ArticleJournal of racial and ethnic health disparities2026
"Another person who loves you": Reconceptualizing Doula Care by Centering Cultural Competence in the Support of Black Birthing People.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBlack birthing people in the United States face disproportionately high rates of pregnancy-related morbidity and mortality, driven by systemic racism, implicit bias, and inequitable access to quality care. Use of doulas—trained professionals who provide non-medical emotional, physical, and informational support—is associated with improved birth outcomes, but limited research has explored how Black birthing people experience doula care. This study aimed to explore doulas’ support of Black birthing people and how those experiences shape perceptions of care during the perinatal period.
methodsWe conducted a qualitative study with 25 participants enrolled in the Today Not Tomorrow Pregnancy and Infant Support Program, a community-based support group for Black pregnant people in Wisconsin. Data collection included longitudinal individual interviews and focus groups conducted between 2019 and 2022. We used reflexive thematic analysis, guided by Black feminist and decolonizing methodologies, to identify key themes in participants’ narratives.
resultsAnalysis revealed four themes in how doulas supported Black birthing people: (1) emotional support, (2) physical guidance, (3) accessible source of information, and (4) culturally competent care. Participants described doulas as trusted advocates who provided continuity, affirmed their experiences, and helped them navigate healthcare systems often marked by racial bias.
conclusionDoula care offers meaningful support to Black birthing people, particularly when it is culturally competent and community rooted. While not a standalone solution to systemic inequities, doulas represent a promising component of broader efforts to improve perinatal care and reduce racial disparities in pregnancy-related health outcomes.
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