Doula Programs Improve Cesarean Section Rate, Breastfeeding Initiation, Maternal and Perinatal Outcomes [11P

Abstract

INTRODUCTION: Doula support for socially disadvantaged women during pregnancy, childbirth and postpartum period is associated with improved outcomes, including lower rates of cesarean section, higher rates of breastfeeding initiation, and decreased maternal and perinatal complications. The purpose of our study is to report rates of primary cesarean section rate, breastfeeding initiation, and maternal and perinatal complications among socially or economically disadvantaged pregnant patients enrolled in a doula program in a large inner city setting. METHODS: Retrospective chart review of birth outcomes included primary cesarean section rate, breast feeding initiations, maternal and perinatal complications of patients enrolled in a certified doula support program in a large inner city setting. Outcomes were compared to local states percentages. RESULTS: Three hundred twenty two patients enrolled in the doula support program, 248 delivered vaginally and 74 required a cesarean section (cesarean section rate 22%), breast feeding initiation was reported in 269 patient (83% rate breast feeding initiations) and no maternal or perinatal loss was reported. CONCLUSION: Patients enrolled in a certified doula support programs in an inner city setting have improved cesarean section rates (22% vs 27%), breast feeding initiation rate (83% vs 80%) and improved maternal and perinatal outcomes compared to local state percentages. Our study confirms that pregnancy support by doulas are associated with improved outcomes in socially disadvantaged mothers because of racial disparities and psychosocial factors. Given these benefits certified doula support programs should be an available option during prenatal and postpartum care.