This case study highlights how culturally matched doula care can support historically marginalized families and identifies lessons for organizations seeking to implement similar programs.

Background

Significant racial disparities in perinatal health outcomes, including maternal and infant mortality and preterm birth, are linked to structural racism and inequities in access to health care, housing, employment, and other social determinants of health. Community-based doulas provide emotional, informational, and advocacy support throughout the perinatal period and may help improve outcomes by delivering culturally responsive care and building trust with families. This case study examines a nonprofit community-based doula program that provides doula care, lactation support, and connections to community resources, highlighting lessons, barriers, and facilitators for organizations seeking to implement similar models.

About this Resource

This resource describes Open Arms Perinatal Services, a nonprofit organization that provides community-based doula and related support services to primarily low-income and historically marginalized families across 10 counties in Washington State. Using a mixed-methods approach that included program data from more than 1,800 families and listening sessions with 25 providers, the study examined implementation, outcomes, and factors influencing program sustainability. Facilitators included holistic, culturally matched services that built trust with families and strong organizational support for doulas. Barriers included limited community resources, structural inequities affecting both families and providers, and power imbalances within birth settings that contributed to challenges for doulas and risk of burnout.

Program/Policy Takeaways

Community-based doula programs can help address persistent racial disparities in perinatal health by providing culturally responsive, person-centered support. In addition to offering emotional and informational guidance, community-based doulas often share cultural backgrounds, lived experiences, or community connections with the families they serve, helping to build trust, strengthen advocacy, and connect individuals to services that support both pregnancy and early parenting. Organizations seeking to develop similar culturally attuned models can draw on the implementation lessons highlighted in this case study, while policymakers may consider community-based doula programs as a strategy to advance equity in perinatal health outcomes.