Background/Purpose: The purpose of this critical appraisal of the literature is to discern if there are variations to birth outcomes as a result of having a doula present as a continuous support during labor and delivery. Theoretical/Conceptual Framework: Watson’s (2010) Theory of Human Caring will be the framework for this literature appraisal. Dr. Watson’s theory is founded on holistic care that involves putting a heart-centered caring process into action based upon Watson’s 10 carative factors. Methods: Thirty research articles that were relevant to the scope of variations to birth outcomes as a result of having a doula present as a continuous support during labor and delivery were reviewed. Results/Findings: Doula care resulted in decreased levels of pain and epidural usage, shorter labors, increases in spontaneous vaginal deliveries even when there was an induction of labor, higher Apgar scores at one and five minutes of life, increased rates of breastfeeding within the first hour of life, and an overall higher rating of satisfaction with the birth experience. Doula support also reduced the use of Pitocin, increased exclusive breastfeeding at one month of life, decreased health care disparities for the disadvantaged, and presented significant financial savings. Conclusion: The findings of this critical review of literature support the notion that the use of doula care during labor and delivery results in significant discernable improvement to birthing outcomes across care settings around the world. Implications for Research and Practice: Nurse-midwives are charged with the evaluation and incorporation of scientific evidence into clinical practice in order to provide guidance and counseling to their patients so they can make educated, informed choices. Doula care during labor and delivery, as a practice standard, has the potential to significantly improve birthing outcomes.
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Hunter-Severson, N. I. (2017). Variations to Birth Outcomes with Labor and Delivery Doula Support [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/310