Companionship to Modify the Clinical Birth Environment: Long-Term Effects on Mother and Child

Abstract

OBJECTIVE

- The objectives are to determine whether the introduction of· supportive companionship given by a "doula" (a lay labour companion) to nulliparous women during labour, will have long-term effects on feeding practices, the mother's perception of her baby, parenting practices or her relationship with her partner one year after delivery.

SETTING

The study was conducted at an . academic state hospital serving a lowincome urban population in the Western Suburbs of Johannesburg.

STUDY DESIGN

Two hundred and sixty two primigravidae who were in established labour without any obstetrics complications, and who had no labour companion with them were enroled into the study. They were randomly chosen to receive the additional support from a "doula" during their labour, or to receive the standard nursing and obstetric supportive care. The subjects and their babies were followed up one year after delivery.

MAIN OUTCOME MEASURES

Feeding practices, mother's perception of her baby, parenting practices and the relationship with her partner.

RESULTS

The findings partially confirm the results of studies that have shown positive effects of labour support on short-term outcomes. The results indicate a possible trend towards positive long-term effects of companionship during labour, but most differences were not statistically significant. A decisive conclusion cannot be reached.

CONCLUSIONS AND RECOMMENDATIONS

This project evaluated the long-term effects of companionship during labour. In view of the equivocal results, future research on companionship during labour should be directed towards identifying the most effective method of promoting long-term effects. Methods such as continuous support during labour and postpartum follow-up by lay woman in the society could be implemented. Women could be encouraged to visit primary health care centres. Health workers at primary health care centres could be encouraged to provide facilities for counselling, and social and emotional support.

Alternate abstract:

DOEL

Die doel is om te bepaal of die implimentering van ondersteunende kameraadskap deur'n "douia" Cn leke kraamondersteuner) aan nullipareuse vrouens gedurende baring, langtermyn veranderinge ten opsigte van voedingsgewoontes, moeder se persepsie van haar kind, ouerskaps praktyke en verhouding met haar metgesel kan meebring.

NAVORSINGS OMGEWING

Die studie is gedoen by 'n akademiese hospital wat hoofsaaklik aan 'n lae inkomste stedelike populasie in die Westelike voorstede van Johannesburg diens voorsien.

NAVORSINGS ONTWERP

Twee honderd twee en sestig primigravidas wat in gestabiliseerde baring was met geen verloskundige komplikasies, en wat geen ondersteuner by haar gehad het nie, het toestemming verleen om aan die studie deel te neem. Hulle was ewekansig toegewys om addisionele ondersteuning deur 'n "douia" gedurende baring te ontvang, of die gewone standaard prosedure van verpleegsorg te ontvang. Die deelnemers en hul babas is een jaar na die bevalling opgevolg.

HOOF MEETBARE VERANDERLIKES

Voedingsgewoontes, moeder se persepsie van haar kind, ouerskapspraktyke en verhouding met haar metgesel.

RESULTATE

Die resultate kom gedeeltelik ooreen met ander studies wat positiewe korttermyn invloede van 'n leke kraamondersteuner bewys het. Daar was 'n positiewe neiging in die meerderheid van die resultate van die vrouens wat ondersteuning gedurende baring ontvang het. Hierdie resultate het egter geen statistiese beduidenheid getoon nie.

GEVOLGTREKK/NGS EN AANBEVELINGS

In hierdie projek is die langtermyn effekte van ondersteuning gedurende baring geëvalueer. Verdere navorsing ten opsigte van kraamondersteuning behoort gerig te wees op die identifisering van effektiewe metodes van ondersteuning om langtermyn effekte aan te moedig. Metodes soos die instelling van ondersteuning gedurende baring en nageboorte opvolg deur 'n "douia" vanuit die gemeenskap kan in werking gebring word. Vroue kan aangemoedig word om primêre gesondheidsdienste gereeld te besoek. Gesondheidswerkers by primêre gesondheidsdienste kan aangemoedig word om konsulterende dienste t.o.v raadgewing, sos ia Ie en emosionele ondersteuning aan moeders te bied.