Continuous care in labor

I love the journal Birth. I just got a fresh copy of their table of contents in my email inbox, and I found this gem on continuous labor support in there. I have only read the abstract – I have a tab open in the EBSCO database as we speak for the full text. But wow wow WOW the results look great. Too bad they are from over a decade ago! Women’s bodies and doula practices have not changed a lot since then, but hospital practices and intervention rates have.

“Results: The doula group had a significantly lower cesarean delivery rate than the control group (13.4% vs 25.0%, p = 0.002), and fewer women in the doula group received epidural analgesia (64.7% vs 76.0%, p = 0.008). Among women with induced labor, those supported by a doula had a lower rate of cesarean delivery than those in the control group (12.5% vs 58.8%, p = 0.007). On questionnaires the day after delivery, 100 percent of couples with doula support rated their experience with the doula positively.”

I am going to find out how many women were in that induction group. I am sure induction rates have climbed significantly since 1992, like most other labor interventions. But a reduction of failed induction of 58.8% to 12.5%?? I don’t think every cesarean birth is a failed birth by any means, but a cesarean after labor induction, in general, is a failed induction. One does not induce labor with the intent of doing a cesarean, even though it is often the consequences of such an action, when issues like an unencouraging Bishop’s score are taken into account.

By the way, when searching the term “Bishop’s score” to provide a link, I found a do-it-yourself Bishop’s score page on one of my favorite websites, Childbirth.org. Women would have to have access to a computer in the triage room or clinic to use it for the most part, I would think, but hey, it’s interesting! I would think it would make more sense to ask the health care practitioner measuring effacement, dilation, etc. what Bishop score those would add up to, and what that means in the progress of your care.

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