What is meant by one-to-one support in labour: Analysing the concept

Background: the term one-to-one support in labour is used in a range of research reports and policy documents internationally without a clear consensus on definition. Aim: the aim of this paper is to examine the variety of meanings and to clarify the concept of one-to-one support in labour. Method: Walker and Avant provide a useful guide for the analysis of concepts and this has been used as a starting point from which to build our discussion. We systematically examined the literature to answer the 'who, what, when, where, and how' for providing one-to-one support in labour. Findings: our paper examines the evidence for one-to-one support in the light of the range of meanings that have been attributed to the concept. Multiple meanings for the concept have created confusion and there is a need for greater clarity, which may be used in directing research, practice, and policy. Conclusions: in spite of strong evidence for the benefits of one-to-one support in labour, the utility of the evidence base is limited by the failure to specify what is meant by one-to-one support leading to a lack of comparability/applicability. There is a need for research that focuses more clearly on articulating what happens during labour between the woman and the range of people who support her, in services that are deemed to offer one-to-one support. (C) 2011 Elsevier Ltd. All rights reserved.