Can virtual doulas help solve the maternal health crisis? Research points to ‘yes’

We are going the wrong direction—that is, in regards to maternal mortality rates, as 2023 numbers showed a terrible trend. US maternal deaths have more than doubled in the last twenty years, with some specific states and races more impacted than others. This isn’t the type of chart we want to top, yet we are the leaders in mothers dying during and after childbirth of the developed nations. So, healthcare professionals and advocates are searching for both root causes, and answers, to save the moms and babies of the future.

A recent study from Maven Clinic showed that virtual doulas hold some promise in this fight. They found that they lower the cesarean section rate by 20%, and neonatal ICU visits by 28%, as well as a 31% reduction in unnecessary ER visits. 

Melissa Dennis, MD, an OB-GYN with Partum Health, says that working with a doula shouldn’t be limited to those who are privileged. “As healthcare deserts become more common, virtual doula care makes working with a birth doula more accessible to a larger population,” she says. The goal of working with a doula is for patients to feel more educated about what’s to come, and therefore empowered to communicate questions and concerns with their care team, she adds. “Doulas also provide means to safely help patients meet their own birthing goals.”

But there are some barriers to ensuring all doulas are properly trained and follow similar protocols across companies and geographical locations. “As virtual doula care is new, there is not yet a standard practice that all doulas follow,” Dr. Dennis adds.

Here’s what to expect from a virtual doula: “During pregnancy, a virtual doula might have prenatal sessions with a family over the phone, Zoom or FaceTime, where the family can discuss their birthing goals and concerns, and education can be provided,” she says. “Birthing preferences can be reviewed and handouts can be shared electronically.  The support a virtual doula provides in labor might consist of texting, phone calls, video chats, video recordings,  and referencing previously shared educational materials.”

The idea that these doulas who are just a text away can reduce actual maternal and newborn outcomes has limited research, but the “benefits appear promising,” Dr. Dennis adds. So far, she says research has shown the following benefits:

• Decreased C-section delivery rate
• Decreased NICU admissions for the baby
• Increased vaginal birth after cesarean delivery (VBAC) rates
• Improved APGAR scores for the baby
• Improved birth experience 

Maven’s study showed that for those who met with the virtual doula more than once, the C-section reduction rate is even greater—at least 60% decreased odds, Maven reports. “If this result can be replicated, it is an incredible step forward for patients who historically have the poorest obstetric outcomes,” she adds. In fact, 80% of maternal deaths are preventable with the right care, the Centers for Disease Control and Prevention report.

“I am not surprised to see that working with a virtual birth doula provides a positive impact.  Much of working with a birth doula centers around education, support, empowerment, and advocacy.  Individuals who work with a birth doula, whether in-person or virtually, are entering their birthing location with a skill set and level of comfort superior to those who do not work with a birth doula,” Dr. Dennis concludes.

Ready to consider a virtual doula?

Here’s how to find one that’s best for you, per Dr. Dennis:

• “When looking for a virtual birth doula, it is important to keep a few things in mind:  How well do I mesh with this individual, do they understand my wishes, and does their offering provide the support I need?”

• “If going through birth with a partner, these questions become a “we” instead of an “I” because a doula interacts with partners quite a bit, especially when the birthing partner is in labor and the support partner needs guidance on how to help best.”  

• “Because there is not a standard for virtual doula care, it is important to clarify how many prenatal visits will occur, what they consist of, what type of education will be provided for later reference, and what, if any, support will be provided during labor.” 

There are multiple platforms offering virtual doula services, such as MajorCare, but you can also ask your local doulas, midwives, OBGYNs, and other moms who they recommend. 

Dr. Dennis hopes that women giving birth in the future won’t see this as a luxury, but the typical experience. 

“I believe that having access to a doula, whether in-person or virtually, should become the standard of care for birthing individuals. Virtual doula care is very exciting as it offers access to those who would otherwise have to go without. I see it as a crucial tool to help improve outcomes and birth equity.”