Continuous support during childbirth may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter labour duration, and reduced caesarean and instrumental vaginal births. Women receiving continuous support were less likely to report negative feelings about their childbirth experience and less likely to use any intrapartum analgesia. They also had a lower likelihood of a baby with a low five-minute Apgar score. No adverse effects of continuous support were identified. Subgroup analyses suggested that continuous support was most effective when provided by a doula and in settings without routine epidural analgesia. Continuous support in settings where women were not allowed to have chosen companions was associated with higher spontaneous vaginal birth rates and lower caesarean birth rates. Continuous support in high- and middle-income countries showed similar benefits, except for caesarean birth, where middle-income countries showed greater reductions. The quality of evidence was low due to study limitations, inconsistency, and imprecision. Future research should focus on longer-term outcomes and include more woman-centred outcomes in low-income settings. Continuous support from a non-family member, such as a doula, may be beneficial. The review highlights the importance of continuous support in improving childbirth experiences and outcomes.Continuous support during childbirth may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter labour duration, and reduced caesarean and instrumental vaginal births. Women receiving continuous support were less likely to report negative feelings about their childbirth experience and less likely to use any intrapartum analgesia. They also had a lower likelihood of a baby with a low five-minute Apgar score. No adverse effects of continuous support were identified. Subgroup analyses suggested that continuous support was most effective when provided by a doula and in settings without routine epidural analgesia. Continuous support in settings where women were not allowed to have chosen companions was associated with higher spontaneous vaginal birth rates and lower caesarean birth rates. Continuous support in high- and middle-income countries showed similar benefits, except for caesarean birth, where middle-income countries showed greater reductions. The quality of evidence was low due to study limitations, inconsistency, and imprecision. Future research should focus on longer-term outcomes and include more woman-centred outcomes in low-income settings. Continuous support from a non-family member, such as a doula, may be beneficial. The review highlights the importance of continuous support in improving childbirth experiences and outcomes.