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Best Evidence: Labor SupportBest evidence: When making important maternity decisions, women should have information from the best available research about the safety and effectiveness of different choices. In general, we can be most confident about results of systematic reviews that summarize randomized controlled trials (or RCTs, a type of study). What is the bottom line about labor support? What is the best evidence about the benefits of continuous support during labor? What appears to influence the impact of labor support? What factors most contribute to women's satisfaction in childbirth? What is the bottom line about labor support?The most recent systematic review of continuous labor support is available in full right on this website, along with a brief overview of the review. It summarizes the experiences of nearly 13,000 women who participated in 15 randomized controlled trials. The authors conclude: Continuous support during labour should be the norm, rather than the exception. All women should be allowed and encouraged to have support people with them continuously during labour (Hodnett and colleagues 2004). What is the best evidence about the benefits of continuous support during labor?This largest and most recent systematic found that when compared to women who did not receive continuous support, those who received continuous support were:
What appears to influence the impact of labor support?Various systematic reviews have looked at the impact of continuous labor support under different conditions.Several reviews have found that the type of person providing the care appears to make a difference. Labor support provided by caregivers who come to the labor setting expressly to provide this care appears to offer women more benefits than labor support provided by nurses or other clinical caregivers from that setting (Hodnett and colleagues 2004, Simkin and O'Hara 2002, Scott and colleagues 1999). In the most recent and largest review, when compared to women who did not receive continuous support, those who received continuous labor support from someone present just for this purpose were
What factors most contribute to women's satisfaction in childbirth?In considering whether to make arrangements for labor support, it may be helpful to consider results of research about satisfaction in childbirth. A systematic review of the best available research (Hodnett 2002) finds that the following four factors make the greatest contribution to women's satisfaction in childbirth:
ReferencesHodnett ED. Pain and women's satisfaction with the experience of childbirth: a systematic review. American Journal of Obstetrics and Gynecology 186,5 (2002) S160-72.Hodnett ED, Gates S, Hofmeyr G J, Sakala C. Continuous support for women during childbirth [PDF]. The Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766. Scott KD, Berkowitz G, and Klaus M. A comparison of intermittent and continuous support during labor: a meta-analysis. American Journal of Obstetrics and Gynecology 180,5 (1999) 1054-1059. Simkin PP and O'Hara MA. Nonpharmacologic relief of pain during labor: systematic reviews of five methods. American Journal of Obstetrics and Gynecology 186,5 (2002) S131-59. Most recent page update: 6/30/2008
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families. |
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