Since the beginning of time, there have been doulas. Long before hospitals and modern medicine, communities relied on the wisdom of experienced caregivers- women who delivered their friends’ babies, who braided hair in between contractions, who held the hand of women and girls giving birth. These caregivers were the earliest doulas. For as long as there has been childbirth, there has been community- and there have been other kinds of doulas, too. The friend who holds your hand while you grieve, who brings you a meal covered in tin foil, who washes your dishes as you rest. There is a doula in the nurse who reassures you, in the person who makes you tea when you’re sick. But today, the way we think of a doula is evolving.

What is a Doula?

In our modern world, we often think of a doula a little differently- the role was born from that same spirit of care, but is now understood to be a trained support person who accompanies women through birth or other life transitions, such as abortion, adoption, loss, fertility journeys, postpartum, and end of life. Doulas offer emotional, practical, and informational support. They may offer educational workshops or classes, and serve as advocates in clinical settings, helping to bridge the space between medical systems and human connection.

While they often collaborate within clinical settings, there is an important distinction to be made: doulas are not medical providers. They do not offer medical care or medical advice, and are not medical practitioners unless otherwise trained. Midwives and doulas are also distinct roles- midwifery refers to the clinical care of individuals during pregnancy, labor, birth, and the postpartum period, including medical assessments and interventions- they are the ones facilitating the birth process. On the other hand, doulas help you to advocate for your preferences and comfort, and provide non-medical emotional, physical, and informational support throughout your birthing experience or other profound transition.

While the role has become more formalized, it remains an extension of that deep, communal instinct to show up for one another. With this evolution comes complexity, as access, equity, and recognition of the doula’s role in clinical spaces continue to shape what this service looks like today. Even as we honor the rich history of doula support, there is still a great need. Maternal health in our country faces a crisis: too many women experience inadequate support and disparities in care.

The Maternal Health Crisis and how Doulas Make a Difference

In today’s world, the presence of a doula makes a profound difference. Doulas provide continuous emotional, practical, and informational support that has been shown to improve clinical outcomes and reduce interventions.This is especially vital when we consider the facts: shockingly, recent statistics revealed that the U.S. has one of the highest maternal mortality rates among developed countries. Black women in the U.S. have a maternal mortality rate that is more than double the national average, and are 49% more likely to receive late or no prenatal care. Statistics from 2023 report that the mortality rate for Black/African American infants was 95% higher than infants nationwide (Office of Minority Health, 2026). And even more disturbingly, many of these maternal and infant deaths have been deemed preventable.

Klaus and Kennell (1997) studied 11 randomized trials. Researchers looked at first-time moms to see if having a trained support person (like a doula) during labor made a difference. They found that it led to shorter labor, less need for pain medication, fewer C-sections, and boosted maternal satisfaction rates after birth. These findings have stood the test of time- research has consistently supported the idea that having doula support yields better birth outcomes and less interventions. In 2024, Kang et al. analyzed nine studies that looked at the effects of doula support on pregnancy, birth, and early parenting outcomes. They found that overall, doula support was linked to higher breastfeeding rates, lower use of pain medication, more respectful care, and some positive effects on preterm birth and cesarean rates- doulas even helped some parents engage in early learning and safety practices for their infants. But, this scoping review also found that many pregnant women of color reported low knowledge of a doula’s role during the pre- and post-partum periods.

If we know that doula services are, to a reasonable extent, a potential anecdote for things like unnecessary interventions and a lack of supportive resources, then it is logical to infer that we should focus our efforts on expanding access to doula care, especially for marginalized groups who are often left out of the conversation. In a time when hospital rooms can feel clinical and overwhelming, doulas bring an extra layer of human connection that every woman deserves. They work as advocates, as witnesses, as companions and educators, to ensure that no one has to navigate their perinatal experiences alone. Doula work is as vital today as it was centuries ago- perhaps even more so.

At CHOICES, we are working to expand access to doula support, and are integrating it into every aspect of the care experience. We believe that every woman deserves to be supported throughout transition- through birth and beyond- guaranteeing dignity and agency in moments of vulnerability. In the words of Dr. John Kennell, “if a doula were a drug, it would be unethical not to use it.”

References

Klaus, M. and Kennell, J. (1997), The doula: an essential ingredient of childbirth rediscovered. Acta Pædiatrica, 86: 1034-1036. https://doi.org/10.1111/j.1651-2227.1997.tb14800.x

Office of Minority Health. (2026). Infant mortality and Black/African Americans. U.S. Department of Health & Human Services. https://minorityhealth.hhs.gov/infant-health-and-mortality-and-blackafrican-americans

Kang, E., Stowe, N., Burton, K. et al. Characterizing the utilization of doula support services among birthing people of color in the United States: a scoping review. BMC Public Health 24, 1588 (2024). https://doi.org/10.1186/s12889-024-19093-6