Midwifery Care and Doula Support for Black Women in the United States: A Systematic Review of Maternal, Birth, and Infant Outcomes.

Black women in the United States face significant maternal and birth disparities, including high rates of mortality and morbidity. Midwifery care and doula support are promising sources of support for Black women and have been associated with improved maternal, birth, and infant outcomes; however, population-specific research is limited. This systematic review examined and synthesized findings across the literature on the impacts of midwifery care and doula support associated with Black maternal and birth outcomes in the United States. Peer-reviewed studies assessing any maternal, birth, or infant outcomes associated with midwifery care and/or doula support among Black women were searched via seven databases (CINAHL, Embase, Medline Ovid, PubMed, PsycINFO, Scopus, and Web of Science) in January and November 2025. Reference lists were also manually reviewed. Articles with samples less than 50% Black or where Black participants were not the largest group were excluded. The final sample included 16 studies assessing midwifery care (n = 6) and doula support (n = 10). Midwifery care was associated with prenatal care utilization, improvements in preterm birth, low birthweight, and breastfeeding. Doula support fostered positive care experiences, was associated with improvements in preterm birth, cesarean delivery, low birthweight, and breastfeeding initiation, and could lead to economic savings across the United States. However, existing literature on the maternal, birth, and infant impacts of midwifery care and doula support among Black women remains severely limited. Support of Black women through perinatal midwifery care and doula support may improve outcomes, though further examination in this population is critical.