Campbell, D. A., Lake, M. F., Falk, M., & Backstrand, J. R. (2006). Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(4), 456-464.
Many studies have documented the beneficial effects of doulas in reducing the length of labor, decreasing the rate of cesarean deliveries, lessening the use of analgesia, and decreasing the proportion of infants with 5-minute Apgar scores less than 7. Because many insurance programs do not cover the services of doulas, women often have to pay doulas directly. The $300-1,800 cost often means that low-income women cannot afford the services of a professional doula. This study describes the results of a 4-hour training program provided to female volunteers selected by the pregnant women. The education was provided to the pregnant women and the volunteers at a community-based setting selected by the participants. The lay doula attended the labor in addition to the spouse or the male partner. When compared to a control group of women who did not have doula support, the study participants had significantly shorter labors, were further dilated before receiving analgesia, and had significantly higher proportion of babies with 5-minute Apgar scores less than 7. Although there was no significant decrease in the rate of cesarean deliveries, the authors propose that this is due to the already low rate of cesarean deliveries, noting that the doula group had a 10.6% cesarean rate. The authors suggest that this relatively low-cost intervention, which could be added to childbirth preparation classes, may allow for supportive care by a caring woman to become an option for women who cannot afford the services of a professional doula.
Judith A. Lewis