PT - JOURNAL ARTICLE AU - Jacqueline H. Fortier AU - Marshall Godwin TI - Doula support compared with standard care DP - 2015 Jun 01 TA - Canadian Family Physician PG - e284--e292 VI - 61 IP - 6 4099 - http://www.cfp.ca/content/61/6/e284.short 4100 - http://www.cfp.ca/content/61/6/e284.full SO - Can Fam Physician2015 Jun 01; 61 AB - Objective To determine the effect of support provided by doulas on the rate of medical interventions during labour for low-risk women intending to deliver vaginally at term.Data sources Comprehensive searches of the MEDLINE, EMBASE, and CINAHL databases were undertaken using the search terms labour support and doula.Study selection Randomized controlled trials evaluating the use of trained doulas for medical interventions during labour were selected and evaluated for methodologic quality. Articles of adequate quality were included in the synthesis. The outcomes of interest were rates of cesarean section, instrumental vaginal delivery, the use of oxytocin, and epidural anesthesia.Synthesis Outcomes were synthesized to determine overall odds ratios for relevant outcomes. Sensitivity analysis using only studies with high methodologic quality was completed, and publication bias was assessed. The presence and support of a trained doula reduced the odds of delivery by cesarean section and instrumental vaginal delivery. No significant effect was seen for the use of epidural anesthesia or the rates of oxytocin use. There was considerable heterogeneity among the studies.Conclusion Trained doulas help to reduce the odds of certain medical interventions during labour for low-risk women delivering at term.