Why hire a doula?

Feb 15 2015

Only about 5% of births in the United States are attended by a doula, which I reckon means that in the remaining 95%, women have an important question…

We should be contributing to the baby’s college savings after all…

Great question!  I understand this question personally, as investing in a doula while I was pregnant was not a light financial decision since I was already a self-pay patient.  After all, the baby was going to arrive, doula or not!

However, the results are not entirely the same for women who have hired doulas as for those who have not, and a growing body of evidence supports this claim.  Here I provide a few resources from which you may learn more about the role of the doula and the difference she makes:

1. The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth, by Marshall H. Klaus, MD, John H. Kennel, MD, and Phyllis H. Klaus, MFT, LMSW. The title of this book says it all!  Not really, though. Klaus and Kennel add much more detail about the role of a doula and all of the tremendous benefits she provides.  Read it to learn for yourself!  I keep The Doula Book in my library, from which I allow all of my clients to borrow.  However, I will make an exception with this title; if you are not yet a client and are on the fence about hiring a doula, please contact me so I can check out this valuable book to you.  I’ll have no hurt feelings if you return the book and choose not to go the doula route, however, the case presented by Dr. Klaus and Dr. Kennel is certainly compelling!

The Doula Book is also available on Amazon and Barnes & Noble, in hardcopy, kindle, and nook formats.

2. 7 North American Trials of Continuous Labor Support with Doulas Compared to Usual Care, Including 2259 Women

The results of these studies were compiled by DONA International, the premier training and certifying organization of doulas with which I have chosen to affiliate.  Click on the above link to see the details which prove that women supported by doulas are less likely to give birth by cesarean section,  less likely to give birth with a vacuum extractor or forceps, less likely to use any analgesia or anesthesia, and less likely to be dissatisfied or negatively rate their birth experience.

3. 2013 Cochrane Study Compiling 22 Trials of 15,288 Women

This is about as comprehensive and current of research as I have seen on the results of a doula during labor and birth, and the authors’  conclusion is affirmative:

“Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.”

There are many other scholarly articles published on the value of labor support, and I encourage you to investigate them for yourself.  Some trustworthy sources of information are: the BMJ’s Clinical Evidence, the Cochrane Collaboration, Google Scholar, PubMed, and Medcape.  At this point, it is important to make a distinction between continuous labor support by nurses as opposed to continuous labor support by doula.  Because savvy hospitals are recognizing the value of doulas in maternal and newborn care, many are having nurses trained to provide similar, continuous labor support.  Some studies you may find from the aforementioned research sites will reveal that, unfortunately, there is no significant difference in the number of cesarean sections when a nurse providing continuous labor support is present.  Cochrane reviewers are wary that “divided loyalties, additional duties beyond labour support, self-selection, and the constraints of institutional policies and routine practices may have all played a role.” (Hodnett, Gates, Hofmeyr & Sakala, 2008 p. 10)  Therefore, consider hiring a doula no matter what the practices are of the hospital where you are planning to deliver.  There is truly no substitute for a doula!