Group Prenatal Care and Doula Care for Pregnant Women

  • Susan C. Vonderheid
  • Rieko Kishi
  • Kathleen F. Norr
  • Carrie Klima


There is widespread recognition of the need for innovation to improve the quality of care for ­childbearing women and to reduce the long-standing racial/ethnic disparities in pregnancy outcomes (Carroli, Rooney, & Villar, 2001; Hughes & Runyan, 1995; Institute of Medicine, 2003; Lu & Halfon, 2003; Misra, Grason & Weisman, 2000). This integrated review will examine two promising innovations for childbearing women, group prenatal care and doula care.


Preterm Birth Prenatal Care Cesarean Section Rate Individual Care Birth Experience 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abramson, R. (2004). The critical moment and the passage of time: Reflections on community-based doula support. International Journal of Childbirth Education, 19(4), 34–35.Google Scholar
  2. Abramson, R., Breedlove, G., & Isaacs, B. (2006). The community-based doula: Supporting families before, during, and after childbirth. Washington, DC: Zero to Three.Google Scholar
  3. Alexander, G. R., Kogan, M. D., & Nabukera, S. (2002). Racial differences in prenatal care use in the United States: Are disparities decreasing? American Journal of Pubic Health, 92(12), 1970–1975.CrossRefGoogle Scholar
  4. Breart, G., Mlika-Cabane, N., Kaminski, M., Alexander, S., Herruzo-Nalda, A., Mandruzzato, P., et al. (1992). Evaluation of different policies for the management of labour. Early Human Development, 29, 309–312.CrossRefPubMedGoogle Scholar
  5. Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus R. (2007) Impact of the nurse shortage on hospital patient care: Comparative perspectives. Health Affairs . 26(3):853–862.CrossRefPubMedGoogle Scholar
  6. Campbell, D. A., Lake, M. F., Falk, M., & Backstrand, J. R. (2006). A randomized control trial of continuous support in labor by a lay doula. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(4), 456–464.CrossRefGoogle Scholar
  7. Carroli, G., Rooney, C., & Villar, J. (2001). How effective is antenatal care in preventing maternal morbidity? An overview of the evidence. Paediatric and Perinatal Epidemiology, 15(Suppl. 1), 1–42.PubMedGoogle Scholar
  8. Cesario, S. K. (2004). Reevaluation of Friedman’s Labor Curve: A pilot study. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(6), 713–722.CrossRefGoogle Scholar
  9. Chicago Health Connection. (2003). History. Retrieved December 16, 2006, from
  10. Chicago Health Connection. (2004). Annual report. Retrieved December 16, 2006, from
  11. Cogan, R., & Spinnato, J. A. (1988). Social support during premature labor: Effects on labor and the newborn. Journal of Psychosomatic Obstetrics & Gynecology, 8, 209–216.CrossRefGoogle Scholar
  12. Cox, R., Obichere, T., Knoll, F., & Baruwa, E. M. (2006). A study to compare the productivity and cost of the Centering Pregnancy model of prenatal care with a traditional prenatal care model. Final Report to March of Dimes.Google Scholar
  13. DeClercq, E., Sakala, C., Corry, M. P., Applebaum, S., & Risher, P. (2006). Listening to mothers: Report of the second national survey of women’s childbearing experiences. New York: Childbirth Connection. Maternity Center Association/Harris Interactive.Google Scholar
  14. Dickinson, J. E., Paech, M. J., McDonald, S. J., & Evans, S. F. (2002). The impact of intrapartum analgesia on labour and delivery outcomes in nulliparous women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 42(1), 59–66.CrossRefPubMedGoogle Scholar
  15. DONA International. (2005). DONA international certification. Retrieved March 2, 2006, from
  16. Dundek, L. H. (2006). Establishment of a Somali doula program at a large metropolitan hospital. Journal of Perinatal & Neonatal Nursing, 20, 128–137.Google Scholar
  17. Ford, K., Beglicki, L., Kershaw, T., Schram, C., Hoyer, P. J., & Jacobson, M. L. (2002). Effects of a prenatal care intervention for adolescent mothers on birth weight, repeat pregnancy, and educational outcomes at one year postpartum. Journal of Perinatal Education, 11(1), 35–38.PubMedGoogle Scholar
  18. Fullar, S. A., Lum, B., Sprik, M. G., & Cooper, E. M. (1988). A small group can go a long way. MCN: The American Journal of Maternal Child Nursing, 13(6), 414–418.Google Scholar
  19. Gabbe, S., Niebyl, J., & Simpson, J. L. (2007). Obstetrics. Philadelphia, PA: Churchill Livingstone.Google Scholar
  20. Gagnon, A. J., & Waghorn, K. (1999). One-to-one nurse labor support of nulliparous women stimulated with oxytocin. JOGNN – Journal of Obstetric, Gynecologic, & Neonatal Nursing, 28, 371–376.CrossRefGoogle Scholar
  21. Gagnon, A. J., Waghorn, K., & Covell, C. (1997). A randomized trial of one-to-one nurse support of women in labor. Birth, 24, 71–80.PubMedGoogle Scholar
  22. Gale, J., Fothergill-Bourbonnais, F., & Chamberlain, M. (2001). Measuring nursing support during childbirth. American Journal of Maternal Child Nursing, 26(5), 264–271.CrossRefPubMedGoogle Scholar
  23. Gilliland, A. L. (2002). Beyond holding hands: The modern role of the professional doula. JOGNN – Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31, 762–769.Google Scholar
  24. Gordon, N. P., Walton, D., McAdam, E., Derman, J., Gallitero, G., & Garrett, L. (1999). Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstetrics & Gynecology, 93(3), 422–426.CrossRefGoogle Scholar
  25. Grady, M. A., & Bloom, K. C. (2004). Pregnancy outcomes of adolescents enrolled in a Centering Pregnancy program. Journal of Midwifery & Women’s Health, 49(5), 412–420.CrossRefGoogle Scholar
  26. Greenberg, M. B., Cheng, Y. W., Hopkins, L. M., Stotland, N. E., Bryant, A. S., & Caughey, A. B. (2006). Are there ethnic differences in the length of labor? American Journal of Obstetrics & Gynecology, 195(3), 743–748.CrossRefGoogle Scholar
  27. Greenberg, M. B., Cheng, Y. W., Sullivan, M., Norton, M. E., Hopkins, L. M., & Caughey, A. B. (2007). Does length of labor vary by maternal age? American Journal of Obstetrics & Gynecology, 197(4), 428.e1–7.CrossRefGoogle Scholar
  28. Healy, A. J., Malone, F. D., Sullivan, L. M., Porter, T. F., Luthy, D. A., Comstock, C. H., et al. (2006). Early access to prenatal care: Implications for racial disparity in perinatal mortality. Obstetrics and Gynecology, 107(3), 625–631.CrossRefPubMedGoogle Scholar
  29. Hemminki, E., Virta, A. L., Koponen, P., Malin, M., Kojo-Austin, H., & Tuimala, R. (1990). A trial on continuous human support on childbirth outcomes. Journal of Psychosomatic Obstetrics & Gynecology, 11, 239–250.CrossRefGoogle Scholar
  30. Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. (2007). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 2003(3), CD003766. DOI: 10.1002/14651858.CD003766.pub2. Retrieved November 11, 2007 from the Cochrane Library.Google Scholar
  31. Hodnett, E. D., Lowe, N. K., Hannah, M. E., Willan, A. R., Stevens, B., Weston, J. A., et al., (2002). Effectiveness of nurses as providers of birth labor support in North American hospitals: A randomized controlled trial. JAMA, 288(11), 1373–1381.CrossRefPubMedGoogle Scholar
  32. Hodnett, E. D., & Osborn, R. W. (1989). Effects of continuous intrapartum professional support on childbirth outcomes. Research in Nursing & Health, 12, 289–297.CrossRefGoogle Scholar
  33. Hofmeyr, G. J., Nikodem, V. C., Wolman, W. L., Chalmers, B. E., & Kramer, T. (1991). Companionship to modify the clinical birth environment: Effects on progress and perceptions of labour, and breastfeeding. British Journal of Obstetrics & Gynaecology, 98, 756–764.Google Scholar
  34. Hoyer, P. J., Jacobson, M., Ford, K., & Walsh, E. (1994). Pregnancy care for the adolescent. The Nurse Practitioner, 19(4), 27–28, 31–32.CrossRefPubMedGoogle Scholar
  35. Hughes, D. C., & Runyan, S. J. (1995). Prenatal care and public policy: Lessons for promoting women’s health. Journal of the American Medical Women’s Association, 50(5), 156–159, 163.PubMedGoogle Scholar
  36. Ickovics, J. R., Kershaw, T. S., Westdahl, C., Magriples, U., Massey, Z., Reynolds, H., et al. (2007). Group prenatal care and perinatal outcomes – A randomized controlled trial. Obstetrics and Gynecology, 110(2), 330–339.PubMedGoogle Scholar
  37. Ickovics, J. R., Kershaw, T. S., Westdahl, C., Rising, S.S., Klima, C., Reynolds, H., et al. (2003). Group prenatal care and preterm birth weight: Results from a matched cohort study at public clinics. Obstetrics and Gynecology, 102(5), 1051–1057.CrossRefPubMedGoogle Scholar
  38. Institute of Medicine. (2003). Priority areas for national action: Transforming health care quality. (K. Adams & J. M. Corrigan, Eds.). Washington, DC: National Academy Press.Google Scholar
  39. Jones, M., & Larson, E. (2003). Length of normal labor in women of Hispanic origin. Journal of Midwifery & Women’s Health. 48(1), 2–9.CrossRefGoogle Scholar
  40. Kennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C. (1991). Continuous emotional support during labor in a US hospital. A randomized controlled trial. JAMA, 265, 2197–2201.CrossRefPubMedGoogle Scholar
  41. Kennell, J. H., & McGrath, S. K. (1993). Labor support by a doula for middle income couples: The effect on cesarean rates. Pediatric Research, 32, 12A.Google Scholar
  42. Klaus, M. H., & Kennell, J. H. (1997). The doula: An essential ingredient of childbirth rediscovered. Acta Paediatrica, 86, 1034–1036.CrossRefPubMedGoogle Scholar
  43. Klaus, M. H., Kennell, J. H., & Klaus, P. H. (1993). Mothering the mother: How a doula can help you have a shorter, easier, and healthier birth. New York, NY: Harper Collins Publisher.Google Scholar
  44. Klaus, M. H., Kennell, J. H., Robertson, S. S., & Sosa, R. (1986). Effects of social support during parturition on maternal and infant morbidity. British Medical Journal Clinical Research Ed., 293, 585–587.CrossRefPubMedGoogle Scholar
  45. Klima, C., Vonderheid, S. C., & Norr, K. F. (2006). Current Research on the Centering Model: Centering Pregnancy in Chicago. Paper presentation at Group Health Care for the 21st century annual multidisciplinary conference, Chapel Hill, NC.Google Scholar
  46. Kochanek, K. D., Murphy, S. L., Anderson, R. N., & Scott, C. (2004). Deaths: Final data for 2002. National Vital Statistics Report, 53(5), 1–115.Google Scholar
  47. Langer, A., Campero, L., Garcia, C., & Reynoso, S. (1998). Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers’ wellbeing in a Mexican public hospital: A ­randomized clinical trial. British Journal of Obstetrics & Gynaecology, 105, 1056–1063.Google Scholar
  48. Leavitt, J. W. (1986). Brought to bed: childrearing in America 1750–1950. New York: Oxford University Press.Google Scholar
  49. Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.CrossRefPubMedGoogle Scholar
  50. MacDorman, M. F., Martin, J. A., Mathews, T. J., Hoyert, D. L., & Ventura, S. J. (2005). Explaining the 2001–02 infant mortality increase: Data from the linked birth/infant death data set. National Vital Statistics Report, 53(12), 1–22.Google Scholar
  51. Madi, B. C., Sandall, J., Bennett, R., & MacLeod, C. (1999). Effects of female relative support in labour: A randomized controlled trial. Birth, 26(1), 4–8.CrossRefPubMedGoogle Scholar
  52. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., & Kirmeyer, S. (2006). Births: Final data for 2004. National Vital Statistics Report, 55(1), 1–101.Google Scholar
  53. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., et al. (2007). Births: Final Data for 2005. National Vital Statistics Report, 56(6), 1–104.Google Scholar
  54. McGrath, S. K., & Kennell, J. H. (2008). A randomized controlled trial of continuous labor support for middle-class couples: Effect on cesarean delivery rates. Birth, 35(2), 92–97.CrossRefPubMedGoogle Scholar
  55. Menacker, F. (2005). Trends in cesarean rates for first births and repeat cesarean rates for low-risk women, United States 1990–2003. National Vital Statistics Report, 54(4), 1–8.Google Scholar
  56. Meyer, B. A., Arnold, J. A., & Pascali-Bonaro, D. (2001). Social support by doulas during labor and the early postpartum period. Hospital Physician, 37(9), 57–65.Google Scholar
  57. Misra, D. P., Grason, H., & Weisman, C. (2000). An intersection of women’s and perinatal health: The role of chronic conditions. Women’s Health Issues, 10(5), 256–267.CrossRefPubMedGoogle Scholar
  58. Newton, P. C. (2004). The doula’s role during L&D. RN, 67(3), 34–38.PubMedGoogle Scholar
  59. Novick, G. (2004). Centering pregnancy and the current state of prenatal care. Journal of Midwifery & Women’s Health, 49, 405–411.CrossRefGoogle Scholar
  60. Public Health Service. (1989). Expert panel on the content of prenatal care. caring for our future, the content of prenatal care: A report of the Public health service expert panel on the content of prenatal care. Washington, DC: Public Health Service. Department of Health and Human Services.Google Scholar
  61. Raphael, D. (1973). Tender gift: Breastfeeding. Englewood, NJ: Prentice-Hall.Google Scholar
  62. Rising, S. S. (1998). CenteringPregnancy. An interdisciplinary model of empowerment. Journal of Nurse-Midwifery, 43(1), 46–54.CrossRefPubMedGoogle Scholar
  63. Rising, S., Kennedy, H., & Klima, C. (2004). Redesigning prenatal care through CenteringPregnancy. Journal of Midwifery and Women’s Health, 49, 398–404.CrossRefPubMedGoogle Scholar
  64. Rosen, P. (2004). Supporting women in labor: Analysis of different types of caregivers. Journal of Midwifery & Women’s Health, 49, 24–31.CrossRefGoogle Scholar
  65. Scott, K. D., Berkowitz, G., & Klaus, M. (1999). A comparison of intermittent and continuous support during labor: A meta-analysis. American Journal of Obstetrics & Gynecology, 180, 1054–1059.CrossRefGoogle Scholar
  66. Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston, MA: Houghton Mifflin.Google Scholar
  67. Shelp, A. (2004). Women helping women: The Somali Doula Initiative. International Journal of Childbirth Education, 19, 4–7.Google Scholar
  68. Sosa, R., Kennell, J., Klaus, M., Robertson, S., & Urrutia, J. (1980). The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. New England Journal of Medicine, 303, 597–600.CrossRefPubMedGoogle Scholar
  69. Stein, M. T., Kennell, J. H., & Fulcher, A. (2003). Benefits of a doula present at the birth of a child. Journal of Developmental & Behavioral Pediatrics, 24, 195–198.CrossRefGoogle Scholar
  70. Trueba, G., Contreras, C., Velazco, M. T., Garcia, L. E., & Martinez, H. B. (2000). Alternative strategy to decrease cesarean section: Support by doulas during labor. Journal of Perinatal Education, 9, 8–13.CrossRefPubMedGoogle Scholar
  71. Zhang, J., Bernasko, J. W., Leybovich, E., Fahs, M., & Hatch, M. C. (1996). Continuous labor support from labor attendant for primiparous women: A meta-analysis. Obstetrics & Gynecology, 88, 739–744.CrossRefGoogle Scholar

Copyright information

© Springer US 2011

Authors and Affiliations

  • Susan C. Vonderheid
    • 1
  • Rieko Kishi
  • Kathleen F. Norr
  • Carrie Klima
  1. 1.Department of Women, Children and Family Health Science846 UIC College of NursingChicagoUSA

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