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In Reply: Drs Kennell and Klaus used our definition of compliance to infer that all women in the experimental group received intermittent support. On the contrary, the nurses aimed to provide 100% continuous labor support. We selected 80% minimum time as our standard for compliance, in recognition of the nurses' needs for meals and personal hygiene breaks at times when another nurse trained in labor support might be unavailable, and in anticipation of rare instances of emergencies with other patients. Because nearly all women had husbands and/or other family members with them, we doubt that any women were ever left completely alone.

We did assess compliance and contamination. Compliance was very high; the appropriate form of care was provided to more than 95% of the patients. We cited evidence that contamination of the control group did not occur. Participants' reports of the supportive care activities they received indicated that each . . . [Full Text of this Article]

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RELATED ARTICLE

Continuous Nursing Support During Labor
John H. Kennell and Marshall H. Klaus
JAMA. 2003;289(2):175-176.
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