Effects of the Presence of the Doula on Pregnant Women's Anxiety and Pain During Delivery: A Randomized Controlled Trial

Abstract

10.30699/jambs.28.131.296 Background & Objective: Doulas can ease labor and delivery in a hospital);however, in Iran, few studies have been conducted on this topic because of the cultural and structural boundaries. Therefore, this study aimed to evaluate the impact of a doula's presence on anxiety and pain in pregnant women during the delivery process. Materials & Methods: This randomized clinical trial was conducted on 80 pregnant women referred to Ayatollah Musavi Hospital (Zanjan, Iran) in 2016. For women in the intervention group, the doula provided emotional and physical support. The mothers' pain severity and anxiety were measured by using a visual analog scale (VAS) and Spielberger questionnaire, respectively. Categorical and continuous variables were compared using chi-square and t tests, respectively. Results: We found that a higher proportion of patients had experienced mild anxiety about entering the postpartum period (47.5% vs 15%) and exiting it (80% vs 40%; P<0.05) compared to the control group. Also, the mean VAS score was significantly higher in the control group at 4-5 cm (86.5±11.39 vs 78.62±14.0; P=0.007) and 7-8 cm of cervical dilatation (99.0±4.41 vs 95.0±8.47; P=0.01) stages. Conclusion: The presence of a trained doula during labor can ease the mental consequences of delivery and decrease women's anxiety and pain during labor.

An investigation into the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companionship in Tehran: a qualitative inquiry on mitigating mistreatment of women during childbirth

“…This practice is recognized as a significant strategy for enhancing the quality of care and the birthing experience [ 12 ], and is considered a crucial element of respectful maternity care (RMC) [ 14 ]. Evidence shows that having birth companions is associated with reduced pain intensity and duration of labour, increased likelihood of spontaneous vaginal birth, decreased need for analgesia, episiotomy, and cesarean section, improved birth experience, early initiation of breastfeeding, and reduced postpartum depression [ 15 – 17 ]. Despite recognizing these benefits, the successful implementation of birth companions remains a challenge.…”

Impact of continuous labour companion- who is the best: A comprehensive meta-analysis on familiarity, training, temporal association, and geographical location

“…The woman feels a sense of loss of control, isolation and fear, peaking the level of anxiety (2). To cope with this tocophobia, pregnant women sometimes choose cesarean section over natural birth (3). Increased anxiety makes the woman more vulnerable to increased pain perception, prolonging the duration of labour and contributing to dystocia (4).…”

“…Support methods include having an accompanying companion for continuous labour support, induced sleep, hydrotherapy, and the Lamaze relaxation method (6). The labour companion can be a non-caregiving nurse, midwife, friend, relative, family member, husband or a person trained in supporting labour (doula) (3). WHO defines labour support as the supportive care provided to women during labour, including emotional support, physical comfort, advice and information giving (5).…”