We studied the effects of a supportive lay woman (“doula”) on the length of labor and on mother-infant interaction after delivery in healthy Guatemalan primigravid women. Initial assignment of mothers to the experimental (doula) or control group was random, but controls showed a higher rate (P<0.001) of subsequent perinatal problems (e.g., cesarean section and meconium staining). It was necessary to admit 103 mothers to the control group and 33 to the experimental group to obtain 20 in each group with uncomplicated deliveries. In the final sample, the length of time from admission to delivery was shorter in the experimental group (8.8 vs. 19.3 hours, P<0.001). Mothers who had a doula present during labor were awake more after delivery (P<0.02) and stroked (P<0.001), smiled at (P<0.009), and talked to (P<0.002) their babies more than the control mothers. These observations suggest that there may be major perinatal benefits of constant human support during labor. (N Engl J Med. 1980; 303:597–600.) IN all but one of 150 cultures studied by anthropologists, a family member or friend, usually a woman, remained with a mother during labor and delivery (Raphael D. Unpublished data). Before childbirth moved from the home to the hospital, it was also the practice in industrialized nations for family members to support the mother actively in labor, often with the assistance of a trained or untrained midwife. Although more fathers, relatives, and friends have been allowed into labor and delivery rooms in the past 10 years, a considerable number of mothers still undergo labor and delivery in some hospitals without.
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