When the pandemic first hit, many birthing people found themselves without in-person access to their doulas. Virtual doulas became the only option for extra support for many birthing people. Given the poor maternal infant health outcomes the US sees, eliminating support was and is a major concern.
Obstetrician and researchers Neel P. Shah, MD, discussed this research recently in multiple news outlets. Shah, along with several others (Karwa, Smriti MPH; Jahnke, Hannah PhD; Brinson, Alison MSPH; Guille, Constance MD; Henrich, Natalie PhD, MPH) published the study in Obstetrics and Gynecology.
Virtual Doulas – What Did The Study Find?
Titled, Association Between Doula Use on a Digital Health Platform and Birth Outcomes, the goal of the study was to find what impact, if any, virtual doulas have on birth outcomes.
It has been well known, and accepted by major medical institutions that continuous labor support improves birth outcomes. However, we did not know if virtual support could also improve birth outcomes.
The study included 8,989 platform users from January 1, 2020, through April 22, 2023. Researchers found:
- Completion of at least two appointments with a virtual doula was associated with a reduction in odds of cesarean birth among all users.
- Of those with a prior cesarean birth, completion of any number of doula visits was associated with a reduction in odds of repeat cesarean birth.
- Among all platform users, the more virtual doula appointments they had was associated with greater odds of reporting support in decisions around birth preference.
The researchers also found that having at least two or more visits with the virtual doula was associated with:
- Receiving a higher level of emotional support throughout the pregnancy
- Learning medically accurate information about pregnancy complications and their warning signs
- Help managing mental health during pregnancy.
As doulas, this study likely isn’t surprising. We know that we offer so much more than just offering comfort measures during labor. What sets doulas apart from family and friend support is our evidenced-based knowledge.
This study shows that perinatal education and support truly impacts birth outcomes even when we are not physically present with our clients. However, as evidenced-based providers, we love to see proof that virtual doula support is valuable.
What Do Researchers Believe Medical Providers Need to Know About Virtual Doulas?
In a time where infection precaution became the focus, it was difficult to find the balance between that and positive birth experiences. Even as hospitals have opened to doulas as necessary members of a birth team, virtual support increases access.
The researchers concluded:
“This analysis demonstrates that virtual doula support on a digital health platform is associated with lower odds of cesarean birth and an improved birth experience. Positive findings among Black users and users with vaginal birth after cesarean suggest that doula support is critical for patient advocacy, and that digital health may play a meaningful role in increasing health equity in birth outcomes.”
A big take away is that doulas can help parents learn about their options. They can help parents understand when they need to touch base with a provider related to complications.
Doulas encourage self-empowerment and self-advocacy. When parents have someone in their corner assisting with education, support, and empowerment, it is easier for them to advocate for a positive and safe birthing experience.
Is Virtual Doula Support Equal to In-Person Support?
I think what is most important to remember is that every birthing person has unique needs and goals. If our measurement is improved birth outcomes, this study shows virtual doulas provide comparable benefits to in-person doulas.
When the goal is to improve birth outcomes, virtual doula support could be part of the answer. It is a small piece in a very big puzzle, but it is an important piece. Virtual support removes geographic barriers, possibly some scheduling barriers, and in some cases, financial barriers.
Like many things, there will always be clients who prefer hands-on, in-person support. As a doula, offering both in-person and virtual support can allow you to help more families.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...