A qualitative study of doulas providing emotional support during the perinatal period: An unharnessed opportunity in the United States

To address unmet mental health needs, support needs to be integrated into settings where individuals seek care. Doula care during the perinatal period offers a community-based setting for exploring opportunities to promote perinatal mental health. We elucidated doulas’ and perinatal individuals’ views on how doulas can support perinatal mental health through four focus group discussions (FGDs) with doulas (n = 18) and three FGDs with perinatal individuals (n = 10); all participants were living in the United States. Participants reported two main ways doulas can and do support perinatal mental health: first, by acting as a bridge to mental health services and resources, and second, through providing direct emotional support by listening and validating the client’s experiences and emotions. Doulas suggested that because they spend more time interacting with perinatal individuals than most obstetricians, and because they are often seen as an independent third party, they may be more likely to identify social and emotional challenges. However, many doulas indicated they had a lack of formal training in how to provide mental health support and would benefit from additional training. Doulas often provide social and emotional support along with linkage to additional care or resources. Doula FGD participants described a need for additional skills to provide emotional support and to identify when support from a mental health professional is warranted. Doula engagement has the potential to expand support systems to both provide a supportive environment for perinatal individuals and to facilitate prevention and access to treatment for mood disorders. • Doulas can be a critical part of the perinatal mental health support system • Doulas support perinatal mental health directly and indirectly • An increased workforce of doulas trained in mental health is needed