Enhancing Childbirth Education: Integrating Obstetricians to Reduce Intrapartum Interventions

Integration of obstetricians into the Childbirth Educator and Doula Training (CEDT) program was associated with fewer routine intrapartum interventions and lower primary cesarean rates.

The hospital-based evaluation used an observational, comparative survey design, comparing obstetricians who completed CEDT with those who had not. Outcomes included use of routine intrapartum interventions, primary cesarean in nulliparas, and labor-management practices.

CEDT-trained clinicians reported lower use of routine enemas, fewer frequent digital vaginal examinations, and less continuous cardiotocography during labor — a pattern linked to the CEDT program. Reduced use of these procedures can decrease disruption of physiologic labor and lower the risk of cascade effects that precipitate operative delivery.

Trained obstetricians also increased use of nonpharmacologic pain-relief strategies and supported instinctive pushing and upright positions; the study observed an associated reduction in primary cesarean rates among nulliparous patients. Together, the shifts in bedside practice and decision thresholds align with physiologic-birth principles and produced downstream differences in operative-delivery metrics in this sample.