The ACOG recommends doulas to improve labor and delivery outcomes!
“Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery (111). Given that there are no associated measurable harms, this resource is probably underutilized.”
From the article Safe Prevention of the Primary Cesarean Delivery
Okay so first, what is the ACOG? The American Congress of Obstetricians and Gynecologists (ACOG) is an organization for professionals who are dedicated to improving women’s health. It focuses on socioeconomic, political, and grievance activities. The members are physicians who practice in the field of obstetrics and gynecology and hold high ethical and professional standing. They are referred to as fellows and are recognized by the initials FACOG after their name (Fellow, American Congress of Obstetricians and Gynecologists). Membership indicates that a physician has met additional criteria and is always up to date on medical guidelines, treatments, and techniques in health care for women!
The article, Safe Prevention of the Primary Cesarean Delivery, was published in 2014. It discusses new guidelines determined by the ACOG to reduce the rate of cesarean births. Some of these new guidelines are listed below.
· Active phase of labor should start at the cervical dilation of 6 cm according to data found by The Consortium on Safe Labor (instead of 4 cm)
· A prolonged latent phase (greater than 20 hours for a first-time mother or 14 hours if you have previously given birth) should not be an indication for a cesarean section
· Slow but progressive labor should not be an indication of a medically necessary cesarean as long as the mother and baby are doing well
· Women who have previously given birth should be allowed to push for at least 2 hours. First-time mothers should be allowed to push for at least 3 hours
· Operative vaginal delivery techniques in the second stage of labor should be used (such as forceps)
· Manual rotation for breech presentation should be used in the second stage of labor
· Amnioinfusion or scalp stimulation may be used to monitor variable fetal heartrate
· Labor should not be induced before 41 weeks unless medically necessary
· Longer duration of the latent phase of labor should be allowed and Pitocin should be administered for at least 12-18 hours before determining induction a failure
· Continuous labor support, such as support provided by a doula, is one of the most effective ways to improve labor outcomes
What does this mean? Most women will be able to spend more time in the first stage of labor as well as in the pushing stage to reduce the rate of cesarean deliveries. Also, the ACOG recognizes doulas as an important role in a birth team! Although the presence of a doula cannot guarantee a vaginal delivery, the ACOG acknowledges that one-on-one support from a doula can be beneficial to mothers in labor.
Read the full article here.