Childbirth is a profound and transformative experience—one that brings anticipation, excitement, and, for many, anxiety. Questions about pain, uncertainty, and the possibility of medical interventions often arise. Fortunately, continuous labor support, particularly from a doula, has been shown to significantly improve the birth experience and outcomes for many families.
According to the American College of Obstetricians and Gynecologists (ACOG) and a robust body of research, one-on-one emotional and physical support during labor leads to better outcomes for birthing individuals and infants (Hodnett et al., 2013; ACOG, 2023).
1. Shorter Labor Duration
Studies consistently show that continuous labor support reduces the length of labor. In a well-known randomized controlled trial, labor times were significantly shorter when birthing people were supported by a continuous companion (Kennell et al., 1991). A Cochrane Review further concluded that labor support can reduce labor duration by an average of 40 minutes (Hodnett et al., 2013).
Why does this happen?
- Emotional reassurance and physical support reduce stress, which promotes oxytocin release—a hormone essential for labor progression.
- Doulas encourage movement and position changes, helping the baby engage in the pelvis and move downward effectively.
2. Reduced Need for Pain Medication and Epidurals
Fear and tension can amplify the perception of pain. Continuous support helps birthing individuals remain calm and focused, which often reduces their need for pharmacologic pain relief.
- Women who received continuous support were 9% less likely to request pain medication (Hodnett et al., 2013).
- Doulas provide non-pharmacologic comfort techniques—including breathing, massage, counterpressure, and hydrotherapy.
Why does this matter?
- Pain medications can cause sedation or reduce the ability to push effectively.
- Epidurals, while beneficial, can sometimes prolong labor or increase the likelihood of assisted delivery (ACOG, 2023).
- Some medications cross the placenta, potentially impacting newborn alertness and Apgar scores (Hodnett et al., 2013).
3. Lower Cesarean Birth Rates
In the United States, 31.8% of births are by cesarean delivery (CDC, 2023). While cesareans are sometimes life-saving, many are preventable.
- Research shows a 25% reduction in cesarean rates among those who received continuous labor support (Hodnett et al., 2013).
- Doulas help reduce interventions by:
- Supporting upright movement and gravity-based positions
- Encouraging optimal fetal positioning
- Lowering maternal stress levels
4. Emotional Support and Reduced Birth Trauma
Labor is not only a physical event but also an emotional and psychological experience. Having a consistent, calm, and reassuring presence can transform how a person remembers their birth.
- Doulas provide unwavering emotional support, reassurance, and advocacy throughout labor.
- This support can reduce the risk of birth trauma, improve postpartum adjustment, and enhance overall satisfaction with the birth experience (Kozhimannil et al., 2016).
5. Advocacy and Help Navigating the Medical System
Hospitals can be overwhelming, especially for first-time parents or those giving birth in unfamiliar settings.
- Doulas act as bridges between patients and medical staff, helping families understand procedures and terminology.
- They empower clients to make informed choices, ask questions, and advocate for their preferences.
- Research shows higher levels of birth satisfaction and empowerment among those who had doula support (Kozhimannil et al., 2016).
Conclusion: Doulas Enhance Birth Outcomes and Experiences
The evidence is clear: continuous labor support improves both clinical outcomes and the emotional experience of birth.
- Shorter labor durations
- Less need for pain medications
- Lower cesarean rates
- Increased emotional well-being
- Higher satisfaction with the birth experience
As hospital births have become more medicalized, doulas serve as essential allies in helping families reclaim childbirth as a personal, empowering, and supported experience.
Interested in Learning More?
- Visit DONA International to find certified doulas near you.
- Explore the latest research at Evidence-Based Birth.
References
American College of Obstetricians and Gynecologists. (2023). Pain management during labor and delivery. https://www.acog.org
Centers for Disease Control and Prevention. (2023). Birth data: Cesarean delivery rates. https://www.cdc.gov/nchs/nvss/births.htm
Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. (2013). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 7, CD003766. https://doi.org/10.1002/14651858.CD003766.pub5
Kennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C. (1991). Continuous emotional support during labor in a U.S. hospital: A randomized controlled trial. JAMA, 265(17), 2197–2201. https://doi.org/10.1001/jama.1991.03460170051032
Kozhimannil, K. B., Hardeman, R. R., Alarid-Escudero, F., Vogelsang, C. A., Blauer-Peterson, C., & Howell, E. A. (2016). Modeling the cost-effectiveness of doula care associated with reductions in preterm birth and cesarean delivery. Birth, 43(1), 20–27. https://doi.org/10.1111/birt.12218
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