A Study to Evaluate the Effectiveness of Doula Care on Pain, Anxiety and Labor Outcome among Parturient in Selected Hospitals of Theni District

BACKGROUND OF THE STUDY: The main aim or goal of perinatal care is a family-centered approach. Many of the hospitals in the developed countries allow family members to be present during labor. Labor support has appeared in increasing numbers of official and legal documents as well as national and global initiatives. WHO also emphasized that the psychosocial care for women in labor is essential and should be based on a holistic perspective that encourages family-centered care that involves women in decision making. Aim of the study was to evaluate the effectiveness of doula care on pain, anxiety and labor outcome among parturient in selected hospitals of Theni district. METHODOLOGY: A quantitative approach using a quasi experimental (post test) only design was applied to this study. The study was conducted in Holy redeemer maternity hospital, Theni among 200 primi parturient, (100 in the control group and 100 in the interventional group) who were selected by non probability convenience sampling technique. Data collection was based on interview technique and observation method. The tools used in this study were demographic variables, standardized numerical pain rating scale, standardized state anxiety scale, and self developed questionnaire on labor outcome. Data was collected from December 2013 to February 2015, at Holy redeemer hospital, Theni, after obtaining permission and ethical clearance from the concerned authorities. The participant’s written consent was obtained. First 100 parturient were selected conveniently to the control group and the next 100 to the interventional group. Interventional group underwent doula care (Researcher acted as doula) along with routine care from latent phase of 1st stage of labor till immediate postpartum period.(until 1 hr after delivery ). The researcher assessed the level of pain, anxiety during late active phase of first stage labor, and labor outcome was assessed during labor and immediate post partum period. Control group underwent hospital routine care, pain and anxiety were assessed during late active phase of first stage of labor, and labor outcome observed during labor and immediate post partum period. The researcher taught about doula care to the control group to practice for future delivery. The Conceptual Framework for the present study was based on Roy’s adaptation theory (1984). Data were analyzed by descriptive and inferential statistics. RESULTS: There was a notable decrease in level of pain (15.8%, t=6.16) anxiety (10.8%, t=6.01) and improvement in the level of labor outcome (13.2%, t= 7.60) at p < 0.001 level in the interventional group as compared with the control group. Findings on correlation coefficient indicated that pain, anxiety and labor outcome were moderately related to each other among parturient in the interventional and control group Age of the parturient, type of work, history of complications, weight of the parturient had significant association with level of pain among parturient in the interventional group. Age of the parturient, type of family, gestational weeks of parturient and history of complications had significant association with level of anxiety among parturient in the interventional group. Age of the parturient, Type of work, gestational weeks of parturient and history of complications, history of abortion had significant association with level of labor outcome among parturient in the interventional group. CONCLUSION: The findings imply that adding doula care with routine care was found to be effective in reducing the pain, anxiety and in improving the labor outcome among primi parturient during labor. None of the parturient in the study reported adverse effects to doula care. Doula care filled the gap between the parturient and midwives