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Continuous labor support from doulas, nurses, or midwives improves maternal outcomes and labor progressionContinuous Labor Support Improves Outcomes for Women in Labor

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Key Takeaway
Consider continuous labor support from doulas or midwives to improve maternal outcomes and labor progression.

This systematic review synthesizes evidence regarding the impact of continuous labor support provided by doulas, nurses, or midwives for women in labor. The review evaluates several outcomes, including labor duration, obstetric interventions, maternal satisfaction, and neonatal outcomes such as Apgar scores and NICU admission.

The authors conclude that continuous support is associated with positive maternal outcomes, including increased spontaneous vaginal birth, reduced cesarean delivery, and improved breastfeeding initiation. Specifically, midwife-led support was associated with favorable effects on labor progression, while community-based doula programs were noted to benefit socially disadvantaged and migrant women by improving access to culturally responsive care. Neonatal outcomes generally showed positive trends, though findings regarding Apgar scores and NICU admission were less consistent across the included studies.

Several limitations are noted, including significant heterogeneity among intervention models and outcome measures, which limits direct comparisons between studies. Furthermore, the evidence specifically regarding nurse-led continuous labor support remains limited. These findings suggest that continuous labor support is a woman-centered strategy for improving childbirth experiences, though the strength of evidence varies by provider type and specific neonatal metrics.

A review of existing research looked at how continuous support during labor affects mothers and babies. This support can come from various providers, including doulas, nurses, or midwives. The study looked at several outcomes, including the length of labor, the type of birth, and how satisfied mothers felt with their experience.

The findings suggest that women who received continuous support saw more spontaneous vaginal births and fewer cesarean deliveries. These women also experienced shorter labor durations and used fewer medical interventions. Additionally, there were positive trends for breastfeeding initiation and maternal satisfaction. For women from disadvantaged backgrounds or migrant communities, doula programs were noted for providing culturally responsive care.

It is important to note that the evidence for nurse-led support specifically was limited. Also, results regarding baby health, such as Apgar scores and the need for intensive care, were less consistent across the studies. Because different programs used different methods, it is hard to compare them directly. These findings suggest that continuous support is a helpful strategy for a more positive birth experience.

What this means for you:
Continuous support from doulas, nurses, or midwives may improve labor duration and maternal satisfaction.

Common questions

What kind of support helps during labor?

Continuous support can be provided by doulas, nurses, or midwives. This type of support is considered a woman-centered strategy. It can help improve the overall experience of childbirth and may lead to shorter labor times and a lower use of medical interventions.

How does support affect the type of birth?

The review found that continuous support was linked to an increased rate of spontaneous vaginal births and a reduction in cesarean deliveries. These results suggest that having a continuous support person may help with labor progression and the choice of birth method.

Are there specific benefits for different groups?

Community-based doula programs were found to be especially helpful for socially disadvantaged and migrant women. These programs can improve access to culturally responsive maternity care, which helps ensure that the care provided meets the specific needs of the mother.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Continuous labor support provided by doulas, nurses, or midwives is increasingly recognized as an important component of respectful, woman-centered maternity care. Evidence suggests that continuous support during labor may improve maternal and neonatal outcomes by enhancing emotional support, facilitating labor progress, and reducing unnecessary obstetric interventions. However, variations in intervention models and healthcare settings have resulted in inconsistent findings regarding the effectiveness of different support providers. This systematic review aimed to evaluate the impact of continuous labor support provided by doulas, nurses, or midwives on maternal and neonatal outcomes and to identify current evidence gaps to inform clinical practice and future research. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic searches were performed in PubMed, CINAHL, and Web of Science to identify eligible studies published between January 2008 and December 2025. Only peer-reviewed primary empirical studies published in English were included. Eligible studies evaluated continuous labor support provided by doulas, nurses, midwives, or trained birth companions and reported maternal and/or neonatal outcomes. Sixteen studies met the inclusion criteria. Data were synthesized narratively according to study characteristics, intervention type, and reported outcomes. Overall, continuous labor support was associated with improved maternal and selected neonatal outcomes across diverse healthcare settings. The most consistent maternal benefits included increased spontaneous vaginal birth, reduced cesarean delivery, shorter labor duration, lower use of obstetric interventions, improved maternal satisfaction, and enhanced breastfeeding initiation. Midwife-led continuous support demonstrated favorable effects on labor progression, whereas community-based doula programs showed particular benefits for socially disadvantaged and migrant women by improving access to culturally responsive maternity care. Evidence regarding nurse-led continuous labor support remained limited. Although neonatal outcomes generally showed positive trends, findings for Apgar scores and neonatal intensive care unit admission were less consistent across studies. Continuous labor support appears to be an effective, woman-centered strategy for improving childbirth outcomes and maternal experiences. Integrating doulas, nurses, and midwives into models of continuous labor support may contribute to reducing unnecessary obstetric interventions and promoting respectful maternity care. However, heterogeneity among intervention models and outcome measures limits direct comparison between studies. Future research should prioritize high-quality comparative trials evaluating different support providers, particularly nurse-led models, and investigate long-term maternal and neonatal outcomes.
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