That makes sense on the surface, but it's not that simple. Even randomized trials show that having a doula or a "lay doula" will improve outcomes for mothers and babies.
Having continuous support leads to a better birth experience, and there's plenty of evidence to back up that assertion. See below.
Here's a randomized control trial:
http://onlinelibrary.wiley.com/doi/10.1111/j.1552-6909.2006.00067.x/abstract?userIsAuthenticated=false&deniedAccessCustomisedMessage=Objective: To compare labor outcomes in women accompanied by an additional support person (doula group) with outcomes in women who did not have this additional support person (control group).
Design: Randomized controlled trial.
Setting: A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey.
Patients/participants: Six hundred nulliparous women carrying a singleton pregnancy who had a low-risk pregnancy at the time of enrollment and were able to identify a female friend or family member willing to act as their lay doula.
Interventions: The doula group was taught traditional doula supportive techniques in two 2-hour sessions.
Main Outcome Measures: Length of labor, type of delivery, type and timing of analgesia/anesthesia, and Apgar scores.
Results: Significantly shorter length of labor in the doula group, greater cervical dilation at the time of epidural anesthesia, and higher Apgar scores at both 1 and 5 minutes. Differences did not reach statistical significance in type of analgesia/anesthesia or cesarean delivery despite a trend toward lower cesarean delivery rates in the doula group.
Conclusion: Providing low-income pregnant women with the option to choose a female friend who has received lay doula training and will act as doula during labor, along with other family members, shortens the labor process. JOGNN, 35, 456–464; 2006. DOI: 10.1111/J.1552-6909.2006.00067.x
See these articles:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301201Objectives. We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings.
Methods. We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279 008) and births supported by doula care (n = 1079) in Minneapolis, Minnesota, in 2010 to 2012; used multivariate regression to estimate impacts of doula care; and modeled potential cost savings associated with reductions in cesarean delivery for doula-supported births.
Results. The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, odds of cesarean delivery were 40.9% lower for doula-supported births (adjusted odds ratio = 0.59; P < .001). Potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial but depend on states’ reimbursement rates, birth volume, and current cesarean rates.
Conclusions. State Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.
Read More:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301201http://onlinelibrary.wiley.com/doi/10.1177/0884217502239209Birth outcomes;Infant outcomes;Labor support;Maternal outcomes
Supportive care and childbirth have been connected for all of recorded history. The impact of supportive care on health outcomes, however, has only been investigated over the last few decades. Research provides powerful evidence of improved outcomes for mothers and babies when mothers are supported in labor. These outcomes include, but are not limited to, lower rates of analgesia and anesthesia use, lower operative birth rates, shorter labors, fewer newborns with 5-minute Apgar scores less than 7, increased maternal satisfaction with the birthing process, and much more. Intrapartum nurses must be knowledgeable of the research that is directly related to critical aspects of their care, such as labor support. This article provides an overview of the quantitative research related to the effect of labor support on birth and maternal and fetal outcomes during childbirth. By understanding and applying this research in clinical practice, bedside nurses may improve outcomes and transform intrapartum care.