Why hire a doula?

Several studies have shown that Doula supported births tend to be shorter, more satisfying, have fewer cesarean sections, fewer forceps deliveries, and better postpartum bonding. Much of this is attributed to continuous labor support  in general but a trained Doula offers specific techniques to help with the natural progression of labor (increasing the incidence of spontaneous labor and decreasing the incidence of cesarean section) and pain relief as well as emotional and postpartum support.


  “. . . if I had told you today about a new medication or a new electronic device that would reduce problems of fetal asphyxia and the progress of labor by two-thirds, cut labor length by one-half, and enhance mother-infant interaction after delivery, I expect that there would be a stampede to obtain this new medication or device in every obstetric unit in the United States, no matter what the cost. Just because the supportive companion makes good sense does not decrease its importance.”  Marshall Klaus 

Kennell, JH. The physiologic effects of a supportive companion (doula) during labor. In: Klaus MH, Robertson MO, eds. Birth, Interaction and Attachment. Silkman, NJ: Johnson & Johnson, 1982. 


Evidence of the power of Doula support:


 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/ 


 https://pdfs.semanticscholar.org/47b9/13912af49f26512aa0564ff147f79446a466.pdf 



"... For two of these outcomes (designated with asterisks*), the best results occurred when a birthing person had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of their social network. The researchers found that overall, people who have continuous support during childbirth experience 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; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff" https://evidencebasedbirth.com/the-evidence-for-doulas/ 

 

"Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits described in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and fewer reports of dissatisfaction with the experience of labor (1, 17). As summarized in a Cochrane evidence review, a woman who received continuous support was less likely to have a cesarean birth (RR, 0.75; 95% CI, 0.64–0.88) or a newborn with a low 5-minute Apgar score (RR, 0.62; 95% CI, 0.46–0.85) (1). Continuous support for a laboring woman that is provided by a nonmedical person also has a modest positive effect on shortening the duration of labor (mean difference –0.69 hours; 95% CI, –1.04 to –0.34) and improving the rate of spontaneous vaginal birth (RR, 1.08; 95% CI, 1.04–1.12) (1).

It also may be effective to teach labor-support techniques to a friend or family member. This approach was tested in a randomized trial of 600 nulliparous, low-income, low-risk women, and the treatment resulted in significantly shorter duration of labor and higher Apgar scores at 1 minute and 5 minutes (18). Continuous labor support also may be cost effective given the associated lower cesarean rate. One analysis suggested that paying for such personnel might result in substantial cost savings annually (19). Given these benefits and the absence of demonstrable risks, patients, obstetrician–gynecologists and other obstetric care providers, and health care organizations may want to develop programs and policies to integrate trained support personnel into the intrapartum care environment to provide continuous one-to-one emotional support to women undergoing labor." https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth?IsMobileSet=false 



Experience birth with a Doula for yourself, contact us to schedule a consultation. 

 

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