Doulas Saving lives

Doula care improves health outcomes and leads to more satisfying birthing experiences
Studies on the effectiveness of doula care conclusively demonstrate that women[1] who are supported by a doula during labor and childbirth are less likely to require a cesarean birth or use pain medication, and more likely to give birth spontaneously, have a shorter labor, and feel satisfied with their birthing experience. By reducing the need for medical interventions such as cesarean births, doulas help mitigate the potentially severe complications associated with risky interventions. For example, complications such as death, cardiac arrest, blood clots, and infections are three times more common following a cesarean birth. Babies born via cesarean birth are also more likely to experience health problems including asthma, Crohn’s disease, and allergies.

Community-based doulas are well suited to reduce racial disparities

Black women in the United States are three times more likely to die from complications related to pregnancy and childbirth than white women. Notably, the deep racial disparities in maternal health outcomes persist across income and education levels, indicating that racism in the health care setting is a driving force of disparities. A growing body of research indicates that stress related to daily exposure to racism detrimentally impacts birth outcomes. Moreover, communities of color have consistently reported mistreatment and dismissive behaviors from perinatal health care providers.

Community-based doulas are particularly well suited to improve racial disparities in health outcomes by ensuring that pregnant people who face the greatest risk of discrimination and mistreatment in the medical system receive the additional support they require. As members of the communities they serve, community-based doulas are able to intimately understand the needs of their clients and effectively build trusting relationships. Research demonstrates that a strong doula/client relationship grounded in trust and shared experience increases a pregnant person’s engagement in care, agency in decision-making, and overall improved health outcomes.

Doula care reduces overall perinatal spending

Rigorous studies show that doula care results in substantial cost savings by reducing the need for medical interventions including cesareans, instrument assisted births, and pain medication. Considering that cesarean births cost 50 percent more than vaginal delivery, and about one-third of all births in the U.S. occur via cesarean, the potential cost savings is dramatic.

In addition to cesarean births, Neonatal Intensive Care Unit (NICU) admissions are a driving factor of high health care costs. The Institute of Medicine estimates that the annual health care cost in the United States associated with preterm delivery is $26.2 billion, or $51,600 per infant. One study found that when looking at the beneficial impact of doulas on cesarean and preterm birth rates among Medicaid beneficiaries regionally, doula care was associated with a savings of $58.4 million and 3,288 fewer preterm births annually.

In another study assessing the cost effectiveness of doula care among a theoretical cohort of 1.8 million women, Oregon researchers determined that doula care saved $91 million dollars and led to 219,530 fewer cesarean births, 51 fewer maternal deaths, 382 fewer uterine ruptures, and 100 fewer hysterectomies.

Doulas also have the potential to reduce spending as research shows that doula care increases the initiation and duration of breastfeeding. Breastfeeding reduces a parent’s risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure. Breastfed babies have lower rates of asthma, type 1 diabetes, and sudden infant death syndrome. The CDC estimates that the health concerns associated with low rates of breastfeeding add over $3 billion dollars to U.S. health care costs annually.