randomized control trial of continuous support in labor by a lay doula.
abstract: OBJECTIVE
  To compare labor outcomes in women accompanied by an additional support person (doula group) with outcomes in women who did not have this additional support person (control group).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey.
  
  
  METHODS
  Six hundred nulliparous women carrying a singleton pregnancy who had a low-risk pregnancy at the time of enrollment and were able to identify a female friend or family member willing to act as their lay doula.
  
  
  METHODS
  The doula group was taught traditional doula supportive techniques in two 2-hour sessions.
  
  
  METHODS
  Length of labor, type of delivery, type and timing of analgesia/anesthesia, and Apgar scores.
  
  
  RESULTS
  Significantly shorter length of labor in the doula group, greater cervical dilation at the time of epidural anesthesia, and higher Apgar scores at both 1 and 5 minutes. Differences did not reach statistical significance in type of analgesia/anesthesia or cesarean delivery despite a trend toward lower cesarean delivery rates in the doula group.
  
  
  CONCLUSIONS
  Providing low-income pregnant women with the option to choose a female friend who has received lay doula training and will act as doula during labor, along with other family members, shortens the labor process.
authors.affiliation: Study on Sleep & Functional Performance in Heart Failure at the University of Medicine and Dentistry of New Jersey, School of Nursing, Newark 07101-1709, and Division of Maternal Fetal Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA.
authors.forename: Della A
authors.initials: DA
authors.lastname: Campbell
authors.forename: Marian F
authors.initials: MF
authors.lastname: Lake
authors.forename: Michele
authors.initials: M
authors.lastname: Falk
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Backstrand
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D003266:Continuity of Patient Care / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D003479:Curriculum; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology; D005260:Female; D033062:Friends / Q000523:psychology; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology / Q000523:psychology; D008880:Midwifery / Q000193:education / Q000458:organization & administration*; D009515:New Jersey; D015403:Nursing Evaluation Research; D010298:Parity; D011203:Poverty; D011247:Pregnancy; D011256:Pregnancy Outcome; D015397:Program Evaluation; D012380:Role; D012944:Social Support; D013997:Time Factors