Supportive companions of women in labor : a descriptive analysis

Although the effectiveness of labor companions (or "doulas") in reducing the length of labor and perinatal complications recently has been demonstrated, the specific doula behaviors that reduce maternal stress and anxiety have yet to be indentified. To systematically document the behavior of supportive companions during labor and delivery, three lay women employed to function as doulas for primigravid women were systematically observed. The doulas were observed with 13 mothers for 26 repeated (i.e., early and late in labor) observations, each 48 minutes in length. A behavioral coding scheme for describing the observable state of the mother and four aspects of doula behavior (i.e., Proximity, Talking, Touching, and Caretaking) was employed using a time sampling procedure with 15-second interval recording. Results showed that doulas spent 79% of the observed intervals within one foot of the mother and 41% of the intervals talking to the mother. Doulas touched the extremities and the trunk of the mother most often, using primarily a clutching or stroking style. When the mothers were distressed, doulas moved closer, talked more, touched more, and exhibited less caretaking behaviors (p<.05). Implications of these findings for understanding the effects of doulas on stress and anxiety during labor and delivery are considered.Psychology, Department o