A randomized control trial of continuous support in labor by a lay doula

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). Design: Randomized controlled trial. Setting: A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey. Patients/participants: 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. Interventions: The doula group was taught traditional doula supportive techniques in two 2-hour sessions. Main Outcome Measures: 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. Conclusion: 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.