Survey on Doula Experiences in Navigating the U.S. Healthcare System: Barriers and Challenges

Survey on Doula Experiences in Navigating the U.S. Healthcare System: Barriers and Challenges

In collaboration with Walden University School of Public Health, Shafia Monroe Consulting conducted this survey to shed light on the difficulties and obstacles faced by doulas while working within the American healthcare framework. Conducted in April 2024, this study explores the various barriers doulas encounter, the specific challenges related to collaboration with healthcare providers, and the training needs essential for their effective functioning. By focusing on a diverse sample of doulas, the research provides insights into the systemic issues that impact the integration of doula services into standard healthcare practices.


The study utilized SurveyMonkey to collect data from doulas across various platforms, including Facebook, LinkedIn, and dedicated doula communities. This approach ensured a broad and diverse recruitment of participants. The survey was designed to gather both quantitative and qualitative data, focusing on the challenges doulas face and their training needs. To ensure the validity of the data, pilot testing was conducted, and participant confidentiality was strictly maintained. Transparency and anonymity were prioritized, and responses were used solely for research purposes to derive robust insights into the experiences of doulas.


The survey included doulas ranging from 25 to 75 years old, with the majority identifying as female and one identifying as gender fluid. African American doulas constituted 47.6% of the sample, making them the largest demographic group, followed by Caucasians at 31%, and Latin Americans at 9.5%. The results highlighted significant challenges in collaborating with healthcare providers, including issues related to communication, respect, and integration into the birth team. Additionally, there were substantial concerns about systemic racism and the overuse of medical interventions such as inductions and epidurals.


The findings underscore the complexity of maternal care and the critical role doulas play in advocating for systemic changes. The respondents emphasized the need for better integration of doula services into standard healthcare plans, advocating for Medicaid reimbursement and broader healthcare coverage for doulas. They also called for the establishment of a professional group to standardize doula care, similar to existing medical associations. The results reflect both optimism about potential improvements and ongoing challenges, particularly related to systemic racism and the over-medicalization of childbirth. Recommendations include creating doula-friendly hospitals, ensuring fair compensation for certified doulas, and enhancing the education of healthcare staff about the role of doulas to foster better collaboration and improve maternal care outcomes.


Read the full Survey below.