Efficacy of continuous labor support, 2017 meta-analysis

Outcome	Continuous labor support (eg, doula) versus usual care: Relative risk (95% CI)
Increase in spontaneous vaginal births	1.08 (1.04-1.12)
Reduction in cesarean delivery	0.75 (0.64-0.88)
Reduction in need of medication for pain relief	0.90 (0.84-0.96)
Reduction in use of epidural anesthesia	0.93 (0.88-0.99)
Reduction in instrumented vaginal delivery	0.90 (0.85-0.96)
Reduction in low five-minute Apgar scores	0.62 (0.46-0.85)
Reduction in negative childbirth experiences	0.69 (0.59-0.79)
Reduction in length of labor	Weighted mean difference: 0.69 hours (–1.04 to –0.34)

The overall quality of evidence was low for each outcome.

Data from: Bohren MA, Hofmeyr GJ, Sakala C, et al. Continuous support for women during childbirth. Cochrane Database Syst Rev 2017; 7:CD003766.

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