Peer-reviewed article
Multicultural doula support and obstetric and neonatal outcomes: a multi-centre comparative study in Norway.
Oommen H, Sagedal LR, Infanti JJ, Byrskog U, Severinsen MS et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated a multicultural doula support program in Norway that helps newly arrived migrant women during pregnancy and childbirth. Women who received doula support had better outcomes including fewer emergency caesarean sections, less severe bleeding during vaginal birth, and higher rates of exclusive breastfeeding compared to similar women without this support. The findings suggest the program improves both maternal and newborn health for vulnerable migrant populations.
Key points
- Women receiving multicultural doula support had a 41% lower likelihood of emergency caesarean sections
- Vaginal birth with doula support was associated with 75% lower risk of severe blood loss (≥1000 ml)
- Doula support was associated with more use of pain relief in labour (nearly 3 times higher)
- Exclusive breastfeeding at discharge was more than twice as common in the supported group
- Study involved 339 women with doula support compared to 339 without across nine hospitals in Norway
Limitations
The study is observational and cannot prove causation, only association. It is unclear whether differences in outcomes reflect the doula support itself, selection differences between groups, or other unmeasured factors affecting the two groups of migrant women.
Abstract
Background Migrant women face an increased risk of poor obstetric and neonatal outcomes. Norway implemented a multicultural doula (MCD) program in 2018, which was designed to improve pregnancy care for this group in vulnerable circumstances. This study aimed to assess the impact of MCD support, provided in addition to standard care, on obstetric and neonatal outcomes for selected newly arrived migrants. Methods This was a multi-centre case-control study involving all nine hospitals actively running the MCD program, which covers four of Norway's five regions. Women who received MCD support at the time of childbirth (n = 339), from 2018-2023, were compared to similar newly arrived immigrant women who did not receive MCD support (n = 339) and gave birth within the same timeframe. Hospital records were reviewed, and outcomes were analysed using binary logistic regression. The results are expressed as crude and adjusted associations with 95% confidence intervals (CIs). Results Women receiving MCD support exhibited a 41% lower likelihood of undergoing emergency caesarean sections (adjusted odds ratio [aOR] 0.59, 95% Cl 0.34-0.98) and those giving birth vaginally had a 75% lower risk of estimated blood loss ≥1000 ml (aOR 0.25, 95% Cl 0.12-0.52) compared with women without MCD support. Additionally, MCD support was associated with more use of pain-relief (aOR 2.88, 95% Cl 1.93-4.30) in labour and increased rates of exclusive breastfeeding at discharge (aOR 2.26, 95% Cl 1.53-3.36). Conclusions Our study suggests that MCD support may contribute to improved outcomes for migrants in vulnerable circumstances, potentially impacting their future reproductive health and children's well-being.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Multicultural doula support provided alongside standard antenatal and childbirth care
- Population
- Newly arrived migrant women (n=339 with support, n=339 without) giving birth in Norwegian hospitals 2018-2023
Key finding
41% lower likelihood of emergency caesarean section (aOR 0.59, 95% CI 0.34-0.98)
H et al. · Europe PMC · 24 Dec 2024