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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3375.0: Monday, December 12, 2005 - 5:20 PM

Abstract #121347

Empowering Women Through Multicultural Enhanced Doula Support: An Evaluation of the Birth SistersSM Program

Jean Ewan, CNM, MPH1, Julie Mottl-Santiago2, Catherine Walker, CNM, MPH1, and Suzanne Winder, BA1. (1) Nurse-Midwifery Program, Boston Medical Center, 1 Boston Medical Center Place, Dowling 321 S, Boston, MA 02118, 617-414-5469, Jean.Ewan@bmc.org, (2) Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany Street, Ste 527W, Boston, MA 02118

Background: Lay labor support during childbirth has been shown in several randomized controlled trials to improve perinatal outcomes. The Birth SistersSM Program at Boston Medical Center offers multicultural prenatal, labor and postpartum support to all childbearing women. We conducted an evaluation to determine if Birth Sister Program outcomes are similar to those reported in the literature. Methodology: A retrospective cohort analysis compared outcomes for Birth Sister attended births with non-Birth Sister attended births through the program's first five years. 9818 live births were identified and analyzed from the hospital's previously existing computerized obstetrical database. Demographic profiles and obstetrical risk factors were analyzed for the two group's comparability. Outcome measures included primary and total cesarean delivery rates, epidural use, operative vaginal delivery, Apgar scores, breastfeeding intent and early breastfeeding initiation. Log binomial regression models were constructed to evaluate the relationship between variables and to control for confounders. Subgroup analyses were also performed for each provider service (midwifery and physician) and for primiparous and multiparous women. Results: For overall data (N=9818), significant differences in epidural use (p=.01), intent to breastfeed (p=.0001) and early breastfeeding initiation (p=.0001) were found for Birth Sister attended births compared with non-Birth Sister attended births. For breastfeeding outcomes, results were also true for subgroup analysis where sample size varies with regards to subgroups. Additionally, Birth Sister attended primiparous midwifery births had significantly lower rates of cesarean delivery (p=.006) and epidural use (.04)

Learning Objectives:

Keywords: Midwifery, Access to Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Who's Left to Catch the Baby?

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA