Should I Hire A Birth Doula? Evidence, ACOG, And Celebrities Say, ‘Yes!’
Are you an expectant parent wondering if you should hire a doula?
While few details of Duchess Meghan’s pregnancy and birth plans have been confirmed, recent reports say she’s working with a doula.
When word broke that she may use a doula for the upcoming royal birth, many began to wonder what a doula is and if they should use one too.
Aliza Bancoff, founder and director of the International Doula Institute, says a doula is a, “professional support person trained in the needs of the family during pregnancy and childbirth.
“The doula offers non-judgmental support, guidance, evidence-based education and practical hands-on support during childbirth including comfort measures. Doula originates from the Greek word meaning woman servant.”
Why Would The Royal Family Use A Doula?
While hiring a professional doula may be a newer concept, the use of continuous labor support isn’t new. In past generations, many gave birth surrounded by women with the knowledge and skills to support them through birth.
When birth took place in villages, in the home and surrounded by grandparents, aunts, etc., many possessed the skills to provide continuous, caring support to laboring women.
Today, many of us have little to no experience with birth before going into labor for the first time. Some couples may have a few hours of childbirth preparation classes, but not truly understand how to best cope and make decisions during labor.
Our midwives, doctors and nurses provide excellent medical support. Our partners know us well and play a major role in our support. However, a doula can provide professional, continuous labor support to both the person in labor and their partner.
While Duchess Meghan hasn’t said why she may use a doula, we can assume she is looking for continuous labor support that evidence shows:
- Reduces the likelihood of medical intervention
- Lowers the risk of c-section birth
- Increases the likelihood of a reported positive birth experience (how a person feels about the birth experience, not based on specific birth outcome)
- Supports breastfeeding initiation.
By working with a doula, Duchess Meghan can rest assured she has someone present with the sole purpose of providing her with ongoing emotional, physical and practical support. Midwives, doctors and nurses provide exceptional support, but their primary role is to ensure a medically safe birth for both mother and baby. This leaves less time for continuous support as they manage their clinical role.
Is Continuous Labor Support Evidenced Based?
It’s very possible for a woman to have a wonderfully positive birth without a doula. A woman can also have a challenging birth with a doula. While birth is a natural, physiological process that often unfolds well, it is unpredictable, especially in an era with vast medical interventions available.
While a doula can never guarantee outcomes, evidence shows many benefits to continuous labor support.
The World Health Organization (WHO) recognizes the importance of maternal child research and recently shared about a Cochrane Review comprised of 26 randomized controls including more than 15,800 women.
The WHO reported, “The authors found that women who received continuous labour support were more likely to give birth vaginally, and had fewer caesarean, forceps or assisted vacuum births. In addition, women were less likely to use pain medications, were more likely to be satisfied with their birth experience and had shorter labours. It was also found that newborn babies were less likely to have low ‘Apgar’ scores – a test for the vital signs of health and well-being in infants. No harms of continuous support were identified.”
While more research is needed, given the lack of risk associated with continuous support, and the many potential benefits, it makes complete sense Duchess Meghan would consider using a birth doula.
What Does The American College of Obstetricians and Gynecologists (ACOG) Say About Doulas?
ACOG compiles research, looks at the evidence and makes recommendations for the OB/GYN providers in the US. These recommendations are meant to reduce adverse birth outcomes for mothers and babies and increase positive long-term health outcomes.
Reducing unnecessary medical interventions (not to be confused with medically necessary interventions) which improves outcomes is an important topic for ACOG.
ACOG released Approaches to Limit Intervention During Labor and Birth, a committee opinion. They wrote, “Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor.”
With high c-section rates, reducing the primary c-section rate is a public health concern. While c-sections are medically indicated at times, our current c-section rate in the US is nearly 50% higher than the WHO recommends.
For this reason, new research and official recommendations are released to help reduce c-sections. While there are several guidelines and evidence, ACOG included continuous labor support as one method to reducing c-sections.
ACOG’s Safe Prevention of the Primary Cesarean Delivery says, “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. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that 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. Given that there are no associated measurable harms, this resource is probably underutilized.”
Both the WHO and ACOG recognize that continuous labor support, like that of a professional doula, is an evidenced based method for reducing the likelihood of birth interventions and increasing the likelihood of positive outcomes.
Celebrities And Birth Doulas – Do Celebrities Use Doulas?
Want to give birth like the Royal family? Choosing a midwifery attended birth and perhaps a birth doula is one way to birth like a member of the Royal family.
While living like a Royal or a celebrity is appealing to some, for many there’s no appeal to emulate a celebrity life.
However, what’s interesting about celebrities using doulas is they have access to top services and yet one service many choose is available to everyone. With all the resources at their fingertips, they choose to use a birth doula, and you can too.
They have the time, money and resources to choose anything for their births and many choose to utilize professional labor support to improve their birth experience and health outcomes.
Some celebrities who have used birth doulas include:
- Kelly Ripa
- Mayim Bialik
- Erykah Badu
- Kristen Bell
- Jessa Duggar
- Nicole Kidman
- Tamera Mowry-Housely
- Alyson Hannigan
As you can see, this celebrity list is quite diverse. They’re all famous for different reasons and are known for different lifestyles. A birth doula isn’t for one type of person, or even one type of birth. These celebrities could have made any birth preparation and still chose to include a birth doula.
Every person, pregnancy and birth are unique. While one can’t say you must have a doula, evidence, major health organizations, a duchess and many celebrities say using a birth doula makes a lot of sense.
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...