What’s a doula anyway?

The word “Doula” means “a woman who serves.” A doula acts as the guardian of each woman’s birth story, providing physical and emotional support to both the birthing woman and her partner. As women provide care for other women in something as uniquely feminine as pregnancy and childbirth something powerful happens. The birthing woman is comforted and calmed through the presence and care of this experienced birth guide who knows that what she is experiencing is normal and appropriate. 

“The doula is a professional trained in childbirth who provides emotional, physical, and educational support to a mother who is expecting, is experiencing labor, or has recently given birth. Their purpose is to help women have a safe, memorable and empowering birthing experience.”

– americanpregnancy.org/labor and birth

“Asking your husband to be your sole guide through labor is like asking him to lead the way on a climb of Mount Everest. He may be smart and trustworthy, you may love him, but in the Himalayas you’d both be a lot better off with a Sherpa.”                                           

Pam England

Research Comparing Birth Outcomes With and Without Doula Support

StudyNo Doula SupportDoula Supporting Birth
Guatemala (Sosa, 1980)Length of labor: 19.3 hoursLength 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 hoursLength 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

MeasuresPlanned NarcoticsDoula SupportingPlanned Epidural
Development of Fever in Mother23.5%12.3%29.6%
Cesarean rate11.6%3.1%16.8%
Epidural use26.8%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

MeasureNo Doula SupportWith Doula Support
Breastfeeding 6 weeks postpartum29%51%
Breastfeeding on demand47%81%
Feeding problems63%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.