A hospital-based doula program and childbirth outcomes in an urban, multicultural setting.

OBJECTIVES: The objective of this study is to determine whether there are differences in birth and breastfeeding outcomes for women who received labor support through a hospital-based doula program, compared with those who did not receive doula support in labor. METHODS: We conducted a retrospective...

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Publicado en:Maternal & Child Health Journal Vol. 12; no. 3; pp. 372 - 378
Autores principales: Mottl-Santiago J, Walker C, Ewan J, Vragovic O, Winder S, Stubblefield P
Formato: research tables/charts Journal Article
Publicado: Springer Nature May2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2008
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      pub: Springer Nature
      place: New York, New York
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        atl: A hospital-based doula program and childbirth outcomes in an urban, multicultural setting.
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          Mottl-Santiago J
          Walker C
          Ewan J
          Vragovic O
          Winder S
          Stubblefield P
        affil: Department of Obstetrics and Gynecology, Boston University School of Medicine/Boston Medical Center, 91 East Concord Street, Rm 4113, Boston, MA, 02118, USA, Julie.MottlSantiago@bmc.org.
      sug:
        subj:
          Breast Feeding
          Doulas
          Pregnancy Outcomes
          Program Evaluation
          Analgesia, Epidural
          Apgar Score
          Cesarean Section
          Chi Square Test
          Confidence Intervals
          Data Analysis Software
          Descriptive Statistics
          Female
          Hospitals
          Mantel-Haenszel Test
          Massachusetts
          Pregnancy
          Prospective Studies
          Regression
          Relative Risk
          Retrospective Design
          T-Tests
          Urban Areas
          Wilcoxon Rank Sum Test
          Human
          Female
      ab: OBJECTIVES: The objective of this study is to determine whether there are differences in birth and breastfeeding outcomes for women who received labor support through a hospital-based doula program, compared with those who did not receive doula support in labor. METHODS: We conducted a retrospective program evaluation to compare differences in birth outcomes between births at 37 weeks or greater with doula support and births at 37 weeks or greater without doula support through the first seven years of a hospital-based doula support program. Log-binomial regression models were used to compare differences in cesarean delivery rates, epidural use, operative vaginal delivery, Apgar scores, breastfeeding intent and early breastfeeding initiation after controlling for demographic and medical risk factors. The propensity score was included as an additional covariate in our regression model to minimize issues of selection bias. Analyses were conducted for the whole cohort of 11,471 women and by parity and provider service in subgroup analyses. Cochran-Mantel-Haenszel test was performed to detect differences in effects over time. RESULTS: For the whole cohort, women with doula support had significantly higher rates of breastfeeding intent and early initiation. Subgroup analysis showed that having doula support was significantly related to: (a) higher rates of breastfeeding intent and early initiation rates for all women regardless of parity or provider with the exception of multiparous women with physician providers; (b) lower rates of cesarean deliveries for primiparous women with midwife providers. CONCLUSION: A hospital-based doula support program is strongly related to improved breastfeeding outcomes in an urban, multicultural setting.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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