Doula support more effective in improving obstetric outcomes – latest review

In February 2011, the new Cochrane Review of Continuous support for women during childbirth was published.

The study includes 21 randomized controlled trials with 15,060 women with doulas and hospital staff (including 4 newly added trials that compared trained support people from the woman’s own social network (partner, family friends)).

This review confirms previous findings that improved obstetric outcomes are associated with continuous support, especially the support of a doula.

A ‘doula’ labour support companion has the strongest impact on health and safety during labour and birth, compared with women who have no support in labour, or support from a member of the hospital staff, friend or family member.

Women with continuous support from a doula or other independent person were:

  • 28% less likely to have a caesarean section
  • 31% less likely to use synthetic oxytocin to speed labour
  • 9% less likely to use any pain medication
  • 34% less likely to rate their childbirth experience negatively.
  • A new finding with this review is that doulas are also more effective in improving outcomes than people in the woman’s social network (partners, family, friends).

The Cochrane Review concluded:
“Continuous support during labour should be the norm, rather than the exception. Policy makers should consider making continuous labor support a covered service, and hospitals should implement programs to offer continuous labor support. In present maternity care environments, benefits of continuous support are likely to be greater with companions who are not hospital staff members than with members of the hospital staff.”

Read the Childbirth Connection Quick Facts about Continuous Labour Support here

The Cochrane Review of Continuous support for women during childbirth can be found here

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About Kate Emerson

Kate Emerson, BA (sociology/politics) Kate is a clinical student pursuing her interest in neonatal transitional physiology and clinical cord clamping practices. She produces media to increase the level of awareness about delayed cord clamping for parents, students and interested practitioners. Please visit to read more.

Posted on June 6, 2011, in About birth attendants/ doulas, Doula and tagged , , , , , , . Bookmark the permalink. 6 Comments.

  1. This is a thing I have to do more research into, many thanks for the posting.

  2. Fantastic! Thanks for sharing! :-)
    I am a student doula and this just makes me even more excited at the thought of becoming a qualified doula! :-)

  3. i would add that being cared for by one midwife in particular whom you have grown to trust and get on with, also has this effect and that a doula has. this highlights that women need consistent, positive support ,and this should be as the report says, the “norm”

  4. So pleased to read this new evidence! Thanks for the great summary.

    There is a lot to be said for peer to peer non-medical support in birth. Even if Midwives were suddenly able to case load, the stats show that the additional emotional support from another mother who is trained and trusted lowers the intervention rates even further.

    Why aren’t the NHS funding Doula’s?!

  5. This is quite a powerful study in that there are new findings from the comparison of different types of continuous support.

    While I think it could be so important and helpful to have public finding for doulas since they do help with health outcomes. On the other hand, right now doulas are hired by the women themselves and clearly work only for the interests of the women. If they are paid by an external agency, they may be pressured to support the interests of the agency paying them in situations where it conflicts with the interests of the women.

    Lastly, in response to another comment about midwives, midwives clearly improve outcomes for low-risk women, however, the role of the doula and the midwife is not the same, even though they may have similar approaches to birth. I made that mistake in my first pregnancy, thinking that I wouldn’t need a doula because I had a fantastic midwife. In labour, I learnt how different the roles were, and how beneficial it was to have a doula AND the midwife.

  1. Pingback: Doula Support Rocks!!!!! « ujalamama

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