Effect of continuous support during labor on duration of labor and rate of cesarean delivery.

OBJECTIVE: To evaluate the effect of continuous support provided by midwives during labor on the duration of the different stages of labor and the rate of cesarean delivery. METHOD: A randomized trial of 100 eligible nulliparous women who had not received education classes on childbirth. In the intervention group (n=50), continuous support during labor was provided; the control group (n=50) did not receive continuous support. RESULTS: The two groups did not differ by age, employment, educational level, gestational age, economic status, and neonatal weight. Mean duration of the active phase of labor (167.9+/-76.3 vs 247.7+/-101 min, P<0.001), second stage of labor (34.9+/-25.4 vs 55.3+/-33.7 min, P=0.003), and the number of cesarean deliveries (4 vs 12, P=0.026) were significantly lower in the intervention group compared with the control group. The rates of oxytocin use and Apgar scores of less than 7 at 5 minutes were similar between the two groups. CONCLUSION: Continuous support provided by midwives during labor may reduce the duration of labor and the number of cesarean deliveries; this model of support should be available to all women.