Benefits of Having a Doula
Results of 7 North American Trials of Labor Support including 2259 women
(comparing continuous labor support by doulas with “usual care”)
Author
Year
(# subjects)
 Cesarean
Rate   
 Oxytocin
Rate
 Epidural
Rate
 Narcotics Use
 Instrumental
Delivery
 Maternal
Emotional
Distress
 5 min.
Apgar <7
NICU
Cogan (1)
1988 (25)
 N.A.
 No diff
 N.A.
 decrease
 N.A.
 N.A.
 decrease
Hodnett (2)
1989 (103)
 No diff
 increase
 N.A.
 decrease
 No diff
 N.A.
 N.A.
Kennell (3)
1991(616)
 decrease
 decrease
 decrease
 No diff
 decrease
 N.A.
 decrease
Kennell (4)
1993 (570)
 decrease
 N.A.
 No diff
 N.A.
 N.A.
 N.A.
 N.A.
Gordon (5)
1999 (314)
 No diff
 No diff
 decrease
 No diff
 No diff
 decrease
 N.A
McGrath (6)
1999 (531)
 decrease
 decrease
 decrease
 decrease
 No diff
 N.A.
 N.A.
Trueba (7)
2000 (100)
 decrease
 decrease
 decrease
 N.A.
 N.A.
 N.A.
 N.A.
KEY: No diff- no statistically significant difference between groups: N.A. – not assessed; increase – statistically significant
increase in the supported group; decrease – statistically significant decrease in the supported group.

The results of 3 North American Trials 8, 9, 10 including 8052 women (comparing continuous labor support by NURSES – not
doulas – with “usual care”) showed no differences in any outcomes listed in Table 1.
“Given the clear benefits and no known risks associated with intrapartum support, every effort
should be made to ensure that all labouring women receive support, not only from those close to
them but also from specially trained caregivers.
This support should include continuous presence, the provision of hands-on comfort,
and encouragement.”
~ The Cochrane Collaboration’s Pregnancy and Childbirth Group in Oxford, England
Findings of Hodnett’s et al meta-analysis of 15 trials from N. America, Europe, and Africa (11)
Women cared for during labor by a birth doula, compared to those receiving “usual care” were

•        26% less likely to give birth by cesarean section
•        41% less likely to give birth with a vacuum extractor or forceps
•        28% less likely to use any analgesia or anesthesia
•        33% less likely to be dissatisfied or negatively rate their birth experience
Colorado Birth Resources