Evidence on: Doulas

In a Cochrane Review from 2017, researchers found that overall, continuous support during birth leads to a:

• 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*

• 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*

• 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference

• Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference

• 38% decrease in the baby’s risk of a low five-minute Apgar score; there is no data on if the type of person providing continuous support makes a difference

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

Why Doulas are Effective (The "Buffer" Effect): Doulas act as a "buffer" against the stress of a hospital environment. High stress can lead to increased adrenaline, which can slow down labor (by inhibiting oxytocin). A doula’s presence keeps the birthing person feeling safe, which allows labor to progress more naturally.