title: Doula support during first-trimester surgical abortion: a randomized controlled trial.
abstract: OBJECTIVE
  The objective of the study was to evaluate the impact of doula support on first-trimester abortion care.
  
  
  METHODS
  Women were randomized to receive doula support or routine care during first-trimester surgical abortion. We examined the effect of doula support on pain during abortion using a 100 mm visual analog scale. The study had the statistical power to detect a 20% difference in mean pain scores. Secondary measures included satisfaction, procedure duration, and patient recommendations regarding doula support.
  
  
  RESULTS
  Two hundred fourteen women completed the study: 106 received doula support, and 108 received routine care. The groups did not differ regarding demographics, gestational age, or medical history. Pain scores in the doula and control groups did not differ at speculum insertion (38.6 [±26.3 mm] vs 43.6 mm [±25.9 mm], P = .18) or procedure completion (68.2 [±28.0 mm] vs 70.6 mm [±23.5 mm], P = .52). Procedure duration (3.39 [±2.83 min] vs 3.18 min [±2.36 min], P = .55) and patient satisfaction (75.2 [±28.6 mm] vs 74.6 mm [±27.4 mm], P = .89) did not differ between the doula and control groups. Among women who received doula support, 96.2% recommended routine doula support for abortion and 60.4% indicated interest in training as doulas. Among women who did not receive doula support, 71.6% of women would have wanted it. Additional clinical staff was needed to provide support for 2.9% of women in the doula group and 14.7% of controls (P < .01).
  
  
  CONCLUSIONS
  Although doula support did not have a measurable effect on pain or satisfaction, women overwhelmingly recommended it for routine care. Women receiving doula support were less likely to require additional clinic support resources. Doula support therefore may address patient psychosocial needs.
authors.affiliation: Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL. Electronic address: jchor@bsd.uchicago.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Chor
authors.affiliation: Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Brandon
authors.initials: B
authors.lastname: Hill
authors.affiliation: Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Summer
authors.initials: S
authors.lastname: Martins
authors.affiliation: Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mistretta
authors.affiliation: Department of Obstetrics and Gynecology, The John H. Stroger Jr Hospital of Cook County, Chicago, IL.
authors.forename: Ashlesha
authors.initials: A
authors.lastname: Patel
authors.affiliation: Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Melissa
authors.initials: M
authors.lastname: Gilliam
mesh_terms: D000028:Abortion, Induced / Q000451:nursing*; D059037:Doulas; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055815:Young Adult
keywords: abortion; doula; lay health worker