Potential benefits of increased access to doula support during childbirth.
Am J Manag Care
; 20(8): e340-52, 2014 Aug 01.
Article
in En
| MEDLINE
| ID: mdl-25295797
ABSTRACT
OBJECTIVES:
The annual costs of US maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between doula support, desire for doula support, and cesarean delivery, distinguishing cesarean deliveries without a definitive medical indication. STUDYDESIGN:
Retrospective analysis of a nationally representative survey of women who delivered a singleton baby in a US hospital in 2011- 2012 (N = 2400).METHODS:
Multivariable logistic regression analysis of characteristics associated with doula support and desire for doula support; similar models examine the relationship between doula support, desire for doula support, and 1) any cesarean or 2) nonindicated cesarean.RESULTS:
Six percent of women reported doula care during childbirth. Characteristics associated with desiring but not having doula support were black race (vs white; adjusted odds ratio [AOR] = 1.77; 95% CI,1.03-3.03), and publicly insured or uninsured (vs privately insured; AOR = 1.83, CI, 1.17-2.85; AOR = 2.01, CI, 1.07-3.77, respectively). Doula-supported women had lower odds of cesarean compared without doula support and those who desired but did not have doula support (AOR = 0.41, CI, 0.18-0.96; and AOR = 0.31, CI, 0.13-0.74). The odds of nonindicated cesarean were 80-90% lower among doula-supported women (AOR= 0.17, CI, 0.07-0.39; and AOR= 0.11, CI, 0.03-0.36).CONCLUSIONS:
Women with doula support have lower odds of nonindicated cesareans than those who did not have a doula as well as those who desired but did not have doula support. Increasing awareness of doula care and access to support from a doula may facilitate decreases in nonindicated cesarean rates.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Delivery, Obstetric
/
Doulas
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Manag Care
Journal subject:
SERVICOS DE SAUDE
Year:
2014
Document type:
Article
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA