Evaluation of a Student-Nurse Doula Program: An Analysis of Doula Interventions and Their Impact on Labor Analgesia and Cesarean Birth

Mary T. Paterno, Shirley E. Van Zandt, Jeanne Murphy, Elizabeth T. Jordan

Research output: Contribution to journalArticle

Abstract

Introduction: The aim of this study was to describe specific doula interventions, explore differences in doula interventions by attending provider (certified nurse-midwife vs obstetrician), and examine associations between doula interventions, labor analgesia, and cesarean birth in women receiving doula care from student nurses. Methods: A secondary analysis of data from the Birth Companions Program at the Johns Hopkins University School of Nursing was conducted usingttests, chi-square statistics, and logistic regression models. Results: In the 648 births in the sample, doulas used approximately 1 more intervention per labor with certified nurse-midwife clients compared to obstetrician clients. In multivariate analysis, the increase in the total number of interventions provided by doulas was associated with decreased odds of epidural (adjusted odds ratio [AOR] 0.92; 95% confidence interval [CI], 0.86-0.98) and cesarean birth (AOR 0.90; 95% CI, 0.85-0.95). When examined separately, a greater number of physical interventions was associated with decreased odds of epidural (AOR 0.85; 95% CI, 0.78-0.92) and cesarean birth (AOR 0.80; 95% CI, 0.73-0.88), but number of emotional/informational interventions was not. Discussion: Student nurses trained as doulas have the opportunity to provide a variety of interventions for laboring clients. An increase in the number of interventions, especially physical interventions, provided by doulas may decrease the likelihood of epidural use and cesarean birth.

Original languageEnglish (US)
Pages (from-to)28-34
Number of pages7
JournalJournal of Midwifery and Women's Health
Volume57
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Doulas
Analgesia
Nurses
Parturition
Students
Odds Ratio
Confidence Intervals
Nurse Midwives
Logistic Models
School Nursing
Multivariate Analysis

Keywords

  • Childbirth
  • Doula
  • Labor
  • Midwifery
  • Obstetric analgesia
  • Student nurse

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

Cite this

Evaluation of a Student-Nurse Doula Program : An Analysis of Doula Interventions and Their Impact on Labor Analgesia and Cesarean Birth. / Paterno, Mary T.; Van Zandt, Shirley E.; Murphy, Jeanne; Jordan, Elizabeth T.

In: Journal of Midwifery and Women's Health, Vol. 57, No. 1, 01.2012, p. 28-34.

Research output: Contribution to journalArticle

Paterno, Mary T. ; Van Zandt, Shirley E. ; Murphy, Jeanne ; Jordan, Elizabeth T. / Evaluation of a Student-Nurse Doula Program : An Analysis of Doula Interventions and Their Impact on Labor Analgesia and Cesarean Birth. In: Journal of Midwifery and Women's Health. 2012 ; Vol. 57, No. 1. pp. 28-34.
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