Community-Based Doulas — Can Clinicians Share Power to Improve Maternal and Infant Health Outcomes?

This perspective article highlights the critical role of community based doulas in addressing racial disparities in maternal and infant health outcomes in the U.S. Black birthing individuals face significantly higher rates of complications and mortality compared to their White counterparts, even after adjusting for socioeconomic factors. The authors argue that integrating doulas trained nonclinical professionals who provide emotional, physical, and advocacy support into perinatal care can improve outcomes such as reduced C section rates, NICU admissions, and preterm births while enhancing patient satisfaction. Despite evidence supporting their benefits, doulas attend only 6% of U.S. births, partly due to lack of insurance reimbursement and clinician reluctance to share decision making authority. The article calls for systemic changes, including Medicaid reimbursement for doula services, hospital policies welcoming doulas, clinician training in collaborative care, and academic reforms to dismantle hierarchical structures in medicine. By fostering partnerships between clinicians and community based doulas, the authors propose a path toward equitable, patient centered maternal care.

This perspective article highlights the critical role of community based doulas in addressing racial disparities in maternal and infant health outcomes in the U.S. Black birthing individuals face significantly higher rates of complications and mortality compared to their White counterparts, even after adjusting for socioeconomic factors. The authors argue that integrating doulas trained nonclinical professionals who provide emotional, physical, and advocacy support into perinatal care can improve outcomes such as reduced C section rates, NICU admissions, and preterm births while enhancing patient satisfaction. Despite evidence supporting their benefits, doulas attend only 6% of U.S. births, partly due to lack of insurance reimbursement and clinician reluctance to share decision making authority. The article calls for systemic changes, including Medicaid reimbursement for doula services, hospital policies welcoming doulas, clinician training in collaborative care, and academic reforms to dismantle hierarchical structures in medicine. By fostering partnerships between clinicians and community based doulas, the authors propose a path toward equitable, patient centered maternal care.