A comparison of intermittent and continuous support during labor: A meta-analysis

Our goal was to contrast the influence of intermittent and continuous suppo rt provided by doulas during labor and delivery on 5 childbirth outcomes. D ata were aggregated across 11 clinical trials by means of meta-analytic tec hniques. Continuous support, when compared with no doula support, was signi ficantly associated with shorter labors (weighted mean difference -1.64 hou rs, 95% confidence interval -2.3 to -.96) and decreased need for the use of any analgesia (odds ratio .64, 95% confidence interval .49 to .85), oxytoc in (odds ratio .29, 95% confidence interval .20 to .40), forceps (odds rati o .43, 95% confidence interval .28 to .65), and cesarean sections (odds rat io .49, 95% confidence interval .37 to .65). intermittent support was not s ignificantly associated with any of the outcomes. Odds ratios differed betw een the 2 groups of studies for each outcome. Continuous support appears to have a greater beneficial impact on the 5 outcomes than intermittent suppo rt. Future clinical trials, however, will need to control for possible conf ounding influences. Implications for labor management are discussed.