2025 Theses Master's

Empowering Autonomy: Navigating Challenges in Doula Advocacy in Reproductive Healthcare

Berg, Helen

Doulas are non-clinical birth attendants utilized by women of color to mitigate stressors, such as racism from healthcare providers, while providing physical and emotional support throughout the birthing process.

This study builds on previous research that addresses the positive outcomes of including doulas on birthing teams and complexities within doula-provider relationships. This study aims to ask how do doulas navigate barriers in advocating for their clients’ bodily autonomy in medicalized birthing environments? The goal is to understand the complexities doulas face in the field, and how barriers can ultimately affect their ability to advocate for their clients.

This study uses a qualitative approach, conducting interviews with 5 doulas and analyzing the testimony of 5 doulas through secondary, previously conducted interviews. Across the data set, four key issues I identified: (1) doulas face challenges in integrating into birthing teams and working with healthcare providers; (2) doulas utilize multiple types of strategies to mitigate negative interactions with other health providers; (3) hospitals implementing the Midwifery Model of Care would provide an integrative view on the process of birth and would promote the utilization of birth workers such as doulas, to their practices; (4) policies that support doulas as a career (such as advocating for doula services to be covered by insurance) and recognize the work doulas provide, specifically for women of color, would be beneficial for how doulas are compensated.

The results suggest that there is a need for solutions that would acknowledge the positive outcomes that a doula’s presence provides on births and recognize the importance of doulas on birthing teams notwithstanding their non-clinical status. Additionally, solutions that would help doulas stay economically viable must be created and implemented.