A National Study of the Outcomes of Doula-Assisted Births

OBJECTIVE This study is a descriptive analysis of doula-assisted care in the United States from a national sample of women, including African American, Hispanic/Latina, Asian, and Native American. METHODS The study population (n=12,577) comprised primiparous women with normal pregnancies, and no planned cesareans, who received intrapartum care from doulas from 2000 to 2013. Descriptive statistics were calculated for characteristics of mothers, and their outcomes during labor, birth, and immediate postpartum, by race and ethnicity. Comparisons were drawn with national data. RESULTS Cesarean delivery rates for doula mothers ranged from 12-22% depending on ethnicity, compared to the national rate of 32.8%. Doula mothers were nearly 50% less likely to use medical interventions, and more likely to initiate breastfeeding than the general population of birthing mothers. CONCLUSIONS Substantial evidence indicates intrapartum care by doulas may be a safe way to decrease medical interventions, lower the primary cesarean rate, and increase breastfeeding initiation for primiparous women in the United States.Master of Public Healt