Racquel Washington, MA, Project & Program Coordinator – Community Doula Program, Division of Community & Social Impact, Department of Community Health, Atrium Health 

The role and benefits of doulas  

Doulas are trained professionals who provide physical, emotional, and informational support to individuals and families during pregnancy, childbirth, and postpartum. Unlike medical providers, doulas do not perform clinical tasks but serve as advocates, ensuring that birthing individuals are informed, empowered, and supported throughout their journey. While doula-ing, as I call it, has always been in the background of my life and work, it wasn’t until my own experience with pregnancy, childbirth, and then loss, that I truly stepped into the work.  

Through person-centered care, doulas support improved birth outcomes, enhanced maternal satisfaction, reduced racial disparities, improved mental health outcomes, and increased breastfeeding success. They provide critical emotional, informational, and advocacy support – often becoming like family to the patients they serve. Doulas are there to support mothers as they transition along their individual spectrum of motherhood.  

Why a community-based hospital doula program?  

Research has shown that when people are cared for by people in their own communities, they have better outcomes. While families are not giving birth at home as often as in the past, there are ways to incorporate birth work and traditional midwifery to benefit birthing families. Atrium Health’s RISE Community Doula Program aims to integrate trained doulas into medical settings, ensuring that individuals receive culturally competent, continuous, and community-informed support throughout the entire perinatal period. This program started in April 2025 and serves as a bridge between the medical system and the community, improving trust, communication, and birth experiences.  

The projected benefits of establishing this program extend beyond just improving birth outcomes. Doulas help navigate medical settings, ensuring that individuals can advocate for themselves by understanding their rights, options, and birth preferences. Hospital-based doulas can provide a seamless connection between prenatal, labor, and postpartum support, leading to better overall health outcomes and creating a stronger continuity of care. With fewer medical interventions and complications, doula-supported births often result in shorter hospital stays and cost savings for healthcare systems. In fact, Doulas support a lower cost to birth.  

Challenges in establishing this program  

Just like any new initiative, we have experienced some challenges establishing this program. Some hospitals may be reluctant to incorporate doulas into clinical settings due to concerns about disrupting existing care models. Likewise, some doulas are reluctant to integrate with hospitals. Much of this stems from not understanding each person’s respective roles as an essential part of the care team. As we develop this program our work is grounded in recognizing doulas as an essential part of the care team. While doula care can result in lower health care costs, establishing and maintaining a doula program requires sustainable funding, often needing grants, hospital investments, and community partnerships.  

Policy changes also support this work. Initiatives such as Medicaid expansion to include insurance coverage of doulas services are steps to making doula care accessible. If the program is truly community based, hospitals must prioritize recruiting and onboarding doulas who reflect the diverse backgrounds and lived experiences of the communities they serve. Doulas and medical professionals must work collaboratively, training healthcare staff on the role and benefits of doulas.  

Those closest to “the problem” are also closest to the solution!  

To ensure our program is successful, community led, driven and informed, we established a Community Advisory Board (CAB) to support the development of this program. We recognize that a successful hospital-based doula program must be anchored in community voices. The CAB plays a pivotal role in shaping program priorities, ensuring that services align with the needs and values of the communities they serve. They engage in efforts to elevate and amplify success stories, speak up on concerns most pressing to the community, advocate for the needs of both birthing families and doulas, secure hospital buy-in, and promote systemic support for doulas in medical settings.  

Doulas are an essential part of improving maternal health outcomes and an essential part of the care team. Atrium Health’s RISE Community Doula Program offers an opportunity to bridge the gap between medical institutions and communities. By centering community leadership, overcoming institutional barriers, and securing sustainable support, this model has the potential to create lasting change in maternal health care. Investing in doulas is an investment in health access, dignity, and life-saving care for birthing individuals and families.