Supporting in solidarity: An examination of social support, advocacy, and barriers among birthing doulas

ABSTRACT Doula assistance before, during, and after childbirth can reduce infant mortality, improve birth outcomes, and ensure a birthing person’s physical and emotional needs are met. However, doula care in the U.S. remains underutilized. Both birthing persons and medical providers may be unaware of the support roles doulas fulfill. The goal of this study is to examine how birth doulas communicate about their role as advocates through the provision of social support and describe the barriers they encounter when doing so. In-depth interviews with 10 doulas showed evidence of indirect advocacy through network, emotional, and tangible support as well as direct advocacy through informational and esteem support. Further, doulas discussed barriers related to the hospital setting, compensation, and accessibility. This study aims to cast light on the ways interpersonal health advocacy and support are intertwined in doula work and consider how doula assistance can be optimized and expanded.