Dickinson 2002.

Methods	RCT, stratified by induced or spontaneous labour at trial entry
Participants	992 nulliparous women at term (499 to continuous support and 493 to control), cephalic fetal presentation, cervical dilatation < 5 cm, in a hospital in Perth, Western Australia
Interventions	Group 1: continuous physical and emotional support by midwifery staff, and women were encouraged to use pharmacologic and nonpharmacologic alternatives to epidural analgesia. Group 2: continuous midwifery support was not provided and women were encouraged to have epidural analgesia as their primary method of pain relief in labour
Outcomes	Labour length (expressed as median and interquartile range), epidural analgesia, mode of delivery, 5 min Apgar score < 7, arterial cord pH
Notes	The stated purpose was to compare the effects of intrapartum analgesic techniques on labour outcomes. Continuous midwifery support was conceptualised as an analgesic technique. Both groups had access to opioids and nitrous oxide. No data were presented about the number of women who used no pharmacologic analgesia. Because the type of analgesia used was a measure of compliance rather than an outcome, no data on analgesic outcomes are included in this review. It was not stated if other support person was allowed. epidural analgesia was available and EFM was used routinely Dates of study: May 1997 ‐ October 1999 Funding: The conduct of this research was supported by NH&MRC Grant 970076. Conflicts of interest: not reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No details about how the blocks of treatment allocations were produced
Allocation concealment (selection bias)	Unclear risk	Randomisation on presentation in the labour and delivery unit, "by selection from a blocked group of eight sealed opaque envelopes, replenished from blocks of 12". No further details about process
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding of participants and personnel is not possible
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear if the outcome assessor was blinded to group assignment
Incomplete outcome data (attrition bias) All outcomes	Low risk	There was 100% follow‐up for medical record data and in‐hospital survey. A 6‐month questionnaire was completed by 64.7% of the sample and these data were not used
Selective reporting (reporting bias)	Low risk	All main outcomes were reported. Effects on breastfeeding were not analysed by treatment group and thus the results could not be included in the review
Other bias	Low risk	No other sources of bias noted