Yes, dear doulas, you read that correctly.  Yesterday the guidelines for the care of women during pregnancy and birth were revised heavily to address the growing rate of surgical birth for first time mothers in the United States. In those new guidelines, doulas were highlighted as an effective and underutilized solution.

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) joint statement: Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery says this about the effect of labor support:

Increasing women’s access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates.”

Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”

“…the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

Given that there are no associated measurable harms, this resource is probably underutilized.”

DONA Doula Chronicle readers, this goes far to affirm the value of labor support and the impact our presence has on the health and well-being of mothers and babies.

The shout-out to doulas aside, this new joint statement marks a tremendous shift in the guidelines for maternity care and will have profound impacts on the management of pregnancy, labor and delivery.  There is much, much more in this joint statement, including recommendations for labor progression measurement, increasing the length of the second stage including an additional hour of pushing when an epidural is in use, delivery of twins and on and on.   As usual with ACOG and SMFM statements, research is cited throughout and given the authority of these organizations, we can expect that these new guidelines will get a great deal of attention from the maternity care community. To find out more on the Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery:

Read the full statement.

Our friends at Lamaze International have a very nice summary available.

— Adrianne Gordon, CD(DONA)