While using a doula during birth may seem like a new trend, the original research by Klaus and Kennell on doulas is now over 30 years old. Yet more information is coming out all the time about how doula support is uniquely different from other types of support. Doulas may be more effective than family, friends or members of the hospital staff who provide support to the mother during labor.
Review of Existing Doula Research
Research lead by Ellen Hodnett, from the University of Toronto, Bloomberg Faculty School of Nursing involved reviewing a number of studies that examined the effect of one-to-one support from a doula versus standard care in the hospital.
The research team also wanted to discover if the effects of support were affected by routine practices of the facility, the supportive person's relationship to the hospital and the mother and the timing of the support given to the mother.
21 Doula Studies, 15,000 Women Included in Review
Researchers compiled data from the Cochrane Pregnancy and Childbirth Group's Trials Register. Twenty-one studies with both published and unpublished studies that compared the effects of doula support to standard care were included in the review. Information from more than 15,000 women and their birth experiences were analyzed by two authors who independently reviewed all of the data.
Doula Support Leads to More Vaginal Births, Less Analgesia, Shorter Labors
Much like the research originally conducted by John Kennell and Marshal Klaus in 1980, Hodnett's review confirmed that the effect of having a doula during labor were much more likely to have a vaginal birth and much less likely to have analgesics (Stadol, Nubaine) in labor. The review also showed that women were more likely to report satisfaction in their birth experience if they had doula support.
In addition, doula support lead to statistically shorter labors, fewer cesareans, less instrumental deliveries (vacuum, forceps), less use of epidurals and reduced risk of a baby with a low Apgar score at 5 minutes.
Doulas More Effective than Hospital Staff or Mother's Loved Ones
While researchers did not find that there was any difference in the timing of the support given to the laboring woman, there was a difference in the person providing the support. When compiling the data from the 21 studies, results shows that support was more effective when it was provided by a woman who was not a part of the hospital staff or from the mother's social network such as family or friends.
Support was even more beneficial when the birth occurred at a location where epidurals were not routinely available.
The authors of the study concluded: "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."
Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.
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