Evidence for our care and practice at Enhancing Doulas of Lubbock, Texas

Evidence

Evidence is one of the Principles that shapes our practice.  Here are some great resources for the evidence on doula care and practice as well as other topics relevant to our clients, organized by topic. A full reference list is included at the bottom of this page.



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Research and recommendations supporting both birth and postpartum doula care have come from:


These organizations cite a number of benefits of doula care, among them decreases in:

  • Operative birth, including operative vaginal deliveries and cesarean births,

  • Requests for pain medication,

  • Delayed onset of milk production,

  • Medical interventions,

  • Time spent in labor,

  • Postpartum depression and anxiety,

  • Births of preterm and low birth weight babies,

  • Birth complications for mother and baby, and

  • Costs of care associated with interventions during labor and birth and ongoing care resulting from complications and NICU admissions.


And increases in:

  • Desired breastfeeding outcomes, including rates of initiation and duration and delayed introduction of artificial baby milks and complementary foods,

  • Satisfactory birth experiences, and

  • Maternal self-esteem and sense of self-efficacy.



Evidence on doula care and practice from Enhancing Doulas of Lubbock, Texas

Birth doula care reduces:
  • Operative vaginal deliveries (Leeman et al, 2003; Hodnett, Gates, Hofmeyr, & Sakala, 2013)
  • Cesarean deliveries (Leeman et al, 2003; Hodnett, Gates, Hofmeyr, & Sakala, 2013)
  • Requests for pain medication (Leeman et al, 2003)
  • Unsatisfactory birth experiences (Leeman et al, 2003; Buckley, 2015; Hodnett, Gates, Hofmeyr, & Sakala, 2013)
  • Use of epidural anesthesia (Dresang and Yonke, 2015)
  • Early introduction of supplementary foods (Edwards et al, 2013)
  • Length of labor (Hodnett, Gates, Hofmeyr, & Sakala, 2013; South Dakota State University, 2014)
  • Medical interventions (South Dakota State University, 2014)
  • Healthcare costs associated with pregnancy, birth, and newborns (Strauss, Sakala, & Corry, 2016)
Birth doula care increases:
  • Likelihood of vaginal birth (Dresang and Yonke, 2015)
  • Breastfeeding outcomes (Edwards et al, 2013)
  • Maternal satisfaction with birth experience (Caughey, Cahill, Guise, & Rouse, 2014; Hodnett, Gates, Hofmeyr, & Sakala, 2013; South Dakota State University, 2014)
Doula care benefits those most at risk.
  • Birth doula care can improve breastfeeding outcomes in women with a stressful pregnancy (Nommsen-Rivers, Mastergeorge, Hansen, Cullum, & Dewey, 2009)
  • Reduced risk of low birth weight babies and preterm birth, especially among socially disadvantaged women who are generally more likely to have a preterm birth (Buckley, 2015; Stein, Kennel, & Fulcher, 2013)
  • Birth doula care reduces preterm and cesarean birth rates and increases breastfeeding initiation rates among women using Medicaid, who are more likely to be socially disadvantaged (Kozhimannil, 2016; Kozhimannil, Attanasio, Hardeman, & O'Brien, 2013)
  • "Because the benefits are particularly significant for those most at risk of poor outcomes, doula support has the potential to reduce health disparities and improve health equity" (Strauss, Sakala, & Corry, 2016).
Alternatives to doula care from an independent doula
  • "Continuous labor support by nurses does not affect the likelihood of cesarean delivery or other medical or psychosocial outcomes of labor and birth" (Hodnett et al, 2002).
  • Care by a doula who is not an employee of the hospital produces better outcomes from a doula employed by the hospital (Hodnett, Gates, Hofmeyr, & Sakala, 2013)
    Evidence supporting doula care for partners, families, and pets at Enhancing Doulas of Lubbock, Texas

    Doula care supports partners.
      • " The doula does not displace the father but supports him, shows him how he can be helpful, and relieves much of his anxiety" (Stein, Kennel, & Fulcher, 2004).


      Evidence on pregnancy & prenatal care from Enhancing Doulas of Lubbock, Texas

      Doula care during pregnancy improves outcomes.
      • Doula support during pregnancy improves breastfeeding, emotional, and cognitive outcomes (Edwards et al, 2013; Gruber, Capito, & Dobson, 2013).


      Evidence on labor and childbirth from Enhancing Doulas of Lubbock, Texas

      Birth doulas decrease the likelihood of cesarean birth:
      • Use a birth doula during the first and second stages of labor (laboring and pushing, respectively) (Dresang and Yonke, 2015; Caughey, Cahill, Guise, & Rouse, 2014; Hodnett, Gates, Hofmeyr, & Sakala, 2013)
      Birth doulas improve overall outcomes in labor and birth. 
      • "One of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. . . . Given that there are no associated measurable harms, this resource is probably underutilized"  (Caughey, Cahill, Guise, & Rouse, 2014).
      • “Continuous support in labour increased the chance of a spontaneous vaginal birth, had no harm, and women were more satisfied” (Hodnett, Gates, Hofmeyr, & Sakala, 2013).
      • "All women should have support throughout labour and birth” (Hodnett, Gates, Hofmeyr, & Sakala, 2013).
      • Birth doulas reduce stress in labor and birth and reduce the need for stronger interventions and potential hormonal disruption (Buckley, 2015; South Dakota State University, 2014)
      • Birth doulas reduce the length of labor. (Hodnett, Gates, Hofmeyr, & Sakala, 2013; South Dakota State University, 2014)
      • Birth doulas reduce birth complications for women and their babies (Gruber, Capito, & Dobson, 2013)


      Evidence on recovery & postpartum at Enhancing Doulas of Lubbock, Texas

      Doula care reduces postpartum mood disorders.
      • Birth doula care reduces postpartum depression and anxiety and increases maternal self-esteem (Buckley, 2015)


      Evidence on breastfeeding & lactation at Enhancing Doulas of Lubbock, Texas

      Doula care improves breastfeeding.
      • Prenatal and postpartum doula care results in better infant feeding outcomes, including breastfeeding and timing of introduction of complementary foods (Edwards et al, 2013; Gruber, Capito, & Dobson, 2013)
      • [Doula care] "success may lie in the relationship that develops between doula and mother based on shared cultural background and months of prenatal home visiting, and the doula’s presence at the birth, where she supports early breastfeeding experiences” (Edwards et al, 2013).
      • Birth doula care increases likelihood that breastmilk will come in on time and increases initiation and duration of breastfeeding (Nommsen-Rivers, Mastergeorge, Hansen, Cullum, & Dewey, 2009; Kozhimannil, Attanasio, Hardeman, & O'Brien, 2013)


      Evidence on baby care and safety at Enhancing Doulas of Lubbock, Texas

      Doula care is good for babies, too!
        • "Wise pediatricians will recommend a doula to their patients' parents." (Stein, Kennel, & Fulcher, 2004)
        • Birth doula care "has clinically meaningful benefits for women and infants and no known harm" and improves newborn Apgar scores used to assess the baby's adaptation and well-being in the first minutes after birth. "All women should have support throughout labour and birth” (Hodnett, Gates, Hofmeyr, & Sakala, 2013).
        • Birth doula care reduces the rate of preterm birth and low birth weight babies (Stein, Kennel, & Fulcher, 2013)
        • Birth doulas reduce birth complications for women and their babies (Gruber, Capito, & Dobson, 2013)