Doula support for perinatal mental health needs: Perspectives on training and practice

Problem: Doulas are perinatal support professionals who increasingly serve parents across socioeconomic levels in the U.S. Although present during a time of significant emotional upheaval, doulas receive limited training in emotional support.

Background: Research suggests that brief clinical trainings for health professionals can prevent or alleviate depressive symptoms in women of all demographics. Such training has not been extended to doulas, who may be uniquely positioned to address perinatal mood and anxiety disorders (PMADs).

Aim: To understand doulas' perception of their clients' emotional support needs, their desire for further training in emotional support, and their training format preferences.

Methods: We surveyed birth, postpartum, and community doulas across the U.S., recruiting participants via email and social media.

Findings: Doulas (n = 252) overwhelmingly desired more training in emotional support. Nearly all doulas perceived symptoms of emotional distress in their clients and endorsed moderate-to-high frequencies thereof. Doulas expressed a preference for in-person training incorporated into foundational doula training workshops, primarily to gain skills to prevent or address anxiety and depression.

Discussion: Clinical training for doulas may help mitigate the perinatal mental health treatment gap and address doulas' self-reported training needs. Such a training would a) build skills in addressing and preventing symptoms of emotional distress, and b) refine doulas' sensitivity to clients' mental health referral needs, furthering doulas' impact while remaining within their scope of certification.

Conclusion: As doula services become more financially accessible in the U.S., training doulas in emotional support techniques may contribute to maternal mental health equity.