Evidence on the effect of doula support during pregnancy, birth and postpartum

By Sumati

Doulas provide continuous physical, emotional, and information support to people before, during, and shortly after childbirth. Current evidence suggests that pregnant people who receive doula care are more likely to have a healthy birth outcome and a positive birth experience.

The American College of Obstetricians and Gynecologists (ACOG) in 2014 stated: “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.”

And in 2017 after further large scale studies: “women benefit from continuous emotional support and the use of non-pharmacologic methods to manage pain. Support offered by trained labor coaches such as doulas has been associated with improved birth outcomes, including shortened labor and fewer operative deliveries.”

Robust evidence from global studies also demonstrates benefits of doula care in health indicators for mothers and infants. For mothers, doula care is associated with increased maternal engagement in and higher satisfaction with care. Babies are less likely to have low five-minute Apgar scores. Given the data—including a finding that doula care is one of the most effective evidence-based practices for labor and delivery more and more health care systems and birthing families are chosing to have a doula attend their births.

support person (doula) present during labor is associated with decreased use of analgesia, decreased incidence of operative birth, increased incidence of spontaneous vaginal delivery, and increased maternal satisfaction in 15 trials, including 12,791 women.

41 The most effective form of support starts early in labor, is continuous, and is not provided by a member of the hospital staff. The mother should be encouraged to select her doula during pregnancy; they establish a relationship (which is likely to involve the woman’s partner, if any) and discuss the mother’s and partner’s preferences and concerns before labor. The doula brings her experience and training (often to the level of certification) to the labor support role during childbirth, and the mother and doula frequently have telephone and/or face-to-face contact in the early postpartum period.

American Journal of Obstetrics and Gynaecology – 2008

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