Impact of Doula Support on Childbirth Outcomes for Women Undergoing a Vaginal Birth After Cesarean (VBAC)

This study is currently recruiting participants.
Verified December 2012 by University of British Columbia
Sponsor:
Collaborator:
Provincial Health Services Authority (PHSA)
Information provided by (Responsible Party):
University of British Columbia
ClinicalTrials.gov Identifier:
NCT01216098
First received: October 5, 2010
Last updated: December 20, 2012
Last verified: December 2012

October 5, 2010
December 20, 2012
October 2010
October 2013   (final data collection date for primary outcome measure)
Use of epidural analgesia and cervical dilation at time of epidural administration. [ Designated as safety issue: Yes ]
The main outcomes being looked at are use of epidural analgesia and cervical dilation at time of epidural administration. This information will be recorded in the patient charts during the intrapartum period and collected from these charts at a later date by a research assistant.
Same as current
Complete list of historical versions of study NCT01216098 on ClinicalTrials.gov Archive Site
Cervical dilation at time of epidural administration [ Designated as safety issue: Yes ]

The following secondary outcomes will be measured:

  • Use of nitrous oxide analgesia during labour.
  • Use of narcotic analgesia during labour (type and amount).
  • Number of visits to the assessment room before admission.
  • Mode of delivery (cesarean section, spontaneous vaginal, or forceps/vacuum).
  • Indication(s) for repeat cesarean (if applicable).
  • Length of time between admission and the start of active pushing.
  • Length of time between the start of active pushing and delivery.
  • Length of time between delivery and discharge.
Same as current
Not Provided
Not Provided
 
Impact of Doula Support on Childbirth Outcomes for Women Undergoing a Vaginal Birth After Cesarean (VBAC)
Impact of Doula Support on Intrapartum Outcomes for Women Undergoing a Vaginal Birth After Cesarean (VBAC)

The purpose of this study is to evaluate the impact of doula support on childbirth outcomes of women who are eligible for and attempting to have a Vaginal Birth After Cesarean (VBAC). Doulas are paraprofessionals who provide women with continuous physical and emotional support throughout the course of labour. They also conduct home visits in the prenatal and postpartum periods in order to provide women with information on childbirth-related topics and breastfeeding support. They do not perform clinical tasks. Their value lies in the psycho-social care that they provide. It is hypothesized that women who receive doula support alongside standard care will have a lower rate of epidural analgesia use and greater cervical dilation at time of epidural administration, as compared to those who receive standard care alone.

A two-armed randomized controlled trial will be conducted at BC Women's Hospital. The experimental group will receive both standard clinical care and doula support. The control group will receive standard clinical care without doula support. The main outcomes being looked at are use of epidural analgesia and cervical dilation at time of epidural administration. These outcomes have been chosen because of the association between the use of epidural analgesia and both a prolonged length of labour and the need for assisted deliveries (i.e. forceps assisted deliveries, vacuum assisted deliveries, and cesarean births). If it is found that providing doula support for women who are eligible for and attempting to have a VBAC reduces or delays the use of epidural analgesia, then it could be hypothesized that doula support for this population may also shorten the length of labour and reduce the need for assisted deliveries, thereby justifying ongoing research in this area.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Cesarean
Behavioral: Doula support
A doula is a paraprofessional who provides continuous emotional and physical support to women and their families during the intrapartum period.
  • Experimental: Experimental arm - D
    Experimental arm - Women randomized to this arm will receive doula support alongside standard care.
    Intervention: Behavioral: Doula support
  • No Intervention: No intervention - ND
    No intervention - Women randomized to this arm will receive standard care alone.
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
534
May 2014
October 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Women who have had at least one prior cesarean birth, are eligible for VBAC, and plan to attempt a VBAC after counseling at the Best Birth Clinic.
  • Singleton gestation.
  • Cephalic presentation.
  • Term gestation (37-42 weeks at time of delivery).

Exclusion Criteria:

  • Women who have a pre-existing medical condition that would be an indication for an elective cesarean birth.
  • Women who plan to privately hire a doula regardless of placement in either arm of the trial.
Female
18 Years and older
Yes
Contact: Patricia Janssen, BSN, MPH, PhD 604-875-2424 ext 5415 pjanssen@interchange.ubc.ca
Contact: Lee Saxell, RM, MA 604-875-2000 ext 6387 lsaxell@cw.bc.ca
Canada
 
NCT01216098
H10-01551
Yes
University of British Columbia
University of British Columbia
Provincial Health Services Authority (PHSA)
Principal Investigator: Patricia Janssen, BSN, MPH, PhD University of British Columbia
University of British Columbia
December 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP