Abstract

Background: A source of support during birth could be the solution to many negative outcomes for a mother and her baby. In order to improve the birthing experience so that the mother feels more autonomous and increased positive birthing outcomes occur, sources of support during pregnancy should be evaluated and understood. A doula can play an important role in the birthing process. While published studies exist that investigated the impact of doulas on specific outcomes with particular populations, a scoping review culminating the existing evidence was warranted.

Objectives: The goal of this review was to consolidate and synthesize the existing literature on how doulas can improve birth outcomes and present current evidence demonstrating the value of doulas during labor. This scoping review also aimed to shed light on the positive impact emotional support during childbirth can have on the health and well-being of mother and child. The review question was thus, “How does doula support impact birth outcomes.”

Methods: Data collection occurred from August-October 2022 using the databases PubMed and EBSCOhost. Ten reviewers conducted independent searches using the agreed-upon keywords and descriptors: ‘doulas’ AND ‘labor support’ AND ‘birth outcomes’ AND ‘pregnancy’ AND ‘effects during labor.’ The inclusion criteria for article selection included primary studies that conducted research with a healthy patient population, took place in an industrialized nation, were investigating how doulas contributed to birth outcomes, and took place no earlier than 2000. The birth outcomes focused on were short term, for example, delivery method, lactation, tearing, and Apgar score.

Results: The studies indicated that doula guidance in perinatal care was associated with positive delivery outcomes including reduced cesarean and premature deliveries. Doula support, specifically in low-income women, was shown to improve breastfeeding success, with quicker lactogenesis and continued breastfeeding weeks after childbirth. The emotional support provided by doulas was seen to reduce anxiety and stress during the labor period and reduce the length of labor. Having a doula during childbirth helped raise women’s confidence and autonomy throughout labor.

Conclusion: This study has provided evidence regarding the positive impact doulas have on maternal and fetal outcomes in childbirth. Doulas can be a great resource for birthing mothers and consideration should be given to utilizing them more, as they may have a positive impact not only on the emotional and physical wellbeing of the mother, but the child as well. This study also raised questions about the accessibility of doulas, and how they may help mitigate health disparities among women from different socioeconomic levels.