The Impact of Doulas on Birth Outcomes: A Rapid Systematic Review

Although most pregnancies in the United States are uncomplicated, adverse birth outcomes are more common in the U.S. than any other developed country (CDC, n.d.). The use of doula care during labor and delivery has shown to be effective in reducing adverse birth outcomes. A rapid systematic review was conducted to consolidate information on the effectiveness doulas have on certain adverse birth outcomes. These adverse birth outcomes included, low-birth weight, preterm birth, caesarean sections, shorter laboring time, and epidural use. The review of the literature was conducted using PubMed and search terms. PRISMA guidelines were followed and out of the 108 that met the search criteria, 7 studies met the inclusion criteria which required studies that assessed the impact doulas have on birth outcomes. Studies varied in size, quality, intervention type, design, sample, and age. Several studies suggested that doula-assisted births result in a less likely chance of caesarean sections and preterm birth. Some studies suggested that with the use of a doula, expectant mothers would be less likely to use an epidural and have a low-birth weight infant and more likely to have a shorter laboring time. However, most studies had methodological limitations, such as regional sample sizes instead of total populations, and the risk of selection bias existed in nonrandomized studies. Future research is needed in the expansion of doula services to those prone to poorer birth outcomes. Efforts to integrate doula care into usual care as an optional support could improve outcomes among these women and reduce health disparities