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Seeing a doula—a nonclinically trained professional who provides labor guidance and support—even virtually can improve birth outcomes and reduce a person’s likelihood of requiring a cesarean section (C-section), according to new research from digital family health platform Maven Clinic.
The study, published in the journal Obstetrics and Gynecology on December 6, examined birthing data from nearly 9,000 Maven members. Researchers found similar rates of C-sections between individuals who saw doulas in person or online, suggesting that virtual visits can also affect birth outcomes and experiences.
Kate Ryder, founder and CEO of Maven, which uses doulas in its care model, said the findings reaffirm “that virtual doulas have a critical role to play in driving better maternal health outcomes.”
The benefits of doula care were more pronounced among Black birthing people, who saw their odds of requiring a C-section fall by almost 60% after two or more visits, the study found. That compares to an almost 20% drop among all individuals who attended at least two doula appointments during their pregnancies.
People who previously had C-sections but met with a doula at least twice, meanwhile, also saw their odds of needing the procedure again fall by more than 60%, according to the study.
With about a third of all live births in the US involving C-sections—a procedure that can cost on average $5,000+ more than vaginal birth—increasing access to doula care could help save the health industry millions, Maven executives noted in an email.
Beyond costs, the research suggests doulas could make births safer, as patients who deliver via C-section—even when planned—are more likely to face birth-related complications and death than those who deliver vaginally.
Despite the findings, doulas—who are regularly used in other parts of the world—remain largely uncommon in the US, supporting only about 6% of births thanks to lagging insurance coverage, costs, and other factors, federal health officials noted in a December 2022 health brief.
“The evidence on the benefits of doulas has been clear for decades, but the challenge has always been that communities who need them most are seldom able to access them,” Neel Shah, Maven’s chief medical officer, said in a statement. “It is encouraging that virtual access to doulas can have such a profound impact on birth experiences and outcomes, particularly among Black mothers who are made most vulnerable by inequities in our system.”