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What's the Evidence for Doulas?

Skylar VanSteemburg

At Luna Doulas, we often talk about how we as doulas are there to help you make informed choices for your pregnancy and birth; to be a compassionate, non-judgmental sounding board for your concerns; to assist you in preparing for labor and creating personalized birth plans and intentions; and to offer hands-on comfort measures and support during labor.

But those aren’t the only benefits to having a doula. In fact, studies have shown that doula care can have a significant positive impact on birth outcomes! According to the American College of Obstetricians and Gynecologists, “one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”[i]

In honor of World Doula Week, here is some of the evidence for doulas.

Lower Rates of Cesarean Births

·       A 2012 Chochrane review of 22 trials involving over 15,000 women* found that, when they had doula support, women experienced a 28% decrease in the risk of cesarean birth.[ii]

·       Another 2014 study showed that the odds of non-indicated cesarean births were 80-90% lower among women who had doulas, and were 60% lower overall.[iii]

·       Doulas can also increase the chances of a successful VBAC.[iv]

Fewer Interventions

·       Overall, women who have doulas have fewer interventions throughout labor and birth. For example, the Cochrane review showed that women with doula support experienced a 31% decrease in the use of Pitocin and a 12% increase in the chances of a spontaneous vaginal birth. [v]

Decreased Use of Pain Medication

·       Doula support can be especially helpful for those who hope to have an unmedicated birth. The Cochrane review found that, with the support of a doula, women were 9% less likely to choose medications for pain relief.[vi] Rebecca Decker of goes so far as to say that “doulas are a form of pain relief.”[vii]

Shorter Labors

·       Most people would prefer to have a shorter labor rather than a longer one! Interestingly, studies have found that doulas are beneficial here as well – one study showed that, with doula support, labors are as much as 21% shorter.[viii]

Greater Birth Satisfaction

·       As doulas, we do everything we can to support our clients’ goals and ensure that they have a positive birth experience. The evidence shows that we’re on to something! Based on a study of almost 10,000 women, those who had doula care were 27% less likely to be dissatisfied with their births compared to those who didn’t work with a doula.[ix]

Dr. John Kennell famously remarked, “If a doula were a drug, it would be unethical not to use it” – and after reviewing the evidence, we agree! However, it is important to note that we as doulas can neither guarantee certain results, nor are we responsible for the outcome of any labor and birth that we support. In addition, it’s vital to have a knowledgeable and reliable health care provider(s), such as a midwife or an OB, who is aligned with your goals for pregnancy, birth, and postpartum. Still, it’s exciting to see how the simple act of including doulas in your care team can transform your birth experience.

To learn more about how Luna Doulas can support your vision for your birth, contact us today to set up a complimentary consultation!

 *Please note that we exclusively use the term “women” here because this is the terminology used in the studies we’re citing. However, any birthing person can benefit from this information and from doula support, regardless of gender identity, and Luna Doulas remains committed to inclusivity.


[i] American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. “Safe Prevention of the Primary Cesarean Delivery.” American Journal of Obstetrics and Gynecology, March 2014. Web. 

[ii] Hodnett, Gates, Hofmeyr, and Sakala. “Continuous Support for Women During Childbirth.” Cochrane Database Syst Rev, October 2012. Web.

[iii] Kozhimannil,Attanasio, Jou, Joarnt, Johnson, and Gjerdingen MD. “Potential Benefits of Increased Access to Doula Support During Childbirth.” American Journal of Managed Care, August 2014. Web. 

[iv] Jukelevic. “Increasing Your Odds for a VBAC Before and During Labor.” January 2014. Web. 

[v] Decker. “The Evidence for Doulas.” Evidence-Based Birth. Web.  

[vi] Hodnett, Gates, Hofmeyr, and Sakala. “Continuous Support for Women During Childbirth.” Cochrane Database Syst Rev, October 2012. Web. 

[vii] Decker. “The Evidence for Doulas.” Evidence-Based Birth. Web. 

[viii] Klaus, Kennell, and Klaus. The Doula Book, Third Edition. Boston: Del Capo, 2012. Print.

[ix] Lythgoe. “Playing the Doula Numbers Game.” Web.