DOULA FACTS
Evidence-based information on how doulas help moms, babies, and families.
THE SHORT ANSWER:
A doula is a trained professional who gives continuous physical, emotional and informational support before, during and after birth. In a Cochrane review of 26 trials with more than 15,000 women, continuous one-on-one support was linked to fewer c-sections, less pain medication, shorter labors and more positive birth experiences.
What is a doula?
According to DONA International, a doula is a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth, to help her have the healthiest, most satisfying experience possible. Dr. Christine Morton, co-author of the book Birth Ambassadors, describes a doula as a supportive companion during and after birth.
A doula doesn’t replace your doctor or midwife and doesn’t provide medical care. She works alongside them, focused entirely on you.
How many women use doulas?
The answer may surprise you! In a national survey published in 2013, 6 percent of the 2,400 mothers who took part said they had a doula, up from 3 percent in 2005. According to the CDC, there were 3,628,934 births in the U.S. in 2024. At 6 percent, that’s roughly 218,000 births a year supported by a doula.
Does doula support actually help?
Yes. In 2017, Dr. Meghan Bohren and her colleagues published a Cochrane review of continuous support during childbirth. It combined 26 trials with more than 15,000 women. The women were randomly assigned to either continuous one-on-one support during labor and birth or “usual care.”
Women who had continuous support were more likely to have a spontaneous vaginal birth (no vacuum or forceps). They were also less likely to need pain medication, an epidural, a vacuum or forceps delivery, or a c-section. Their labors were shorter, their babies were less likely to have low Apgar scores, and they were less likely to feel negatively about their birth experience.
In short, continuous support during labor leads to better outcomes for mothers and babies.
How do doulas compare to other types of support?
The Cochrane review also asked whether it matters who gives the support: a doula, a hospital staff member like a nurse or midwife, or a friend or family member. The best results came from doulas. Women supported by a doula had a:
39% lower risk of a c-section
15% higher chance of a spontaneous vaginal birth
Across all types of continuous one-on-one support, women also had a:
10% lower chance of using any pain medication
Labor that was 41 minutes shorter, on average
31% lower risk of feeling dissatisfied with their birth experience
38% lower risk of their baby having a low Apgar score at five minutes
Doulas offer a kind of support that’s hard to get any other way.
What does history teach us?
In the early 1900s, most American babies were born at home with a midwife or family doctor. In 1914, “Twilight Sleep” arrived in the U.S. Mothers were given morphine and scopolamine, a drug that didn’t stop the pain but erased the memory of it. Many women never remembered giving birth, and the drugs carried real risks, including dangerous overdoses.
Birth moved steadily into hospitals, where it was seen as safer. According to the CDC, the share of babies born in hospitals rose from 55 percent in 1938 to 90 percent in 1948. But hospital birth wasn’t automatically safer. A 1933 White House Conference report linked poor infection control and too many surgical deliveries to high rates of mothers dying.
In 1942, British obstetrician Dr. Grantly Dick-Read published a book, later released in the U.S. as Childbirth Without Fear, that made the case for natural, less medicated birth. Heavily drugged births faded over the following decades, and epidurals became a popular form of pain relief. Epidurals work well for pain, but they can slow labor for some women. That can lead to more interventions, like Pitocin to speed contractions back up.
By the 1980s, more families were choosing birth centers or midwife-attended home births. In 1996, the Coalition for Improving Maternity Services released the Mother-Friendly Childbirth Initiative. It called for birth care centered on the mother’s wellbeing, because when mom is doing well, her baby is more likely to do well too.
In the 2000s, the rate of U.S. mothers dying from pregnancy causes began to rise, and researchers are still studying why. C-section rates climbed too, passing 30 percent of all deliveries by the late 2000s. In 2024, 32.4 percent of U.S. births were c-sections. Today, more families are choosing birth centers, home births and doulas, as research keeps showing that fewer unnecessary interventions can lead to better outcomes.
Why are doulas so effective?
Researchers point to three main reasons.
A calmer birth environment. Hospitals can be stressful places to give birth, with bright lights, strangers coming and going, and routines you don’t control. Stress can slow labor and raise the chance of more interventions. A doula acts as a buffer. She keeps you calm, helps you speak up for what you want, and can ask for simple changes like dimmed lights and quiet voices.
Comfort that eases pain. Continuous, hands-on support helps women cope with pain. In one U.S. hospital study, women with continuous doula support were far less likely to get an epidural.
Hormones that help labor. Feeling safe and supported helps the body release oxytocin, the hormone that powers contractions, and endorphins, the body’s natural pain relievers. Fear and stress can work against both.
Don’t just read the facts… experience them!
Reviewed by Sarah Comis, a doula since 2015, Lamaze Certified Childbirth Educator and Certified Lactation Counselor. Last updated October 2026.