Susan McGrath

Infant Recognition Memory and Later Intelligence.

Abstract The present study asked if tests of visual recognition memory during infancy based on differential fixation to novel and previously seen targets are valid predictors of later intelligence for children scoring in the normal to superior range of intelligence. Statistically significant and moderate correlations of .37 and .57 were obtained between infant recognition memory scores obtained at four to seven months and later vocabulary tests of intelligence, for 54 children tested at four and for 39 children seen at seven years, respectively. The coefficients did not vary by sex, and were independent of differences in socio-economic status.

A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates.

BACKGROUND Previous randomized controlled studies in several different settings demonstrated the positive effects of continuous labor support by an experienced woman (doula) for low-income women laboring without the support of family members. The objective of this randomized controlled trial was to examine the perinatal effects of doula support for nulliparous middle-income women accompanied by a male partner during labor and delivery. METHODS Nulliparous women in the third trimester of an uncomplicated pregnancy were enrolled at childbirth education classes in Cleveland, Ohio, from 1988 through 1992. Of the 686 prenatal women recruited, 420 met enrollment criteria and completed the intervention. For the 224 women randomly assigned to the experimental group, a doula arrived shortly after hospital admission and remained throughout labor and delivery. Doula support included close physical proximity, touch, and eye contact with the laboring woman, and teaching, reassurance, and encouragement of the woman and her male partner. RESULTS The doula group had a significantly lower cesarean delivery rate than the control group (13.4% vs 25.0%, p = 0.002), and fewer women in the doula group received epidural analgesia (64.7% vs 76.0%, p = 0.008). Among women with induced labor, those supported by a doula had a lower rate of cesarean delivery than those in the control group (12.5% vs 58.8%, p = 0.007). On questionnaires the day after delivery, 100 percent of couples with doula support rated their experience with the doula positively. CONCLUSIONS For middle-class women laboring with the support of their male partner, the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia. Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula.

Induction of Labor and Doula Support • 68

Nulliparous women between the ages of 18 and 41 in the third trimester of an uncomplicated pregnancy, who expected to be accompanied during labor by their male partner, were asked to participate in a study of doula support. 555 low-, middle-, and high-income couples were randomly assigned to have continuous emotional support by a doula during labor (doula group) or to receive routine obstetric care (control group). Results of this study demonstrated that providing doula support even when the male partner is also present with the laboring woman has a positive impact on obstetric outcomes.

Doula Support: A Risk Free Alternative for Pain Relief During Childbirth. • 79

In a randomized controlled trial (RCT) of childbirth pain relief methods, 45 women who received epidural analgesia and 39 women received continuous labor support by a woman companion (doula) were asked to evaluate their pain levels at three different times. Healthy primigravidas used a 100 mm visual analog scale to rate their labor pain from no pain to maximum pain at the following times: 1) before receiving pain relief intervention (epidural analgesia or doula support), 2) after pain relief intervention and 3) 24 hours after vaginal delivery. A similar scale was used to indicate how well they were able to cope with their pain.