New Research: Doula Support Reduces Odds of Cesarean Section by 40%

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A new study entitled Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries” was released online last week in the American Journal of Public Health and is creating quite a stir within the childbirth community nationwide.  Paired with National Birth Center Study II, released last month by the Journal of Midwifery and Women’s Health,  it seems that the movement toward more choices in maternity care is gaining strength.  The National Birth Center Study provided evidence for increased access to midwifery care and birth centers by showing that women who receive care at midwife-led birth centers incur lower medical costs and are less likely to have cesarean births compared to women who give birth at hospitals.

The new study on doula care compared childbirth outcomes of women insured by Medicaid who received doula support to those who did not.  Researchers at the University of Minnesota School of Public Health found that doula support reduced a woman’s odds of giving birth via Cesarean section by more than 40%.  They also found a decrease in preterm births of almost 20% in the doula supported group.

Past research has shown that doula support results in other positive birth outcomes, such as:

  • Increased initiation and duration of breastfeeding
  • Shorter labors
  • Less need for anesthesia or analgesia
  • Fewer vacuum and/or forceps births
  • Higher APGAR scores
  • Better mother-baby bonding
  • Less postpartum depression

The study goes on to discuss the possible cost savings to Medicaid programs if they were to provide reimbursement for doula services, since Cesarean sections are approximately 50% more expensive than vaginal births.  The researchers are hesitant to provide concrete numbers because costs and associated benefits would vary widely by state.

But since blogs aren’t held to the same high standards that research articles are, we decided to come up with a very approximate estimate, just for curiosity’s sake.

Number of births in US per year
Estimated Percent of US births covered by Medicaid
Estimated Number of US births covered by Medicaid
US Cesarean section rate (2010)
Estimated number of Medicaid-covered Cesarean sections in US
Percent of Cesarean sections prevented with doula support
Number of cesarean sections preventable through doula utilization
Difference in cost between Cesarean section and vaginal birth
Resulting savings to Medicaid programs per year
3,999,386
46%
1,839,718
32.8%
603,428
40.9%
246,802
$4,500
$1.1B

This very rough sketch of the money that Medicaid programs would save if every mother had access to doula support doesn’t take into account the considerable cost of providing that support.  If Medicaid reimbursed for doula care at $500, and offered support to every mom, the cost would be about $920M.  That would still yield a net savings, after reimbursement, of nearly $200M.  Not to mention all those better outcomes for mom and baby.

This seems (to us) to be one of those wonderfully poised, win-win initiatives that leads to both happier, healthier moms and babies and cost savings for a taxpayer-funded program.  What would happen if there was a campaign in every state to bring this issue to the forefront and get doulas for all women?  And are you willing to help?

Watch CiC’s Executive Director, Elan McAllister, discussing doula care on Huffington Post LIVE

Article Citation:

Backes Kozhimannil, K., Hardeman, R., Attanasio, L., Blauer-Peterson, C., & O’Brien, M.  (2013). Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries. American Journal of Public Health. e-View Ahead of Print.  doi: 10.2105/AJPH.2012.301201

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6 Responses to “New Research: Doula Support Reduces Odds of Cesarean Section by 40%”

  1. Joy In Birthing Presents: Amore Mamma Amore Mio In Greece | Says:

    […] New Research: Doula Support Reduces Odds of Cesarean Section by 40% (choicesinchildbirth.wordpress.com) […]

  2. Doula Support Reduces Odds of Cesarean Section by 40% | Lotus Midwifery • Rowen Holland, LM, CPM Says:

    […] How can doula support lower the Cesarean rate?  Read this new study entitled “Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries” […]

  3. 5 Easy Ways to Boost Your Labor Confidence – Mothering Community | Just My Bump Says:

    […] New Research: Doula Support Reduces Odds of Cesarean Section by 40% […]

  4. 6 Ways to Avoid a Cesarean Section - Says:

    […] help you to avoid cesarean birth.  Did you know that having a doula as your support person can reduce your chance of cesarean section by over 40%?  Doulas are trained in relaxation techniques, massage, positioning, and birth information.  A […]

  5. The rate of C-section births causes concern for medical professionalsBig Online News | Big Online News Says:

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    New Research: Doula Support Reduces Odds of Cesarean Section by 40% | Choicesinchildbirth

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