Doulas: A Key to Better Birth Experiences and Maternal Health

“The best thing you can do for your baby…is control your breathing.” These were the words our doula, Brandie, shared with me as I was beginning to hyperventilate. I was in labor with my first child, and my baby’s heart rate was not recovering from contractions. The professionals who were gathering in the room were doing everything in their control to ensure the health of me and my baby. My baby would be born less than 10 minutes later, in the operating room.

My husband and Brandie were asked to wait in the hallway outside of the operating room because I was under general anesthesia. Brandie reassured my husband that everything was going to be okay. A few minutes later, a passing custodian asked with a grin, “Did you hear the baby crying?” That was how they learned that our baby had survived.

Doulas are trained professionals who provide physical, emotional, and informational support during pregnancy, labor, delivery, and postpartum. I would argue that any soon-to-be parent, and their partner, could benefit from the extra support of a doula—whether a professionally trained doula or an informal one.

The concept of a doula is not new. Before births took place in hospitals, women supported other women in giving birth. These practices have deep roots in community-based births, particularly within Indigenous and Black communities. In the 1970s, training programs for doulas were formalized by organizations like DONA International, which has since become a leading certifying body for doulas worldwide.

Across my pregnancies and births of my two daughters, Brandie was a beacon of calm and the only consistent provider throughout. For each pregnancy, I used a different provider group and delivered at a different hospital. Brandie met with us twice during each pregnancy, provided vital support during labors and deliveries especially when the births didn’t go as expected, and continued her care after birth.

When my daughter was about five weeks old, Brandie visited me at home. I happened to be breastfeeding when she arrived. At the end of her visit, she gently shared her observation that my daughter might be struggling with breastfeeding. Because of her, I sought out more support from lactation professionals and was able to correct an issue that would have likely ended my breastfeeding journey earlier than I intended. Research has shown that doulas increase breastfeeding success—both in establishing breastfeeding and continuing it. Mothers who used doulas were two times more likely to initiate breastfeeding.2 Additionally, research found that mothers supported by doulas were more likely to continue breastfeeding at six weeks postpartum,3 highlighting the extended benefits of doula care. 

Though doulas are not clinical providers, their care results in improved maternal health outcomes. Maternal mortality in the United States rose significantly from 17.4 deaths per 100,000 live births in 2018 to 32.2 in 2021.1 Poor health outcomes disproportionately impact non-Hispanic Black birthing people, resulting in more than twice the maternal mortality risk compared to non-Hispanic white counterparts.1 

Research underscores the value of doulas in improving these outcomes. A systematic review found that continuous support during labor, such as that provided by doulas, significantly reduced the likelihood of cesarean delivery, the use of pain medications, and the need for medical interventions.4 Furthermore, culturally congruent doula care—where doulas share similar cultural or linguistic backgrounds with their clients—has been shown to bridge gaps in communication and trust, particularly for marginalized populations.

Doulas also have a positive impact on healthcare systems. By providing non-clinical, continuous support to patients, doulas allow nurses to focus more on their clinical responsibilities, leading to better overall care for patients. In the Listening to Mothers Survey, doulas were the best-rated sources of supportive care in labor, leading to higher rates of patient satisfaction and overall birth experience.5

In Indiana, where maternal and infant mortality rates are among the highest in the nation8, the integration of doulas into care teams presents a significant opportunity for the healthcare industry to improve outcomes. Nationally, March of Dimes supports increased access to doula care as one tool to help improve birth outcomes and reduce the higher rates of maternal morbidity and mortality among women of color in the United States.7 Programs like Indiana Minority Health Coalition's Community Doula Services aim to address these challenges by providing consistent, holistic support to families during pregnancy and postpartum.6

Investing in doula care is more than an investment in individual families—it’s an investment in healthier communities. For healthcare providers and businesses in Indiana, supporting doula programs can contribute to reducing healthcare costs, improving patient satisfaction, and most importantly, saving lives. For me and my family, Brandie’s presence was life-changing. For many others, it could be lifesaving. 

References:

1. United States Government Accountability Office. (2024). MATERNAL HEALTH. HHS Should Improve Assessment of Efforts to Address Worsening Outcomes. Available at: https://www.gao.gov/assets/gao-24-106271.pdf

2. Journal of Perinatal Education. (2013). The Impact of Doula Care on Breastfeeding Initiation. Available at: https://doi.org/10.1891/1058-1243.22.1.49

3. Journal of Obstetric, Gynecologic & Neonatal Nursing. (2009). Doula Care, Early Breastfeeding Outcomes, and Breastfeeding Status at 6 Weeks Postpartum Among Low-Income Primiparae. Available at: https://doi.org/10.1111/j.1552-6909.2009.01005.x

4. The Cochrane Database of Systematic Reviews. (2017). Continuous Support for Women During Childbirth. Available at: https://doi.org/10.1002/14651858.CD003766.pub6

5. Journal of Perinatal Education. (2006). Doula Support and Attitudes of Intrapartum Nurses: A Qualitative Study from the Patient's Perspective. Available at:https://pmc.ncbi.nlm.nih.gov/articles/PMC1595283/

6. Indiana Minority Health Coalition. Community Doula Services.  Available at: https://communitydoulaservices.org/

7. March of Dimes. (2023). Position Statement Doulas and Birth Outcomes. Available at: https://www.marchofdimes.org/sites/default/files/2023-04/Doulas-and-birth-outcomes-position-statement-final-January-30.pdf

8. March of Dimes. (2024). Report Card for Indiana. Available at: https://www.marchofdimes.org/peristats/reports/indiana/report-card

Jenna Streit is a communications and marketing professional with 15 years of experience advancing healthcare causes. Originally from Hagerstown, Indiana, she has spent the last decade in Indianapolis, where she’s honed her expertise in storytelling, fundraising, and creating meaningful connections. A self-proclaimed sociology nerd, Jenna is passionate about understanding people and improving systems to better serve them. When she’s not diving into big ideas, she’s likely crafting something by hand or brainstorming a business venture.

Summit Managed Solutions is a management consulting and professional services firm that partners with healthcare organizations across the private, public, and social sectors to create value. By providing comprehensive solution management and inclusive business operation services, Summit helps deliver specific, transformative outcomes. With consulting and managed service offerings, Summit helps partners overcome the critical challenges associated with people, process, and technology, while providing partners with flexibility, reliability, and innovation that will propel growth.