| March data reports are on the way |
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 Congratulations to the Support for Birth teams for outstanding data collection and data entry for March! Monthly reports will be sent to all by the end of the week. Only three hospitals have not completed data entry for March; if yours is one of them, please let us know when your data entry is complete so we can generate a report for your team. Keep up the good work for April!
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| Progress on the action plan? |
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 As a reminder, the purpose of collecting data is to give you a tool to evaluate whether the changes you are working on are having the desired impact. How much progress has your team made toward the objectives you set for yourselves on the action plan? We are already at the midpoint of this initiative. If your team is struggling to move forward with changes, please let us know how we can support your work. Some physician champions have recently consulted with Dr. Chescheir about strategies to improve the rate of vaginal birth in the NTSV population.
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| Continuous labor support - impact on the c-section rate |
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 This week we are posting some studies on the Extranet that address the role of continuous labor support in improving the rate of vaginal birth. A Cochrane Review focusing on this topic was updated in January 2011.
Consistent with earlier findings, it suggests that continuous labor support, provided by a member of the hospital staff, a partner or member of the woman's social network or from a person who is present solely to provide support (such as a doula), is associated with several outcomes, including a decreased risk of c-section.
The Cochrane Review examined 21 studies that included a control group and randomization. The analysis found that women with continuous labor support were more likely to give birth spontaneously (fewer operative vaginal deliveries and c-sections), were less likely to use pain medications, had slightly shorter labors, and reported a higher degree of patient satisfaction. Labor support from hospital staff appeared to be a less effective intervention, possibly because of staff limitations due to institutional pressures and policies, while the best outcomes appeared to be associated with the presence of a person whose sole role was to provide labor support. Even with randomization, there is the potential for selection bias in studies of continuous labor support, based on characteristics of patients who are willing to participate in such studies.
The full Cochrane Review can be accessed here; think twice before printing - it's 104 pages long! Look for more references this week on the Extranet that relate to approaches to labor support and impact on the rate of vaginal birth.
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Contact Kate
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Kate Berrien, RN, BSN, MS
UNC Center for Maternal & Infant Health
CB# 7181
Chapel Hill, NC 27599
kberrien@unch.unc.edu
Phone: 919-843-9336 Fax: 919-843-7866 |
