Evidence and Data on Doula Care
Doula care can help families feel more prepared, supported, respected, and informed. This page summarizes the public health case for doula care and community-based doula models.
Plain-language summary
Doulas are not medical providers. They provide emotional, physical, informational, and navigation support. Research has linked doula support with improved birth experiences, stronger communication, and better support before, during, and after birth.
25% lower relative risk of cesarean birth
A Cochrane review of continuous one-to-one labor support found a cesarean relative risk of 0.75 compared with usual care. This finding applies to continuous labor support broadly; studies included support from doulas and other support people
31% lower relative risk of a negative birth experience
People receiving continuous labor support were less likely to report negative feelings about their childbirth experience.
8% more likely to have a spontaneous vaginal birth
Continuous labor support was associated with a modest but meaningful increase in spontaneous vaginal birth and a 10% lower relative risk of operative vaginal birth
About 41 minutes shorter labor, on average
Across 13 trials, continuous support was associated with labor that was approximately 0.69 hours shorter. Individual experiences vary substantially.
29% lower risk of preterm birth among Medicaid members
A 2024 matched observational study of 722 doula-supported Medicaid pregnancies and 722 comparison pregnancies found doula care was associated with a 29% lower risk of preterm birth.
46% more likely to attend a postpartum checkup
The same national Medicaid study found that doula-supported members were 46% more likely to complete a timely postpartum checkup.
Greater odds of respectful care for Black and Medicaid-covered patients
In a California survey, doula support was associated with 2.7 times the odds of high respectful maternity care among Black respondents and 1.8 times the odds among Medi-Cal respondents. Respectful care included communication, support, and participation in decision-making
Citation area
March of Dimes. (2026). Community birthworkers in the United States [Position statement].
National Partnership for Women & Families. (2022, September). Improving our maternity care now through doula support. Developed in collaboration with HealthConnect One, the National Health Law Program, and Tewa Women United.
Zephyrin, L. C., Seervai, S., Lewis, C., & Katon, J. G. (2021, March 4). Community-based models to improve maternal health outcomes and promote health equity. The Commonwealth Fund. https://doi.org/10.26099/6s6k-5330
National Academies of Sciences, Engineering, and Medicine. (2020). Birth settings in America: Outcomes, quality, access, and choice. The National Academies Press. https://doi.org/10.17226/25636