Supporting Women in Labor: Analysis of Different Types of Caregivers

Patricia Rosen, CNM, MSN


J Midwifery Womens Health. 2004;49(1) 

In This Article


The keywords for this search, intrapartum support, labor support, companionship in labor, and doula, were specified at the outset of the project. Although many uses of the term doula can be found in the literature, in this review doula was defined as an unfamiliar yet trained lay woman. Sources were identified for both computer and hand searches of publications in the English language through July 2003. The goal was to retrieve all relevant materials, including randomized trials and other publications. The following data sources were used to identify an array of articles or book chapters that addressed aspects of labor support: CINAHL, Cochrane Database of Systematic Reviews, Medline, OVID Evidence-Based Medicine, PsychInfo, SciSearch Plus, and current textbooks of obstetrics and midwifery.

Articles were read by the author, summarized, and assessed for content and quality. Articles were then grouped into five categories: randomized trials or quasi-randomized studies, prospective studies (nonrandomized), retrospective studies, metanalyses and systematic reviews, and opinions or commentaries. Studies included in this analysis were required to have been fully published in English between 1980 and 2003; be randomized controlled trials (RCTs) or prospective, nonrandomized studies; use analysis by intention to treat or explain low attrition in full analysis; compare a group with support to a group without support; give a clear explanation of who provided support; use continuous or almost continuous support as the independent variable; and examine maternal outcomes, maternal satisfaction, and/or infant outcomes.


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