how beneficial is doula support?
Penny cited the following
10 peer-reviewed research articles
2 professionally-backed sources
Doula Support: What the Evidence Shows
Doula support during pregnancy, labor, and birth is associated with a range of benefits for both birthing people and their babies. Research consistently finds that having a doula can improve birth experiences and outcomes, with particular advantages for those at higher risk for complications or who may lack other support.
Key Benefits of Doula Support
Evidence points to several measurable improvements with doula involvement
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Lower Cesarean Rates and Fewer Interventions: Studies show that people with doula support are less likely to have a cesarean birth and are less likely to need other interventions, such as epidurals or assisted vaginal deliveries.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→
PubMed Central
2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→aspe.hhs.gov
3ArticlePotential benefits of increased access to doula support during childbirth - PMCThe annual costs of U.S. maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between ...→4ArticleImpact of Doula Support During Pregnancy, Childbirth and Beyond (A Systematic Review) | PCORISupport from a doula during labor and childbirth has been associated with increased maternal engagement, higher patient satisfaction with care, lower rates of cesarean birth, fewer obstetric interventions, fewer complications during labor, less pain medication use, shorter labor hours, lower prevalence of poor five-minute Apgar scores and lower birth costs.6,10-12 However, maternal outcomes associated with doula support during the postpartum period have not been well studied, and the impact of the specific timing and length of doula support has also not been well established.→Patient-Centered Outcomes Research Institute
5ArticleDoula Care: A Review of Outcomes and Impact on Birth Experience - PubMedDoula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction.→PubMed
6ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - eClinicalMedicineThe objectives of this study were to: 1) evaluate the integration of doulas with different types of clinical providers during labor and delivery to understand how different combinations of provision of care relate to maternal health outcomes; 2) assess when, over the care continuum (from the first trimester through childbirth), doulas provide the greatest benefit to maternal health; and 3) evaluate whether women gain differential benefits from doulas depending upon certain risk factors, including race/ethnicity and certain chronic conditions. We conducted a retrospective cohort study using claims data from the HealthCore Integrated Research Database (HIRD).→The Lancet
7ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - PMCThrough stratification of analyses by race, we were able to determine that Black expectant mothers who received doula care enjoyed the same health benefits as White women who received doula care. Both groups of women showed lower odds of cesarean delivery and diagnoses of PPA/PPD relative to their non-doula counterparts. Our analyses by high-risk conditions indicate women who received doula care showed a 58% reduction in odds of cesarean delivery relative to women with pregnancy complications without doula care.→8ArticleImpact of Doulas on Healthy Birth Outcomes - PMCThe doula focuses on individualized ... tasks besides direct labor support. Research indicates that the expectation of nurse support by expectant women may be far greater than what is actually provided (Tumblin & Simkin, 2001)....→9ArticleDoula Support Improves Maternal and Child Health Outcomes, Patient and Family Engagement — The National Institute for Children’s Health QualityThe main job is to be in the home to support families with getting sleep, healing in the postpartum, self-care, family integration, and baby care. Postpartum doulas also help with safe sleep options.→nichq.org
10ArticleUnited States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies - ScienceDirectWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.→sciencedirect.com
11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→ -
Shorter Labor and Fewer Complications: Doula support is linked to shorter labors and fewer complications during birth.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→4ArticleImpact of Doula Support During Pregnancy, Childbirth and Beyond (A Systematic Review) | PCORISupport from a doula during labor and childbirth has been associated with increased maternal engagement, higher patient satisfaction with care, lower rates of cesarean birth, fewer obstetric interventions, fewer complications during labor, less pain medication use, shorter labor hours, lower prevalence of poor five-minute Apgar scores and lower birth costs.6,10-12 However, maternal outcomes associated with doula support during the postpartum period have not been well studied, and the impact of the specific timing and length of doula support has also not been well established.→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→
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Better Infant Outcomes: Babies born with doula support are less likely to have low Apgar scores (a measure of newborn health) and are less likely to be born preterm or with low birth weight.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→4ArticleImpact of Doula Support During Pregnancy, Childbirth and Beyond (A Systematic Review) | PCORISupport from a doula during labor and childbirth has been associated with increased maternal engagement, higher patient satisfaction with care, lower rates of cesarean birth, fewer obstetric interventions, fewer complications during labor, less pain medication use, shorter labor hours, lower prevalence of poor five-minute Apgar scores and lower birth costs.6,10-12 However, maternal outcomes associated with doula support during the postpartum period have not been well studied, and the impact of the specific timing and length of doula support has also not been well established.→5ArticleDoula Care: A Review of Outcomes and Impact on Birth Experience - PubMedDoula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction.→6ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - eClinicalMedicineThe objectives of this study were to: 1) evaluate the integration of doulas with different types of clinical providers during labor and delivery to understand how different combinations of provision of care relate to maternal health outcomes; 2) assess when, over the care continuum (from the first trimester through childbirth), doulas provide the greatest benefit to maternal health; and 3) evaluate whether women gain differential benefits from doulas depending upon certain risk factors, including race/ethnicity and certain chronic conditions. We conducted a retrospective cohort study using claims data from the HealthCore Integrated Research Database (HIRD).→8ArticleImpact of Doulas on Healthy Birth Outcomes - PMCThe doula focuses on individualized ... tasks besides direct labor support. Research indicates that the expectation of nurse support by expectant women may be far greater than what is actually provided (Tumblin & Simkin, 2001)....→10ArticleUnited States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies - ScienceDirectWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→
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Higher Breastfeeding Rates: Doulas help improve breastfeeding initiation and continuation, especially among people who might otherwise face barriers.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→5ArticleDoula Care: A Review of Outcomes and Impact on Birth Experience - PubMedDoula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction.→8ArticleImpact of Doulas on Healthy Birth Outcomes - PMCThe doula focuses on individualized ... tasks besides direct labor support. Research indicates that the expectation of nurse support by expectant women may be far greater than what is actually provided (Tumblin & Simkin, 2001)....→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→
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Improved Emotional Well-being and Satisfaction: People who have doula support report less anxiety and stress, greater satisfaction with their birth experience, and a stronger sense of empowerment and self-worth.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→4ArticleImpact of Doula Support During Pregnancy, Childbirth and Beyond (A Systematic Review) | PCORISupport from a doula during labor and childbirth has been associated with increased maternal engagement, higher patient satisfaction with care, lower rates of cesarean birth, fewer obstetric interventions, fewer complications during labor, less pain medication use, shorter labor hours, lower prevalence of poor five-minute Apgar scores and lower birth costs.6,10-12 However, maternal outcomes associated with doula support during the postpartum period have not been well studied, and the impact of the specific timing and length of doula support has also not been well established.→5ArticleDoula Care: A Review of Outcomes and Impact on Birth Experience - PubMedDoula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction.→7ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - PMCThrough stratification of analyses by race, we were able to determine that Black expectant mothers who received doula care enjoyed the same health benefits as White women who received doula care. Both groups of women showed lower odds of cesarean delivery and diagnoses of PPA/PPD relative to their non-doula counterparts. Our analyses by high-risk conditions indicate women who received doula care showed a 58% reduction in odds of cesarean delivery relative to women with pregnancy complications without doula care.→8ArticleImpact of Doulas on Healthy Birth Outcomes - PMCThe doula focuses on individualized ... tasks besides direct labor support. Research indicates that the expectation of nurse support by expectant women may be far greater than what is actually provided (Tumblin & Simkin, 2001)....→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→
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Potential Cost Savings: By reducing the need for interventions and complications, doula support may also lower healthcare costs, especially when cesarean rates are reduced.
3ArticlePotential benefits of increased access to doula support during childbirth - PMCThe annual costs of U.S. maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between ...→9ArticleDoula Support Improves Maternal and Child Health Outcomes, Patient and Family Engagement — The National Institute for Children’s Health QualityThe main job is to be in the home to support families with getting sleep, healing in the postpartum, self-care, family integration, and baby care. Postpartum doulas also help with safe sleep options.→10ArticleUnited States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies - ScienceDirectWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.→
Who Benefits Most from Doula Support?
Support is valuable for everyone, but some groups see even greater impact
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People at Higher Risk: Those with higher risk for complications, including people of color, those with lower incomes, and those with less access to other support, may see the greatest improvements in outcomes with doula support.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→5ArticleDoula Care: A Review of Outcomes and Impact on Birth Experience - PubMedDoula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction.→6ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - eClinicalMedicineThe objectives of this study were to: 1) evaluate the integration of doulas with different types of clinical providers during labor and delivery to understand how different combinations of provision of care relate to maternal health outcomes; 2) assess when, over the care continuum (from the first trimester through childbirth), doulas provide the greatest benefit to maternal health; and 3) evaluate whether women gain differential benefits from doulas depending upon certain risk factors, including race/ethnicity and certain chronic conditions. We conducted a retrospective cohort study using claims data from the HealthCore Integrated Research Database (HIRD).→7ArticleDoula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching - PMCThrough stratification of analyses by race, we were able to determine that Black expectant mothers who received doula care enjoyed the same health benefits as White women who received doula care. Both groups of women showed lower odds of cesarean delivery and diagnoses of PPA/PPD relative to their non-doula counterparts. Our analyses by high-risk conditions indicate women who received doula care showed a 58% reduction in odds of cesarean delivery relative to women with pregnancy complications without doula care.→10ArticleUnited States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies - ScienceDirectWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.→
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First-Time Parents: Evidence suggests that first-time birthing people often benefit from the continuous guidance and reassurance a doula provides.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→
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Those Seeking a Specific Birth Experience: Doulas can help advocate for your preferences and provide information to help you make informed decisions throughout the process.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→
How Doulas Work with the Medical Team
Doulas complement, not replace, clinical care
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Doulas provide emotional, physical, and informational support, but do not perform medical tasks or make clinical decisions.
2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→
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They can help you communicate your preferences to your healthcare team and support you and your partner through the process.
2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→
Considerations and Access
There are some barriers and things to keep in mind
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Access and Cost: Not everyone has access to doula services, often due to cost or lack of awareness. Some states and insurance plans are beginning to cover doula care, especially for those on Medicaid, but coverage is not universal.
2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→3ArticlePotential benefits of increased access to doula support during childbirth - PMCThe annual costs of U.S. maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between ...→9ArticleDoula Support Improves Maternal and Child Health Outcomes, Patient and Family Engagement — The National Institute for Children’s Health QualityThe main job is to be in the home to support families with getting sleep, healing in the postpartum, self-care, family integration, and baby care. Postpartum doulas also help with safe sleep options.→10ArticleUnited States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies - ScienceDirectWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→
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Cultural Fit: Finding a doula whose approach and background align with your needs and values can enhance the benefits you receive.
1ArticleThe Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review - PMCThe support and benefits that doulas provide women during pregnancy and childbirth have been associated with a positive impact on women’s emotional well-being and overall satisfaction. Access to the services a doula can provide is sometimes limited to women due to extrinsic factors, such ...→2ArticleDecember 2022 ISSUE BRIEF 1 HP-2022-24 Doula Care and Maternal Health:Some of the supports that a doula may provide include: ... such as risk factors and warning signs that may need to be addressed and healthy choices to optimize · maternal and infant outcomes. They can also provide emotional support during stressful pregnancy→11ArticleDoula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries - PMCUnlike physicians, midwives, and ... support to the mother before, during and just after birth.”27 Randomized controlled trials provide strong evidence for the clinical benefits of continuous labor support.28,29 A recent Cochrane systematic review...→12ArticleDoula Services and Birth Outcomes: A Scoping Review - PubMedFindings across eligible articles ... breastfeeding initiation, and emotional health. Discussion: Findings suggest having doula support can improve experiences and outcomes....→
What This Means for You
Doula support offers measurable benefits for birth outcomes and satisfaction
The evidence suggests that doula support can make a meaningful difference in both the experience and outcomes of pregnancy and birth. These benefits are seen across a wide range of people and settings, and may be especially significant for those who face additional challenges or risks. If you are considering doula support, you might want to explore options in your area, ask about coverage, and meet with potential doulas to find someone who feels like the right fit for you and your birth plan.