Introducing a baby into your life is, no doubt, an expensive prospect. Why among the many costs of this exciting event did I choose to spend $1500 additional on hiring a doula? Because a doula is essentially a patient advocate.
I am a nurse and have participated in many births myself, however I know that when I become the patient, I will no longer be able to be able to take on the role of advocate for myself. From my personal experience, this is the time to invite a trusted person in to act in this role.
What sealed this decision for me with ease was the evidenced based outcomes. In 2017, Bohren et al.1 published an updated Cochrane review that combined the results of 26 trials including over 15,000 patients in total. They found that the presence of a doula reduced the chance of a C-section by 39%. Furthermore, they found the continuous support to the laboring mother showed shorter labor times by 40 minutes, 10% reduction in use of medications, and 38% decrease in the baby’s risk of a low five minute Apgar score.
My risk of having a C-section just went from 1 in 3 to 1 in 5. I will take those odds! With that small pivot, I have also avoided the further risks that come along with C-section: Infection, hemorrhage, and surgical injury. I will have a shorter recovery time and less pain.
Could we not extrapolate from this data that continuous support during hospitalization or illness could provide better outcomes significantly for patients?
Yes, this is a significant upfront cost, but I believe I will save the money (and furthermore my health, and overall experience) in excess of the upfront cost.
Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766. Published 2017 Jul 6. doi:10.1002/14651858.CD003766.pub6 ↩