The Evidence - Why a Doula is Worth the Investment

Facts. Evidence.

Scientists thrive on it.  The rest of us rely on it for information.

Would you like to know the evidence for doulas?

In 2012, a review was published by Hodnett et al., of a study including 15,000 women from 16 countries and 23 trials of various settings and circumstances (1).  This review's objective was to "to assess the effects of continuous, one-to-one intrapartum support compared with usual care" (2).

It compared the support received from medical staff (nurse, midwife, obstetrician), members of the birthing woman's immediate social network (spouse, partner, family or friend) and someone who is neither of the former and is also experienced, trained and solely there as a labor support person (doulas) on labor and birth outcomes.

The "most meaningful support", aka, the continuous support with the best outcomes, was provided by the experienced, trained labor support person.

How did doulas compare to other types of support? Here are the numbers:

  • 31% decrease in the use of Pitocin

  • 28% decrease in the risk of C-section

  • 12% increase in the likelihood of a spontaneous vaginal birth

  • 9% decrease in the use of any medications for pain relief

  • 14% decrease in the risk of newborns being admitted to a special care nursery

  • 34% decrease in the risk of being dissatisfied with the birth experience

This information is not meant to invalidate the role of your loved ones or medical team at your birth.

Your spouse, loved ones, friends and family are experts in you.  

The medical team are experts in serving your medical needs of you and your baby.

As your birth doula, I am an expert in your desires for birth and am there to support you and your birth team as you achieve them.  

In the words of pediatrician, author and maternal-infant bonding advocate, Dr. John H Kennell:

It would be a honor to help you achieve the birth you desire as your doula during your birth in Central Missouri, whether it be Rolla, Fort Leonard Wood, Waynesville, St Robert, St James, Licking, Cuba, Dixon, Edgar Springs, Jefferson City… I will come to you!

This was Part 3 in the series, Why a Doula is Worth the Investment.  Find the first two posts here:

Part 1 - Being On Call

Part 2 - Professional, Objective Experience


(1) Continuous support for women during childbirth (Review).  Hodnett ED, Gates S, Hofmeyr GJ, Sakala C.  2012. pg. 2.   <>

(2) Continuous support for women during childbirth (Review).  Hodnett ED, Gates S, Hofmeyr GJ, Sakala C.  2012. pg. 1.   <>

DONA Certified Birth Doula and Professional Birth Photographer serving Central Missouri including Rolla, St. James, St Robert, Waynesville, Fort Leonard Wood, Salem, Licking, Dixon, Cuba, Newburg, Jefferson City and more; at General Leonard Wood Army Community Hospital and Phelps County Regional Medical Center.

A Letter to Dads, Spouses and Partners from The Doula

Dear Dads, Partner, Spouses,

I am not there to replace you.  Really!  You truly are an irreplaceable member of this Birth Team.  In fact, you have a very valuable role that no one else can fulfill, including me.

Here's why:

A couple I served were expecting their fourth child and had never had a doula attend any of their previous births.  They were looking to have better outcomes achieving the natural birth they desired. 

At one of our prenatal appointments, the husband, trying to articulate the husband-expecting mom-doula relationship, said, "In my understanding, it sounds like she's the quarterback, you are the coach and I'm the waterboy!".

This analogy was a first, and I would be lying if I said it didn't make me chuckle in the moment.  I loved the way he tried to put each of our roles into a familiar context. 

However - know that his role, and your role, is much more important than being the waterboy!  If you were to ask me today, and we were putting each of our roles into these football analogy "boxes", I would tell you that you are not the waterboy, but in fact the defensive coordinator!

As the defensive coordinator, you know in explicit detail each play in your team's play book (birth plan), are skilled in communicating the team's goals to each team member (doctor, midwife, nurses, loved ones, and doula) and know how to maneuver on the fly to achieve the win (are ready to adapt to whatever the birth may bring while maintaining your birth choices).

As the doula, I am there in addition to, and not in place of you, the partner or spouse.

You are an integral part in the birthing person’s life.  You know them deeply, intimately. 

I am there to embrace and support your relationship, as her doula, as your doula.  I talk to both of you and find common ground between us.

An exercise I like to do with my client couples is to ask the partner/spouse, on a scale of 1 to 10, 1 being not at the birth and 10 being catching the baby yourself, how involved you would like to be at the birth.  

I then turn to the birthing mother, asking her the same question - how involved would she like you to be at the birth?  We then talk through each of your desires and expectations and how we can work together to achieve these desires and birth choices.

This exercise and others we do together (hey, I can't reveal all my tricks!) help to establish our relationship and let me know how I can best support your wife AND YOU during the pregnancy and birth.

Your support to the birthing mother is invaluable.  I am there to enhance this bond and relationship as you welcome sweet, new life into your family and lives.  I look forward to serving you and being on your birth team.

In gratitude,