142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Investing in Doulas: A Cost-Benefit Analysis

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Theresa Hunter, MPH, MS , School of Public Health, Indiana University, Bloomington, IN
Background: The C-section rate in the U.S. rose approximately 60% from 1997- 2011. The cesarean prevention movement grew from this concern, and women who wanted to avoid C-sections were encouraged to have a labor advocate or doula whose purpose was to help them avoid routine procedures that could lead to a C-section.

Methods: 254 first-time mothers who delivered a baby between 2009 and 2013 in Indiana filled out a survey which consisted of various questions related to childbirth experiences and health outcomes. Statistical analyses were completed to compare the various health service costs and childbirth experiences between women who had a doula and those that did not have a doula. Comparisons were calculated on the following childbirth experiences: vaginal birth vs. cesarean birth, induction rate, pain medication use, weeks of gestation, length of hospital stay, and breastfeeding rates after delivery.

Results: The results indicated that 95% of first-time mothers that has a doula present had a vaginal birth. Vaginal birth rate among first-time mothers who did not have a doula present was only 68%.  Women who had a cesarean birth were more likely to stay in the hospital longer than those who had a vaginal birth. In regards to pain medication, epidurals were given to 34% of mothers who had a doula present and 72% of mothers who did not have a doula present.

Conclusions: Overall this study found that women who have a doula present at the time of delivery had better childbirth experiences than those who did not.

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Public health or related education
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the Return on Investment of incorporating doulas into the childbirth process. Compare the differences in birthing outcomes between women who use a doula and those who do not. Describe the benefits of using a doula.

Keyword(s): Maternal and Child Health, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have several years of experience working in the field of Maternal and Child Health programs. I am engaged in research related to maternal services and childbirth outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.