Doulas are under-utilized.

A recent joint statement from the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) set forth new guidelines designed to prevent primary cesareans. Here are a few highlights:

  • “Increasing women’s access to non-medical interventions during labor, such as continuous labor and delivery support, has been shown to reduce cesarean birth rates.”
  • “Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”
  • “… the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

This is a very promising development for the future sustainability of the doula profession!

Elective Induction of Labor?

Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor focusing on evidence-based factors that influence the practice of elective induction. Read more.

Doulas save costs for Medicaid recipients.

A study from the University of Minnesota compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and then estimated the potential cost savings. The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, the odds of cesarean delivery were 40.9% lower for doula-supported births. The potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial. The study’s authors concluded that state Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.

Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries, American Journal of Public Health, 2013-04-01