Across the nation, doulas from marginalized communities are leading a quiet revolution.
Across the nation, doulas from marginalized communities are leading a quiet revolution. They are reclaiming birthwork as a form of community care, cultural healing, and grassroots public health.
Why Representation Matters
Let’s be real—giving birth in the U.S. isn’t always the joyful experience it should be, especially for Black, Indigenous, and other marginalized communities. Even with all our medical advances, we’re still struggling with serious gaps in maternal health outcomes. Too many families are navigating birth and postpartum without the culturally sensitive care they deserve—and the numbers reflect it. Black and Indigenous birthing people continue to face much higher rates of maternal complications and even death (Petersen et al., 2019).
But here’s the hopeful part: when families are supported by people who understand their culture, language, and lived experiences, outcomes can—and do—get better. That’s where community-centered doulas come in. These doulas aren’t just birth workers; they’re trusted guides who walk alongside families with compassion, advocacy, and deep connection. The research backs it up too—care that’s culturally aligned and community-rooted helps improve both experiences and outcomes (Guglielminotti et al., 2022). It’s one of the most powerful tools we have to close the gap and bring dignity and equity back to the birthing experience.
From Training to Transformation
It’s not merely about increasing the number of doulas. It’s about who gets trained and how. Programs that prioritize accessibility, cultural humility, and mentorship foster long-term retention and local leadership. Building in a system of support for those birthworkers also leads to longevity and the creation of pillars within the community.
What Community-Led Birthwork Needs to Thrive
It’s not merely about increasing the number of doulas. It’s about who gets trained and how. Programs that prioritize accessibility, cultural humility, and mentorship foster long-term retention and local leadership. Building in a system of support for those birthworkers also leads to longevity and the creation of pillars within the community.
What Community-Led Birthwork Needs to Thrive
For community doulas to truly succeed and make lasting change, they need real support—not just encouragement. That means:
- Paid apprenticeships and mentorship
So new doulas can learn while earning, not volunteer endlessly. - Affordable, accessible certification and ongoing training
Because the path to becoming a doula shouldn’t be limited by cost or location. - Supportive networks and business tools
Doulas need community and systems that help them build sustainable practices. - A seat at the policy table
Community doulas should be included in shaping maternal health policies—not left out of the conversation.
The Role of Organizations
Organizations and systems have a big part to play in making sure community-led birthwork can thrive. Health departments, hospitals, funders, and training programs can be powerful allies when they commit to more than just words. Here are a few ways they can step up:
- Invest in locally rooted training programs that center culture, lived experience, and accessibility.
- Create clear pathways to certification and sustainable employment so doulas aren’t just trained—they’re hired and valued.
- Include doulas in decision-making and evaluation, not just as providers, but as partners shaping the future of maternal care.
Final Thoughts
When birthwork is led by the community, families feel seen, respected, and empowered. The community THRIVES! The future isn’t about outsourcing care or creating yet ANOTHER program—it’s about returning power it to the people who know their communities best. Join us in building that future.
References:
Guglielminotti, J., Samari, G., Friedman, A. M., Lee, A., Landau, R., & Li, G. (2022). Nurse workforce diversity and reduced risk of severe adverse maternal outcomes. American Journal of Obstetrics & Gynecology MFM, 4(5), 100689. https://doi.org/10.1016/j.ajogmf.2022.100689
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Syverson, C., Seed, K., Shapiro-Mendoza, C., Callaghan, W. M., & Barfield, W. (2019). Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016. MMWR Morbidity and Mortality Weekly Report, 68(35), 762–765. https://doi.org/10.15585/mmwr.mm6835a3
