Doula care improves outcomes, lowers costs, and boosts patient satisfaction. But integrating doulas into existing systems requires more than good intentions and simply hiring a few doulas.
Hospitals, clinics, and community health organizations are increasingly adding doulas to their care teams — and for good reason. Doula care improves outcomes, lowers costs, and boosts patient satisfaction. But integrating doulas into existing systems requires more than good intentions and simply hiring a few doulas.
The Evidence Is Clear
According to Dekker’s (2024) review, studies show that continuous labor support from doulas leads to:
- A 39% decrease in the risk of Cesarean birth
- A 15% increase in the likelihood of spontaneous vaginal birth
- Shorter labors and fewer interventions
- 31% decrease in the risk of being dissatisfied with the birth experience
Common Missteps
Some well-meaning programs fail because they:
- Add doulas without clear roles or workflows
- Underestimate training or onboarding needs
- Lack collaboration with nurses or providers
- Treat doulas as volunteers, not professionals
A Readiness Checklist
Before launching, ask:
- Is there support from healthcare providers and staff?
- Has the community been educated on doulas and their scope of practice?
- How will doulas be compensated or contracted?
- Who will provide supervision or mentorship?
- Is there a clear scope of practice?
What Makes Doula Integration Work
The most successful programs don’t just add doulas—they fully support and value them. Integrated models thrive when they:
- Pay doulas fairly through salaries or stipends, recognizing their time and expertise.
- Provide trauma-informed, culturally responsive training that reflects the communities being served.
- Include doulas in care coordination—team huddles—when appropriate, so they’re part of the circle, not outside it. They really are a part of care teams – and should be!
- Measure impact by tracking outcomes and client feedback to show what’s working and what needs to grow.
What Keeps Doula Programs Growing?
Use a diversified funding model that draws on Medicaid/insurance reimbursement (where available), grants, partnerships with managed care organizations (MCOs), foundations, and hospital community benefit funds. Keep those representatives on the planning team.
Final Thoughts
Doula integration is not a checkbox. It’s a shift toward whole-person, culturally-centered care. When done well, it transforms birth experiences for families and care teams alike. Interested in a readiness assessment? Start here (insert document) and let’s talk.
References: Dekker, R. (2024, December 4). Evidence on: Doulas. Evidence Based Birth®
