The benefits of doula support

Doulas make a difference. Did you know dozens of studies have been done on doulas? Having a doula actually has a significant statistical impact on things such as c-section rates, epidural use, and breastfeeding initiation.
 

What difference does it make?

All studies and resources are referenced at the bottom of the blog. Here is a summary.

• Doulas lower c-section rates. There are quite a few studies that have found this benefit. Check out the resources for specific stats with each study.
• Women who have a supportive partner and a professional doula have significantly lower c-section rates.
• Women who use doulas have lower preterm birth rates.
• Patients using a doula are less likely to need the use of forceps or vacuum delivery.
• Patients with a doula are less likely to need artificial augmentation.
• Women with doulas are more likely to achieve a vaginal delivery.
• Women with doulas are more likely to achieve birthing without an epidural.
• Multiple studies have shown laboring with a support person leads to shorter labor.
• They have less anxiety when supported by a doula.  
• Mothers are more likely to report satisfaction with their birth experience and feel they had a positive experience when they were cared for by a doula.
• They have increased self-esteem.
• They are less likely to suffer postpartum depression.
• They have higher rates of initiating breastfeeding.
• They are more likely to still be breastfeeding at 6 weeks.

 
Think about that. Having a doula increases your chances of having the natural, vaginal delivery many women want. It’s a worthy investment. It’s also an investment that can prevent you having to pay for surgery. Doulas improve outcomes. Doulas also improve the birth experience. Here are some other benefits of doula support.

• Women without a partner or whose partner is not involved can still have support.
• Women whose partner wants to be supportive but isn’t sure how can both be guided by a doula.
• A doula can aid in a couple bonding during birth.
• Couples with challenging family members can benefit from having a doula help with boundaries and nurturing the birth space.
• Doulas help you navigate unexpected situations.
• Doulas help you get as close as you can to your ideal birth.
• Those who have a fear of hospitals have a familiar person to stay with them throughout labor and delivery.
• Anyone with anxiety benefits from having a support person.
• Those with a history of substance abuse can be supported to give birth without medication.
• A doula is a consistent person who takes time to get to know you prenatally. There will be many workers you’ll see during your hospital stay. A doula is someone you’re familiar with and comfortable with who can help you navigate your maternity care.
• A doula helps a new mother get connected to resources and support in her community.
• Any woman who wants to be served by a doula can partner with a professional doula to receive support.
• A woman with a doula is more likely to be educated.
• A woman with a doula knows her options.
• A woman with a doula is empowered.
• A woman with a doula is a woman who is supported.
• A woman with a doula is a woman who is not alone. A doula walks the journey with you.

Professional organizations for obstetricians and nurses are also in support of doulas. 
 
“Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits described in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and fewer reports of dissatisfaction with the experience of labor.”
Approaches to limit intervention during labor and birth. ACOG Committee Opinion No. 766. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133:e164–73.
 
“Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery. Given that there are no associated measurable harms, this resource is probably underutilized.”
Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:693–711.
 
“AWHONN recognizes that childbirth education and doula services contribute to the woman’s preparation for and support during childbirth and supports consideration of these services as a covered benefit in public and private health insurance plans.”
Association of Women's Health, Obstetric and Neonatal Nurses
AWHONN position statement: Nursing support for laboring women.
Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2010; 40: 665-666 https://doi.org/10.1111/j.1552-6909.2011.01288.x

Did you have a doula? What benefits did you experience from professional support? Share your story in the comments below.
 
Are you considering hiring a doula? Did you know about all these benefits? How can doula support benefit you in your birth?

Citations

https://pubmed.ncbi.nlm.nih.gov/10643833/
Scott, K. D., Klaus, P. H., & Klaus, M. H. (1999). The obstetrical and postpartum benefits of continuous support during childbirth. Journal of women's health & gender-based medicine, 8(10), 1257–1264. https://doi.org/10.1089/jwh.1.1999.8.1257

McGrath, S. K., & Kennell, J. H. (2008). A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates. Birth (Berkeley, Calif.), 35(2), 92–97. https://doi.org/10.1111/j.1523-536X.2008.00221.x
 
Mottl-Santiago, J., Walker, C., Ewan, J., Vragovic, O., Winder, S., & Stubblefield, P. (2008). A hospital-based doula program and childbirth outcomes in an urban, multicultural setting. Maternal and child health journal, 12(3), 372–377. https://doi.org/10.1007/s10995-007-0245-9

https://pubmed.ncbi.nlm.nih.gov/23857334/
Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. (2013). Continuous support for women during childbirth. The Cochrane database of systematic reviews, 7, CD003766. https://doi.org/10.1002/14651858.CD003766.pub5
 
https://pubmed.ncbi.nlm.nih.gov/23409910/
Kozhimannil, K. B., Hardeman, R. R., Attanasio, L. B., Blauer-Peterson, C., & O'Brien, M. (2013). Doula care, birth outcomes, and costs among Medicaid beneficiaries. American journal of public health, 103(4), e113–e121. https://doi.org/10.2105/AJPH.2012.301201
 
https://pubmed.ncbi.nlm.nih.gov/26762249/
Kozhimannil, K. B., Hardeman, R. R., Alarid-Escudero, F., Vogelsang, C. A., Blauer-Peterson, C., & Howell, E. A. (2016). Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery. Birth (Berkeley, Calif.), 43(1), 20–27. https://doi.org/10.1111/birt.12218

https://pubmed.ncbi.nlm.nih.gov/28681500/
Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. The Cochrane database of systematic reviews, 7(7), CD003766. https://doi.org/10.1002/14651858.CD003766.pub6
 

Evidence Based Birth has a good article on the benefits of doula support.
https://evidencebasedbirth.com/the-evidence-for-doulas/