Doula care was associated with reduced maternal anxiety and higher breastfeeding initiation in a review of clinical trials.

Background

Poor maternal and infant health outcomes continue to affect many pregnant and postpartum individuals, with particularly pronounced disparities among Black and American Indian or Alaska Native populations. Doula care, which provides non-clinical physical, emotional, and informational support before, during, and after childbirth, has emerged as a strategy to improve birth experiences and outcomes. This systematic review evaluated evidence on how doula care impacted a range of maternal and infant health outcomes.

Findings

This review synthesized evidence from 21 clinical and pilot trials on doula interventions that met inclusion criteria. These studies reported on a range of outcomes, including birth, mental health, child development and parenting, pain, and patient satisfaction outcomes. The quality of evidence was inconsistent overall and varied across outcomes. Doula care was most consistently associated with improved maternal anxiety and higher breastfeeding initiation, with emerging evidence showing improved postpartum follow-up. Outcomes related to pain, delivery model, and birth-related complications were more inconsistent.

Program/Policy Takeaways

Doula interventions, which can vary widely in intensity and scope, are a promising approach to improving infant-maternal health outcomes, especially for some outcomes related to mental health and breastfeeding. Policymakers, health plans, and providers can use this study to help prioritize and target doula services within maternal health programs, particularly where improving maternal well-being and breastfeeding outcomes are key goals.