Studies Show that Doula Support Improves Outcomes:
- 31% decrease in the use of synthetic oxytocin
- 28% decrease in the risk of cesarean surgery
- 34% decrease in the risk of being dissatisfied with their birth experience
- 12% increase in the likelihood of a spontaneous vaginal birth
“There have been at least 22 randomized controlled studies that have considered the benefits of continuous labor support. These studies included more than 15,000 participants and took place in Australia, Belgium, Botswana, Brazil, Canada, Chile, Finland, France, Greece, Guatemala, Mexico, Nigeria, South Africa, Sweden, Thailand and the US under widely disparate hospital conditions, regulations and routines. They looked at the impact of continuous vs. intermittent labor support from a hospital staff member (nurse, doctor or midwife), a friend or relative, and an unrelated, non-staff doula. Factors considered included the length of labor, cesarean rate, the rate of other interventions, admission to the special care nursery, breastfeeding and maternal satisfaction.
The best results were found when there was continuous labor support from a doula who was not a staff member of the hospital and was also not part of the expectant parent’s social network (friend, partner or relative).”
– Childbirth International
Research Comparing Birth Outcomes With and Without Doula Support
| Study | No Doula Support | Doula Supporting Birth |
| Guatemala (Sosa, 1980) | Length of labor: 19.3 hours | Length of labor: 8.7 hours |
| Use of Pitocin: 16% | Use of Pitocin: 2% | |
| Cesarean Rates: 27% | Cesarean Rates: 19% | |
| Guatemala (Klaus, 1986) | Length of labor: 15.5 hours | Length of labor: 7.7 hours |
| Use of Pitocin: 13% | Use of Pitocin: 2% | |
| Cesarean Rates: 17% | Cesarean Rates: 7% | |
| Houston (Kennell, 1991) | Length of labor: 9.4 hours * | Length of labor: 7.4 hours |
| Use of Pitocin: 44% | Use of Pitocin: 17% | |
| Cesarean Rates: 18% | Cesarean Rates: 8% |
Kennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C. (1991). Continuous emotional support during labor in a US hospital: a randomized controlled trial. Jama, 265(17), 2197-2201.
Klaus, M. H., Kennell, J. H., Robertson, S. S., & Sosa, R. (1986). Effects of social support during parturition on maternal and infant morbidity. Br Med J (Clin Res Ed), 293(6547), 585-587.
Sosa, R., Kennell, J., Klaus, M., Robertson, S., & Urrutia, J. (1980). The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. New England Journal of Medicine, 303(11), 597-600.
* You will see that there was much less difference in length of labor between the two groups in the Texas study. In the hospital where this study was done births were actively managed, meaning they would give laboring women Pitocin to ensure labor progression on a pre-determined schedule, so the length of labor was significantly shorter for the birthing women without doula support than it likely would have been without labor augmentation.
Use of Pain Medications
| Measures | Planned Narcotics | Doula Supporting | Planned Epidural |
| Development of Fever in Mother | 23.5% | 12.3% | 29.6% |
| Cesarean rate | 11.6% | 3.1% | 16.8% |
| Epidural use | 26.8% | 6.3% | 87.7% |
| Instrumental Birth (Forceps/vacuum) | 24.8% | 12.2% | 17.2% |
McGrath, S., Kennell, J., Suresh, M., Moise, K., & Hinkley, C. (1999). Doula support vs epidural analgesia: impact on cesarean rates. Pediatric Research, 45, 16A-16A.
Breastfeeding Outcomes
| Measure | No Doula Support | With Doula Support |
| Breastfeeding 6 weeks postpartum | 29% | 51% |
| Breastfeeding on demand | 47% | 81% |
| Feeding problems | 63% | 16% |
Hofmeyr, G. J., Nikodem, V. C., WOLMAN, W. L., Chalmers, B. E., & Kramer, T. (1991). Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding. BJOG: An International Journal of Obstetrics & Gynaecology, 98(8), 756-764.