A 2025 study published in AJOG adds powerful, up-to-date data showing associations between doula care and improved maternal and newborn outcomes. Quantifying the association between doula care and maternal and neonatal outcomes is more evidence for doulas. It backs up what many of us have seen anecdotally.
For doulas — and for IDI doulas in particular — the findings reinforce why our work matters. It shows how it impacts families, and the importance of continuing to advocate for doula care in birth systems. This is pretty clear evidence for doulas, we can improve outcomes.
Evidence For Doulas – What The Study Found
- The researchers examined over 17,800 births between 2021 and 2022; about 486 of those had doula care (prenatal + at delivery), while the remainder did not.
- After controlling for demographic differences and using propensity-score matching, several outcomes were significantly more favorable in the doula cohort.
Key Maternal Outcomes
- More vaginal births after cesarean (VBAC): For every 100 patients who received doula care, there were 15 to 34 additional VBACs compared with those without doula care.
- Higher postpartum follow-up attendance: 5 to 6 more per 100 received postpartum office visits.
Key Neonatal / Infant Outcomes
- Increased exclusive breastfeeding rates: Babies whose families had doula support were more likely to breastfeed exclusively.
- Fewer preterm births (and early preterm births): Doula-supported births showed a reduction in preterm birth rates.
In short, the study links doula care with improvements in birth outcomes — across birth mode (more VBACs), infant health (less prematurity), and early infant care (breastfeeding, postpartum follow-up).
Why This Matters — Especially for Doulas & IDI Graduates
Evidence for doulas – validation of doula care
This research adds to the growing body of literature that supports the physiological, emotional, and practical value we as doulas bring. It’s not just about comfort. Doula care is associated with measurable, important health outcomes. As doulas, having this evidence helps you communicate your value to clients, providers, and payers.
Supporting health equity
Interestingly, the benefits held true across different racial groups and insurance statuses (private vs public). This suggests doula care could be an important tool in reducing disparities in maternal and neonatal outcomes. At IDI, we learn about disparities in care and how we can help reduce disparities.
Strengthening arguments for doula reimbursement & integration
As policy movers and hospitals consider funding or integrating doula services (especially for Medicaid or underserved populations), this study gives concrete data to advocate for inclusion of doulas in standard prenatal and birth care.
As doulas, most of us find our benefit in being outside the hospital system. We work for families, not the hospital. However, collaborative care that allows us to still work for the family first, alongside support from a system could be the balance that increases access to doula care.
Encouraging comprehensive perinatal support
Because the study shows benefits beyond just birth, breastfeeding success, postpartum follow-up, it underscores the value of full-spectrum doula care (prenatal, birth, postpartum). For IDI doulas trained to support families beyond labor and birth, this is powerful affirmation. Being certified in multiple doula programs matters!
What This Means for You as a Doula
- Use the data in conversations with families: When prospective family wonders “Do doulas really help?”, you can reference this study to provide evidence — not just anecdote.
- Share with providers and hospitals: If you collaborate with midwives, OB-GYNs, or hospitals, this research can help foster stronger integration and support for doulas.
- Support advocacy & coverage efforts: If you live in a state pushing for doula reimbursement (e.g. Medicaid), cite this study as backing for policy change.
- Encourage full-spectrum care: Given improved postpartum and infant outcomes, highlight offerings like breastfeeding support, postpartum check-ins, and infant care guidance — not just labor support.
- Continue your education & maintain standards: Since doula care shows impactful results when provided consistently and professionally, continuing training, staying evidence-informed, and upholding scope and ethics matter even more.
Limitations & What to Keep in Mind
- This study is observational/retrospective, not a randomized control trial — causation can’t be proven, only association demonstrated.
- The cohort was from a single institution — outcomes might vary across different regions, care models, or demographics.
- “Doula care” in the study refers to a defined program with prenatal and at-birth support; results may not apply fully if support is limited or inconsistent.
Even so, when taken alongside decades of doula research and real-world practitioner experience, these findings add support for doula care as a key component of perinatal health.
For doulas — especially those trained or training at IDI — this new AJOG study is a great milestone. It offers clear, updated evidence that doula care isn’t just about being a supportive companion during labor. Doula support is linked with improved birth outcomes, better infant health, and better postpartum follow-up.
Not already a doula? Get started today and provide evidence-based care to growing families in your community.
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...