During Labor, Doulas Can Really Make a Difference

Women who were attended by doulas, experienced laywomen who provide comfort and information during childbirth, are significantly less likely to require epidural anesthesia and are more likely to rate the birth experience as positive than women who don’t have such support, according to a study by researchers at Kaiser Permanente Medical Care Program in San Francisco.

Nancy P. Gordon and colleagues studied 314 women older than 18 who gave birth at three Kaiser hospitals in Northern California between January 1994 and December 1996. Half of the women were assigned doulas when they arrived at the hospital in the early stages of labor for what was expected to be an uncomplicated vaginal delivery. The other group gave birth without a doula in attendance.

Both groups of women were similar in age, race, education, childbirth preparation, stage of labor and types of relatives they brought to attend the birth.

Gordon and her team conducted phone interviews four and six weeks after delivery. They found no difference in rates of Caesarean delivery, use of vacuum suction or oxytocin, a drug that stimulates contractions, or in postpartum depression.

The most significant clinical difference was in the use of epidural anesthesia: 54% of women with doulas had an epidural, compared with 66% of the usual-care group.

Also, 82% of women in the doula group viewed giving birth as a “positive experience” compared with 67% of the usual-care group.