Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Oct;22(Suppl 1):105-113.
doi: 10.1007/s10995-018-2537-7.

Randomized Controlled Trial of Doula-Home-Visiting Services: Impact on Maternal and Infant Health

Sydney L Hans  1 , Renee C Edwards  2 , Yudong Zhang  2
Affiliations
Randomized Controlled Trial

Randomized Controlled Trial of Doula-Home-Visiting Services: Impact on Maternal and Infant Health

Sydney L Hans et al. Matern Child Health J. 2018 Oct.

Erratum in

Abstract

Introduction Although home-visiting programs typically engage families during pregnancy, few studies have examined maternal and child health outcomes during the antenatal and newborn period and fewer have demonstrated intervention impacts. Illinois has developed an innovative model in which programs utilizing evidence-based home-visiting models incorporate community doulas who focus on childbirth education, breastfeeding, pregnancy health, and newborn care. This randomized controlled trial (RCT) examines the impact of doula-home-visiting on birth outcomes, postpartum maternal and infant health, and newborn care practices. Methods 312 young (M = 18.4 years), pregnant women across four communities were randomly assigned to receive doula-home-visiting services or case management. Women were African American (45%), Latina (38%), white (8%), and multiracial/other (9%). They were interviewed during pregnancy and at 3-weeks and 3-months postpartum. Results Intervention-group mothers were more likely to attend childbirth-preparation classes (50 vs. 10%, OR = 9.82, p < .01), but there were no differences on Caesarean delivery, birthweight, prematurity, or postpartum depression. Intervention-group mothers were less likely to use epidural/pain medication during labor (72 vs. 83%; OR = 0.49, p < .01) and more likely to initiate breastfeeding (81 vs. 74%; OR = 1.72, p < .05), although the breastfeeding impact was not sustained over time. Intervention-group mothers were more likely to put infants on their backs to sleep (70 vs. 61%; OR = 1.64, p < .05) and utilize car-seats at three weeks (97 vs. 93%; OR = 3.16, p < .05). Conclusions for practices The doula-home-visiting intervention was associated with positive infant-care behaviors. Since few evidence-based home-visiting programs have shown health impacts in the postpartum months after birth, incorporating doula services may confer additional health benefits to families.

Keywords: Breastfeeding; Doula; Home visiting; Safe sleep.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study CONSORT diagram
See this image and copyright information in PMC

References

    1. Bardanzellu F, Fanos V, Reali A. “Omics” in human colustrum and mature milk: Looking to old data with new eyes. Nutrients. 2017;9:843. doi: 10.3390/nu9080843. - DOI - PMC - PubMed
    1. Barlow A, Mullany B, Neault N, Compton S, Carter A, Hastings R, Walkup JT. Effect of a paraprofessional home-visiting intervention on American Indian teen mothers’ and infants’ behavioral risks: A randomized controlled trial. American Journal of Psychiatry. 2013;170(1):83–93. doi: 10.1176/appi.ajp.2012.12010121. - DOI - PMC - PubMed
    1. Bryant AS, Worjoloh A, Caughey AB, Washington AE. Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. American Journal of Obstetrics & Gynecology. 2010;202(4):335–343. doi: 10.1016/j.ajog.2009.10.864. - DOI - PMC - PubMed
    1. Caraballo M, Shimasaki S, Johnston K, Tung G, Albright K, Halbower AC. Knowledge, attitudes, and risk for sudden unexpected infant death in children of adolescent mothers: A qualitative study. Journal of Pediatrics. 2016;174:78–83. doi: 10.1016/j.jpeds.2016.03.031. - DOI - PubMed
    1. Carta JJ, Lefever JB, Bigelow K, Borkowski J, Warren SF. Randomized trial of a cellular phone-enhanced home visitation parenting intervention. Pediatrics. 2013;132(Supplement 2):S167S173. - PMC - PubMed

Publication types