One-to-one nurse labor support of nulliparous women stimulated with oxytocin

Abstract

Objective: To compare the benefits of one-to-one nurse labor support with the benefits of usual intrapartum nursing care in women stimulated with oxytocin.

Design: A secondary analysis of a randomized controlled trial.

Setting: A 637-bed university hospital.

Participants: One hundred nulliparous women 37 weeks or more gestation, carrying singletons, in labor with vertex presentation, stimulated with oxytocin, less than 5 cm dilated at baseline, and not scheduled for cesarean delivery or induction nor having paid labor support present.

Interventions: One-to-one care consisted of the presence of a nurse during labor and birth who provided emotional support, physical comfort, and instruction on relaxation and coping techniques. Usual care consisted of care for 2-3 laboring women with supportive activities varying by nurse.

Main outcome measure: Cesarean delivery.

Results: A beneficial trend because of one-to-one nurse support, with a 56% reduction in risk of total cesarean deliveries [RR of experimental vs. control = 0.44 (95% confidence interval = 0.19 to 1.01)].

Conclusion: The beneficial trend in reducing cesarean deliveries attributed to one-to-one nursing in women stimulated with oxytocin suggests that continuous support by intrapartum nursing staff may benefit women stimulated with oxytocin during labor.