Falconi et al.: Doulas & Mental Health (Lancet eClinicalMedicine, 2022)
57.5% lower odds of postpartum depression. C-sections nearly halved.
57.5% lower odds of postpartum depression/anxiety. During labor specifically: 64.7% reduction. C-section: 18.7% with doula vs 30.7% without.
The Falconi team published a 2022 study in Lancet eClinicalMedicine examining doulas and postpartum mental health. Women who had doula support during pregnancy and labor showed 57.5 percent lower odds of postpartum depression or anxiety. For the women who specifically had a doula present during labor itself, the reduction in PPD/PPA odds was 64.7 percent.
The cesarean rate among women with doula care was 18.7 percent, compared with 30.7 percent without. The study used propensity-score matching to control for the kinds of women who tend to choose doula care, which addresses the obvious selection-bias concern. The results held after adjustment.
57.5%
Lower postpartum depression odds
64.7%
With doula at labor specifically
18.7%
C-section with doula
30.7%
C-section without
Why it matters
The doula effect extends beyond the labor itself. Women who had doula support were dramatically less likely to develop postpartum depression or anxiety, which suggests the protection runs through emotional support across pregnancy, not just the delivery hour.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.