Progress on Doula Access, Persistent Challenges, and Next Steps for Birth Equity

Ensuring access to doula support for pregnant and birthing people in the United States should be a policy priority. Having support from a doula—a trained nonclinical birth worker who provides emotional, physical, and informational support during the perinatal period and for other reproductive health experiences—has been associated with positive health outcomes and high patient satisfaction. For decades, research has demonstrated that doula support during the perinatal period is associated with many desirable perinatal outcomes, including fewer unnecessary cesarean deliveries, fewer preterm births, better birth experiences, and reduced postpartum depression and anxiety. In addition, especially for Black, Indigenous, and People of Color (BIPOC) who give birth, doula support is associated with more autonomy and respect. Doula support has no documented harms and many potential benefits, yet, in a country grappling with a maternal health crisis, most birthing people do not have doula support.