Studies of Doulas and Their Impact on Families

A review by Cochrane (a prestigious international organization that prepares and keeps up-to-date systematic reviews in many areas of health and medicine) on the effect of "Continuous Support for Women During Childbirth*" has drawn astonishing conclusions.  The primary objective of this review was to assess the effects, on mothers and their babies, of continuous, one-to-one intrapartum support as compared to usual care. 
Fifteen trials involving 12,791 women were included.  After review and analysis of the data, the researchers offered the following synopsis:  Continuous labor support reduces a woman's likelihood of having pain medications, increases her satisfaction and chances for 'spontaneous ' birth, and has no known risks.  Supportive care during labor may involve emotional support, information and comfort measures.  Such care may enhance normal labor processes and thus reduce need for obstetric intervention.  The reviewer's offered the following conclusion: All women should have support throughout labor and birth. 
*Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

The Benefits of Labour Doula Support:

Effects on Birth Outcomes:

bulletWomen request less pain medication and epidurals
bulletThere are fewer complications
bulletReduced chances of having a cesarean section
bulletReduced epidural or other painkiller use
bulletReduced use of artificial oxytocin to speed labour
bulletReduced duration of labour
bulletReduced use of forceps
bulletReduced use of vacuum extraction
bulletIncreased chance of spontaneous vaginal birth

Effects on the Mother:

bulletGreater satisfaction with their childbirth, resulting in a more positive birth experience
bulletMore positive assessments of their babies
bulletReduced chances of maternal fever and infection
bulletMothers feel more secure
bulletMothers feel more in control
bulletReduced levels of anxiety
bulletReduced maternal bleeding following birth
bulletMothers have higher regard and increased sensitivity towards babies
bulletReduced incidence of postpartum depression

Effects on the Baby:

bulletBabies have shorter hospital stays and fewer admissions to special care nurseries
bulletMothers are more affectionate to their babies postpartum
bulletReduced chances of health complications and hospitalizations of baby
bulletIncreased chances of successful breastfeeding
bulletFound to be superior to Lamaze

Effects on the Health Care System:

bulletThe cost of obstetrical care is dramatically reduced
bulletWomen are pleased with the personalized care doulas offer


The Benefit of Continuous Support in Labor is Recognized by:

bulletThe Society of Obstetricians and Gynecologists of Canada
bulletThe World Health Organization
bulletThe Medical Leadership Council (an organization of over 1200 U.S. hospitals)


References (by date):

Marya Ostrowski, ed. Patricia Newton. The doula's role during L&D. RN Mar. 1, 2004;67:34.


Hodnett ED. Caregiver support for women during childbirth (Cochrane Review). In: The Cochrane Library, Issue 4 2002. Oxford: Update Software.


Hodnett ED. Continuity of caregivers for care during pregnancy and childbirth (Cochrane Review). In: The Cochrane Library, Issue 4 2002. Oxford: Update Software.


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