Women's Health: Giving birth is better with one-on-one care during labour

Continuous, one-to-one support for women in labour increases the likelihood of an easier birth, but the practice is rare in most hospitals. Having a female attendant provide support to women in childbirth was common practice decades ago, but not any more, according to Ellen Hodnett, a professor in the University of Toronto's school of nursing. "There isn't technically such a thing as a continuous caregiver during labour," Hodnett says. "Husbands are there and family members are welcome and so on. But as far as nurses or midwives or regular hospital staff, it's very unusual that they can spend the entire time with just one woman in labour." Hodnett and her colleagues reviewed 16 studies comparing continuous care with usual care, involving a total of more than 13,000 women. The results indicated that women who received continuous support were seven per cent more likely to have a spontaneous vaginal birth than those who received usual care. They also were less likely to need a caesarean delivery and pain medication, and were less likely to report being dissatisfied with their childbirth experience than women who received usual care. The researchers concluded that continuous support during labour should be routine, rather than an exception. However, providing it can be a challenge. Hodnett says some Canadian hospitals have met that challenge by rethinking how they staff their maternity services. Instead of staffing nurses in each area (labour and delivery, postpartum and nursery) based on a daily average number of births, some hospitals have cross-trained all their obstetrical nurses to work in all of these areas. Instead of each area being overburdened during busy periods and overstaffed during lulls, there are more nurses available for each area when it is busy. Other hospitals have implemented single-room maternity care. "Women are admitted, labour, give birth and have their postpartum stay all in the same room. Again, the staff are trained to look after women during that whole stay."