Community-based bilingual doula support during labour and birth to improve migrant women's intrapartum care experiences and emotional well-being-Findings from a randomised controlled trial in Stockholm, Sweden [NCT03461640]

Erica Schytt; Anna Wahlberg; Amani Eltayb; Nataliia Tsekhmestruk; Rhonda Small; Helena Lindgren

doi:10.1371/journal.pone.0277533

Community-based bilingual doula support during labour and birth to improve migrant women's intrapartum care experiences and emotional well-being-Findings from a randomised controlled trial in Stockholm, Sweden [NCT03461640]

PLoS One. 2022 Nov 18;17(11):e0277533. doi: 10.1371/journal.pone.0277533. eCollection 2022.

Authors

Erica Schytt^{1

2

3}, Anna Wahlberg¹, Amani Eltayb¹, Nataliia Tsekhmestruk¹, Rhonda Small^{1

4}, Helena Lindgren¹

Affiliations

¹ Division of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
² Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
³ Faculty of Health and Social Sciences, Western Norway University of Applied Sciences Norway, Bergen, Norway.
⁴ La Trobe University, Judith Lumley Centre, Melbourne Victoria, Australia.

Abstract

Objectives: To evaluate the effectiveness of community-based bilingual doula (CBD) support for improving the intrapartum care experiences and postnatal wellbeing of migrant women giving birth in Sweden.

Design: Randomised controlled trial.

Setting: Six antenatal care clinics and five hospitals in Stockholm, Sweden.

Participants: 164 pregnant Somali-, Arabic-, Polish-, Russian- and Tigrinya-speaking women who could not communicate fluently in Swedish, were ≥18 years and had no contra-indications for vaginal birth.

Intervention: In addition to standard labour support, women were randomised to CBD support (n = 88) or no such support during labour (n = 76). Trained CBDs met with women prior to labour, provided support by telephone after labour had started, then provided emotional, physical and communication support to women throughout labour and birth in hospital, and then met again with women after the birth.

Primary outcomes: Women's overall ratings of the intrapartum care experiences (key question from the Migrant Friendly Maternity Care Questionnaire) and postnatal wellbeing (mean value of Edinburgh Postnatal Depression Scale) at 6-8 weeks after birth.

Results: In total, 150 women remained to follow-up; 82 women (93.2%) randomised to receive CBD support and 68 women (89.5%) randomised to standard care (SC). Of women allocated CBD support, 60 (73.2%) received support during labour. There were no differences between the groups regarding women's intrapartum care experiences (very happy with care: CBD 80.2% (n = 65) vs SC 79.1% (n = 53); OR 1.07 CI 95% 0.48-2.40) or emotional wellbeing (EPDS mean value: CBD 4.71 (SD 4.96) vs SC 3.38 (SD 3.58); mean difference 1.33; CI 95% - 0.10-2.75).

Conclusions: Community-based doula support during labour and birth for migrant women neither increased women's ratings of their care for labour and birth nor their emotional well-being 2 months postpartum compared with receiving standard care only. Further studies on the effectiveness of CBD powered to evaluate obstetric outcomes are needed.

Trial registration: Trial registration at ClinicalTrial.gov NCT03461640 https://www.google.com/search?client=firefox-b-d&q=NCT03461640.

Copyright: © 2022 Schytt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Doulas*
Female
Humans
Maternal Health Services*
Parturition
Pregnancy
Sweden
Transients and Migrants*

Associated data

ClinicalTrials.gov/NCT03461640

Grants and funding

Funding for the study was awarded by the Stockholm County Council (Stockholms Läns Landsting). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.