The classic Klaus and Kennell research in the 1980s showed that doula support during labor and birth shortened the length of labor and decreased the cesarean rate. Since then, numerous other studies have supported the initial research and added to the evidence that continuous doula support throughout labor improves birth outcomes, increases maternal satisfaction, and improves maternal self-confidence and maternal empathy.
Here are summaries of four of those studies. (All underlining is mine.)
1. A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates, by McGrath and Kennell was published in the journal, Birth, in 2008. Results from this Ohio study done on first-time mothers are described as follows:
The doula group had a significantly lower cesarean delivery rate than the control group (13.4% vs 25.0%, p = 0.002), and fewer women in the doula group received epidural analgesia (64.7% vs 76.0%, p = 0.008). Among women with induced labor, those supported by a doula had a lower rate of cesarean delivery than those in the control group (12.5% vs 58.8%, p = 0.007). On questionnaires the day after delivery, 100 percent of couples with doula support rated their experience with the doula positively.
For middle-class women laboring with the support of their male partner, the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia. Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula.
- A randomized control trial of continuous support in labor by a lay doula, by Campbell DA, et al, was published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing in 2006. Results from this New Jersey study with first-time mothers included:
Significantly shorter length of labor in the doula group, greater cervical dilation at the time of epidural anesthesia, and higher Apgar scores at both 1 and 5 minutes
3. I have always felt that a woman's birth influences her postpartum time; it is the primary reason I became a birth doula. I was happy to see a study that compared mothers assigned a doula for birth to mothers who had taken a Lamaze childbirth education class and how the interventions informed the postpartum time. The study: A birth intervention: the therapeutic effects of Doula support versus Lamaze preparation on first-time mothers' working models of caregiving, by Manning-Orenstein was published in Alternative Therapy Health Medicine in 1998. Here are the results:
The prebirth to postbirth rating analysis of the interviews revealed that the mothers in the doula group were significantly less rejecting and helpless in their working models of caregiving than were the mothers in the Lamaze group. The mothers in the doula group also showed greater security than did mothers in the Lamaze group, a difference that approached but did not reach significance. In addition, the women in the doula group were less emotionally distressed and had higher self-esteem than did the women in the Lamaze group, and the women in the doula group rated their infants as significantly less fussy than the mothers in the Lamaze group rated their infants.
4. And finally, published in Evidence-Based Nursing in 2013, Women who receive continuous support during labour have reduced risk of caesarean, instrumental delivery or need for analgesia compared to usual care, by McDonald, concluded:
Models of care supporting continuous support during labour were shown to be more likely to result in a spontaneous vaginal birth. Women receiving continuous support required less analgesia and were less likely to report negative feelings about the birth experience. Women receiving continuous support experienced shorter labours and their babies were less likely to have low 5-min Agpar scores.
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