Seattle’s Child: New study: Doulas’ role supporting mental health

But more mental health training for doulas is needed

By Cheryl Murfin / March 8, 2024

A new study from the University of Washington suggests that community-based doulas—providers who share cultural and language congruence with the pregnant or postpartum people they serve—can play an important role in helping their clients navigate substance abuse and mental health challenges like depression, anxiety, post-traumatic stress disorder, and psychosis.

A case for mental health training for doulas

Giving doulas the mental health training they need to understand and support a client’s emotional and psychological well-being just makes sense, according to the study from the university’s Perinatal Mental Health & Substance Use Education, Research & Clinical Consultation (PERC) Center. Why? Study authors found that most doulas already support the mental health and well-being of pregnant and postpartum clients in several different ways, including “addressing barriers to mental health treatment that may be unique to underserved populations.”

The researchers worked with Seattle-based nonprofit Open Arms Perinatal Services, which offers community-based doula services and other support to families with limited income, to find participants for the small study. In total, nine doulas affiliated with Open Arms or other doula practices in western Washington and 10 postpartum parents participated in the small study. Five of those parents were Spanish-speaking.

Doula synergy and access to care

The researchers found that the synergy of culture, language and shared experiences of community-based doula care can positive doula-client relationships and could potentially increase access to perinatal mental health care.

“The study highlights that varying cultural attitudes towards mental health issues, as well as socio-economic challenges, are significant obstacles but underscores that doulas with shared cultural identities can break down these barriers, facilitating increased access to screening and treatment,” Open Arms spokesperson Elena M. Teare write this week in a release. Open Arms has been providing free pregnancy, birth, lactation, early childhood support, and social services referrals since 1997.

Addressing BIPOC maternal health disparities

According to the U.S. Centers for Disease Control and Prevention (CDC), maternal mental illness is the leading cause of pregnancy-related deaths in the United States. Among high-income nations, the U.S. has some of the poorest maternal and infant health outcomes, with alarming disparities among BIPOC parents. Culturally connected doula support aims to close that gap.

The PERC researchers noted the dearth of perinatal mental health training for doulas and raised concerns about whether providing mental health support fits within a doula’s scope of practice. At the same time, they stressed that as lawmakers in several states, including Washington, fight to add doula care to the list of services covered by Medicaid, now is the time to consider providing that training to doulas.

Community voices are critical to closing the gap

“This could be an inflection point for better coordination between healthcare and community-based systems and an opportunity to decrease inequities in [perinatal mental health] and [substance use disorder] treatment,” the authors concluded. “With adequate support and training, doulas can play an important role in supporting their clients’ emotional well-being.”

“Centering community voices is crucial when working on solutions to expand inclusive perinatal care pathways,” said Joanne Quiray, the study’s lead author. “In simple terms, our study asks doulas and clients, ‘What are you currently doing? What do you need to thrive?’”

‘Demonstrates what we have known’

Along with its questions, the new study points to action: With appropriate training and support, doulas, especially community-based doulas who share a culture and language with their clients, can be “instrumental in connecting at-risk birthing individuals of color with essential mental health and substance use disorder treatment.”

Dila Perera, Open Arms executive director, said in a release that the research affirms the longtime work of the organization.

“This study demonstrates what we have known through our work, which is that trusted birth doulas have the capacity to help identify mental health concerns and form the trusting relationships necessary to help pregnant and parenting families reach out for life-changing support,” Perera said.

Read the Original Article in Seattle’s Child. 

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