Comparing the Effects of Standard Maternity Care and Continuous Support by Doula Midwife and Female Relatives during Labor

Pain in labor causes stress and reduces self-steem. Effective support is a key factor in reducing stress during delivery. The present study aimed to investigate and compare the effects of standard maternity care, continuous supports from private midwife, and female relatives on type and process of delivery, maternal satisfaction, and breastfeeding.

A clinical trial was done in 165 primiparous women attending Amol Imam Ali Hospital, Iran 2018. They were randomly classified into three groups to recieve standard maternity care during delivery (n=55), continuous supports from private midwife (n=55), and female relatives (n=55). The following parameters were compared between all groups: duration and severity of labor pain, type of delivery, maternal satisfaction, Apgar scores, and the start of lactation and continuation of breastfeeding.

The duration (P<0.001) and pain severity (P<0.001) of active phase of labor were significantly lower in groups that received continuous support by private midwife and female relatives. In these groups, the satisfaction rates of delivery (P<0.001) and breastfeeding (P=0.01) were significantly higher than the control group in 6 months after delivery. No significant differences were found between the groups in length (P=0.92) and severity of pain (P=0.99) at the second stage of delivery, cesarean delivery (P=0.20), Apgar score (P=0.87), start of lactation (P=0.35), and breastfeeding in three months after the delivery (P=0.34). Severity of pain in active phase of delivery was significantly lower in the group that received continuous support by private midwife, than that of those who received supports from female relatives (P= 0.019).

Continuous supports by relatives or private midwife have positive effects on duration and severity of pain in active phase of labor and breastfeeding and could influence mothers' decisions for future pregnancies.