Quality Improvement Project in the School of Nursing to Support Physiologic Birth Support

Abstract

An elective pilot course to teach doula skills and provide hands-on experience, titled “Supporting Physiologic Labor and Childbirth for Nurses,” was created within a school of nursing for prelicensure students. The purpose was to teach physical and emotional labor support techniques to promote low-intervention birth. The school partnered with the university hospital to provide doula services for women who were admitted while they were in labor and who wanted labor support. To enhance current maternal nursing curricula by offering an elective course modeled on evidence-based doula care and skills to support physiologic childbirth by using the Doulas of North America International model of care and curriculum. Twelve prelicensure students enrolled in an elective two-credit course that incorporated the Doulas of North America International curriculum, enhanced with additional seminars. They provided labor support for a minimum of four 8-hr shifts at the partner hospital. Data were collected before and after the course to measure differences in student knowledge of labor support techniques. Data were also collected from students, clients, and providers to describe techniques used and effectiveness of labor support as well as labor and birth outcomes. Eleven of the 12 students completed the course. The students reported an increase of more than 50% in competence in providing emotional and breastfeeding support, community resources, and supporting patients of diverse backgrounds. Students also reported a 47% increase in competence in providing physical labor support and a 32% increase in knowledge about postpartum mood disorders. Clients, providers, and students reported high effectiveness of physical and emotional support, incorporation of partner–family, and overall usefulness. Nursing students interested in maternity care benefited from learning comprehensive labor support techniques, and their services were valued by women giving birth and providers. This innovative pilot course offers a replicable and scalable approach for other schools to enhance their curricula.