Alternative Strategy to Decrease Cesarean Section: Support by Doulas During Labor

This research was conducted in a public general hospitalGUADALUPE TRUEBA is a doula trainer and Lamaze Interna-in Mexico City, Mexico. The objective was to evaluatetional Certified Childbirth Educator practicing in Mexico efficacy of the support given by a doula during labor toCity, Mexico. She is also a coordinator for the Lamaze reduce cesarean rate. From March 1997 to FebruaryInternational Certification Program at Anahuac University 1998, a group of 100 pregnant women were studied.in Mexico City and a member of the Lamaze International These women were at term, engaged in an active phaseEducation Council. CARLOS CONTRERAS is a physician at of labor, exhibited 3 cm. or more cervical dilatation,Hospital Manuel Gea González in Mexico City, Mexico. were nuliparous, had no previous uterine incision, andMARIA TERESA VELAZCO is a physician and chief of the possessed adequate pelvises. The group was randomlyTeaching Department at Hospital Manuel Gea González divided into two subgroups comprising 50 women, each:in Mexico City, Mexico. ENRIQUE GARCIA LARA is a physi-The first subgroup had the support of a childbirth educa-cian and the director of the Obstetrics and Gynecologic tor trained as a doula, while the second subgroup didDepartment at Hospital Manuel Gea González in Mexico not have doula support. Measurements were recordedCity, Mexico. HUGO Martinez is a physician and chief of on the duration of labor, the use of pitocin, and whetherthe Obstetrics and Gynecologic Department at Hospital or not the birth was a vaginal birth or cesarean section.Manuel Gea González in Mexico City, Mexico. Characteristics and gestational age were similar in both groups. Results confirmed that support by doulas during labor was associated with a significant reduction in ce-sarean birth and pitocin administration. There was a trend toward shorter labors and less use of epidurals. The results of this study showed, as in other trials mea-suring the impact of a doula’s presence during labor and birth, that doula support during labor is associated with positive outcomes that have physical, emotional, and economic implications