Community Based Doulas for Migrant Women in Labour and Birth in Sweden - a Randomised Controlled Trial

Summary

One initiative to address communication problems between migrant women not fluent in Swedish and caregivers throughout childbirth is to provide language assistance, cultural interpretation and labour support to the woman through Community Based Doulas (CBDs). CBDs are bilingual women from migrant communities trained by midwives to provide cultural, language and labour support to migrant women throughout their labour and birth.

The study will evaluate the effectiveness of community-based doula support for improving the intrapartum care experiences and postnatal wellbeing of Somali-, Tigrinya -, Arabic- and Russian-speaking migrant women giving birth in Stockholm, Sweden.

The randomisation ratio will be 1:1; CBD support in addition to standard intrapartum care or standard intrapartum care. Women allocated to receive CBD support in addition to standard intrapartum care (intervention group), will be contacted by a Somali, Arabic-, Russian- or Tigrinya-speaking CBD as appropriate, and arrangements will be made for the doula and the women to meet twice prior to the birth to get to know each other and discuss the woman's wishes regarding support in labour and what the CBD can offer. Each woman will then contact her CBD when she goes into labour and the CBD will attend hospital with her and stay with her throughout labour and birth, in addition to any other support people she may have, such as her partner. Women allocated to the comparison arm of the trial will receive standard intrapartum care as provided at their chosen hospital of birth.

The hypothesis is that women randomised to receive CBD support in labour will rate their care for labour and birth more highly and have better emotional wellbeing (lower mean scores on the Edinburgh Postnatal Depression Scale) two months after birth than women allocated to standard care.

Conditions

• Labor Pain
• Satisfaction, Consumer
• Language
• Birth Depression
• Childbirth Problems

Interventions

OTHER

Community-based doula support for labour

CBDs will be recruited, trained and employed by non-profit organization MIRA. Women allocated to receive CBD support will be contacted by an either a Somali, Arabic-, Russian- or Tigrinya-speaking CBD as appropriate, and arrangements made for them to meet twice prior to the birth to get to know each other and discuss the woman's wishes regarding support in labour and what the CBD can offer. Each woman will then contact her CBD when she goes into labour and the CBD will attend hospital with her and stay with her throughout her labour and birth, in addition to any other support people she may have, such as her partner.

BEHAVIORAL

Standard labour support

Standard labour support by health care providers only. Women allocated to the comparison arm of the trial will receive standard intrapartum care as provided at their chosen hospital of birth. That is emotional, information and instrumental support from a helping nurse or a midwife or in some cases a doctor. The support includes caring actions, such as comforting, massage, information and presence. Note: Women partner and/or other support people to accompany throughout her childbirth will be allowed, regardless of their trial allocation.

Sponsors & Collaborators

• Region Stockholm

  collaborator OTHER_GOV

• Karolinska Institutet

  lead OTHER

Principal Investigators

• Erica Schytt, Professor · Karolinska Institutet

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2018-03-10

Primary Completion

2020-05-05

Completion

2020-05-05

Countries

• Sweden

Study Locations