Systematic Review Finds Doula Support Linked to Better Birth Outcomes

A systematic review and meta-analysis of 12 RCTs and 18 nonrandomized studies evaluated doula support compared with standard US maternity care. Using GRADE criteria, the review found moderate-certainty evidence linking doula support to lower rates of preterm birth and cesarean delivery, improved birth experiences, and increased postpartum visit attendance, with low-certainty evidence for additional benefits including increased spontaneous vaginal birth, breastfeeding initiation, and reduced infant mortality. The authors noted substantial study heterogeneity and high risk of bias in many included studies, and reported that four of five studies focused on populations at risk of disparities showed at least some benefit from doula support.

Most relevant for: Pregnant and postpartum patients, including those from populations at risk of health disparities such as low-income, publicly insured, or incarcerated individuals, and those considering or receiving doula support during pregnancy, childbirth, or the postpartum period.

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