Doula Support Improves Outcomes for Moms + Babies

from the normalise doula support series

The evidence we have for doula support looks at the use of continuous support in childbirth. A 2017 Cochrane review demonstrated that 𝗶𝗳 𝗮 𝗯𝗶𝗿𝘁𝗵𝗶𝗻𝗴 𝗽𝗲𝗿𝘀𝗼𝗻 𝗿𝗲𝗰𝗲𝗶𝘃𝗲𝘀 𝗰𝗼𝗻𝘁𝗶𝗻𝘂𝗼𝘂𝘀 𝗹𝗮𝗯𝗼𝘂𝗿 𝘀𝘂𝗽𝗽𝗼𝗿𝘁, 𝗯𝗼𝘁𝗵 𝗺𝗼𝘁𝗵𝗲𝗿𝘀 𝗮𝗻𝗱 𝗯𝗮𝗯𝗶𝗲𝘀 𝗮𝗿𝗲 𝗺𝗼𝗿𝗲 𝗹𝗶𝗸𝗲𝗹𝘆 𝘁𝗼 𝗵𝗮𝘃𝗲 𝗯𝗲𝘁𝘁𝗲𝗿 𝗼𝘂𝘁𝗰𝗼𝗺𝗲𝘀. Let’s look at the findings (Evidence Based Birth 2019)[1]:

• 25% decrease in the risk of Caesarean birth, with an even greater decrease if the support person was a doula (39% decrease)*

• 8% increase in the likelihood of a spontaneous vaginal birth; doula support increased this likelihood to 15%*

• 10% decrease in the use of any medications for pain relief, including epidurals

• Shorter labours by around 40 minutes

• 38% decrease in the risk of low five-minute Apgar score for babies

• 31% decrease in the risk of being dissatisfied or unhappy with their birth experience; note that this risk was reduced with continuous support provided by either a doula someone in their social network, but not hospital staff

What Qualifies as Continuous Support?

Those who birth in the UK, even in a hospital, know that many hospitals have a one-to-one care policy. So, you may be wondering, why do I need a doula if my midwife will provide continuous labour support? First, let’s remember what I wrote about in the second post of this series: midwives perform clinical care. Doulas do not. They have different responsibilities at your birth. A doula’s primary focus is on the birthing person. Also, realistically, not every hospital can provide one-to-one care in times where we have massive shortages of midwives.

Hospital-based midwives also work in shifts, so there’s a reasonable chance that you will have at least two different midwives if you birth in the hospital. And what’s more, the results from the Cochrane review demonstrated two of improved outcomes (indicated by an asterisk* above), the best results occurred when a birthing person had continuous labour support from a doula – someone who was not a staff member at the hospital, and someone who was not part of their social network (a partner, family member, or friend).

So, what it comes down to is that𝙬𝙚 𝙝𝙖𝙫𝙚 𝙚𝙫𝙞𝙙𝙚𝙣𝙘𝙚 𝙩𝙝𝙖𝙩 𝙘𝙤𝙣𝙩𝙞𝙣𝙪𝙤𝙪𝙨 𝙡𝙖𝙗𝙤𝙪𝙧 𝙨𝙪𝙥𝙥𝙤𝙧𝙩 𝙞𝙢𝙥𝙧𝙤𝙫𝙚𝙨 𝙤𝙪𝙩𝙘𝙤𝙢𝙚𝙨 𝙛𝙤𝙧 𝙢𝙤𝙢𝙨 𝙖𝙣𝙙 𝙗𝙖𝙗𝙞𝙚𝙨, 𝙚𝙨𝙥𝙚𝙘𝙞𝙖𝙡𝙡𝙮 𝙬𝙝𝙚𝙣 𝙩𝙝𝙖𝙩 𝙨𝙪𝙥𝙥𝙤𝙧𝙩 𝙞𝙨 𝙥𝙧𝙤𝙫𝙞𝙙𝙚𝙙 𝙗𝙮 𝙖 𝙙𝙤𝙪𝙡𝙖. You may think, “but what about my partner?” Don’t worry, I’m not leaving them out. I’m just dedicating another post especially to how doulas and partners work together in birth 🙂

[1] Dekker, R. (2022, April 8). Evidence on: Doulas. Evidence Based Birth®. Retrieved October 18, 2022, from https://evidencebasedbirth.com/the-evidence-for-doulas/