What Is a Doula and What Do They Do?
A doula is a non-medical professional who supports mothers and families through childbirth. Unlike doctors or midwives who focus on medical care, doulas provide holistic support tailored to the individual’s needs. This can include:
- Physical support: Techniques like massage, positioning assistance, and breathing exercises during labor.
- Emotional support: Providing reassurance, encouragement, and a calming presence during what can be an intense and uncertain time.
- Informational support: Helping expectant parents understand their options, creating birth plans, and navigating complex healthcare systems.
Doulas advocate for their clients, ensuring their voices are heard and their preferences respected in the often clinical and overwhelming setting of a hospital or birthing center.
For more information, visit our What is a Doula and Doula Support.
Evidence of Positive Outcomes with Doula Support
The impact of doulas on childbirth outcomes is well-documented. Numerous studies and reviews have found that doula support leads to lower rates of medical intervention, improved maternal and infant health, and greater satisfaction with the birth experience.
1. Reduction in Cesarean Deliveries and Medical Interventions
A landmark systematic review published in The Cochrane Database of Systematic Reviews revealed that women who received continuous support during labor—such as that provided by doulas—experienced significantly lower rates of cesarean deliveries, instrumental births, and the use of pain relief interventions such as epidurals. These women were also more likely to have spontaneous vaginal births.
One study found that women supported by doulas were 39% less likely to have a cesarean birth. With cesarean deliveries carrying higher risks of complications and longer recovery times, this reduction represents a substantial improvement for maternal health.
2. Better Outcomes for Marginalized Communities
The benefits of doula care are particularly striking for women from underserved populations. Low-income women and women of color, who face higher rates of maternal mortality and morbidity, often experience more positive outcomes when supported by doulas. Research has shown that Medicaid beneficiaries with doula support are less likely to experience preterm births and low-birthweight babies, both of which are critical indicators of neonatal health.
Doulas also help to counteract racial disparities in maternal care. A study highlighted in the American Pregnancy Association website noted that doulas can act as cultural brokers, advocating for women of color and helping them navigate medical systems that may not always prioritize their needs.
3. Improved Emotional Well-being
Childbirth is not just a physical process—it’s an emotional journey. The presence of a doula significantly reduces maternal anxiety and fear, creating an environment of empowerment and calm. This emotional support helps mothers feel more in control during labor, which contributes to a greater sense of satisfaction with the birth experience. Evidence from the American Pregnancy Association underscores the value of this emotional reassurance, particularly for first-time mothers or those with prior traumatic birth experiences.
4. The Postpartum Advantage: Doulas After Birth
Doulas don’t just provide care during labor—they also play a crucial role in the postpartum period. New mothers often face challenges such as breastfeeding difficulties, exhaustion, and postpartum depression. Postpartum doulas step in to offer support, helping with tasks like:
- Establishing breastfeeding routines.
- Offering practical advice on infant care.
- Providing emotional reassurance during the often overwhelming first days of parenthood.
Postpartum doulas are particularly beneficial for mothers at risk of postpartum depression. Emotional support during this time can help reduce feelings of isolation and anxiety, ensuring mothers have the tools they need to thrive in their new roles.
5. Doula Care and Public Policy
Recognizing the immense value of doulas, policymakers are increasingly exploring ways to integrate doula services into maternal healthcare systems. States like Minnesota, Oregon, and Rhode Island have implemented Medicaid reimbursement programs for doula care, making this support accessible to low-income families.
Expanding these programs nationwide could help address disparities in maternal health outcomes, particularly among marginalized communities. Additionally, increasing reimbursement rates and offering grants to train and certify more doulas would ensure a robust and diverse doula workforce.
Doulas: A Holistic Approach to Maternal Support
Doulas stand out in the maternity care landscape because they focus on the birthing person as a whole—addressing not just physical needs but also emotional and informational ones. This holistic approach is especially valuable in environments where medical procedures and protocols often take precedence over individualized care. By providing consistent, personalized attention, doulas fill a critical gap, offering continuity that fosters confidence and trust.
For example, a doula can help a laboring woman interpret medical jargon, advocate for her preferences in a high-pressure environment, and provide comfort techniques that ease pain and anxiety. Studies show that this level of support directly contributes to more positive birth experiences and better clinical outcomes, including reduced rates of cesarean sections and epidurals.
Empowering Families Through Education and Advocacy
One of the most powerful aspects of doula care is the emphasis on education and informed choice. From the earliest stages of pregnancy, doulas help families understand their options, develop birth plans, and set realistic expectations for labor and delivery. This educational component not only empowers families to make decisions that align with their values but also fosters collaboration between parents and medical providers.
In labor, doulas often act as advocates, ensuring that their clients' preferences are respected. For marginalized populations—who may face systemic biases or communication barriers—this advocacy is especially vital. Doulas create a bridge between families and healthcare providers, encouraging shared decision-making and respectful care.
Transforming the Birth Experience
The presence of a doula profoundly shapes the emotional and psychological landscape of childbirth. Birth can be an intense, unpredictable journey, but having a trained, calming presence makes all the difference. Whether offering encouraging words, massaging a laboring person's back, or guiding breathing techniques during contractions, doulas bring reassurance and stability to the birth space.
This emotional support reduces feelings of fear and helplessness, contributing to a more positive perception of the birth process. A doula’s continuous care also fosters trust, which can enhance the body's natural ability to progress through labor. Women who feel supported are more likely to report satisfaction with their birth experiences, regardless of whether their delivery goes according to plan.
More Questions? Reach Out to Kooshlie Care Today
All Doulas with Kooshlie Care Services are certified or in process for certification. Collectively we have 25+ years of experience to offer the families who bring us into your journey. Our doulas hold a wide range of certifications including DONA International, Lamaze, Hypno-Babies, Pro-Doula, and the Elite Doula Co.
Throughout this article we have described findings from the Cochrane Review, the American Pregnancy Association and the ASPE Office of Health Policy. The evidence points to many clear benefits of Doula services. We also have much first-hand evidence in the form of testimonials from families who have used our services! Reach out to us if you’d like to discuss becoming a doula, or being supported in your birth journey by one.
