New U of M Study Links using a Doula and Reduction in C-Sections

Updated: 08/30/2014 8:37 AM By: Kate Renner

Photo: Photo: KSTP-TV

Having someone by your side could be a big help for pregnant women.

A new University of Minnesota study found that having a doula, or birth coach, in the delivery room can lower a mother's chances of having a cesarean section. Over the past two decades, c-section rates have jumped from a little more than 20 percent to a record 33 percent of births.

The study released Friday by the U of M School of Public Health says there is one clear factor that leads to a reduction in c-section rates: hiring a doula to coach and advise women in labor.

"If you have some kind of fear, it can actually physically hold you back, so we can help moms work through those fears in the moment," said Erin Stertz-Follett, a certified doula, and owner of Flutterby Birth.

Before Stertz-Follett was a doula, or even a mom, she witnessed what she calls a traumatic birth. Her sister was put under for a medically unnecessary c-section.

"You have those visions of meeting your baby for the first time, and you get to hold your baby and have this moment, and she didn't have that. We saw her baby first," said Stertz-Follett.

The latest study from the U of M School of Public Health validates Stertz-Follett's skill-set.

The study found when comparing women with a doula to women without a doula in the delivery room, the presence of a doula at birth was linked to an almost 60 percent reduction in women's odds of having a c-section.

There are a variety of reasons a c-section might be considered not medically necessary.

"Something like wanting to delivery with a particular provider or wanting to control the timing of labor and delivery were not considered medically necessary," said Katy Kozhimannil, the study's author and assistant professor at the U of M School of Public Policy.

For those cases, a doula's presence lowered the odds of having a non-medically necessary c-section by 80 percent.

In 2008, the World Health Organization estimated that 3.2 million cesarean sections across the globe were medically necessary but that 6.2 million cesarean sections were not medically necessary.

C-sections cost about $10,000 more than a vaginal birth. The study's author thinks its findings could encourage insurance companies to take a second look at covering a doula's services.

"I think it's an impetus for health care and especially health insurance companies, to really look at, are there ways they can really increase access to this service among women they insure, and would that help allow for a better birth experience," said Kozhimannil.

Stertz-Follett says, compared to the one-in-3 women nationally who have c-sections, approximately 20% of the moms served through Flutterby in Burnsville birthed via cesarean.

The average cost for a doula's services in the Twin Cities is between $500 and $1,000. Most HSA's and FSA's can be used to pay for this.

The American College of Obstetrics and Gynecologists released a statement this year, saying the quick jump in c-sections raises concerns the surgery is overused. The statement also said, giving women more access to non-medical continuous support like a doula has been shown to cut down on c-section rates.