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Doulas' Experiences Addressing Maternal Mental Health and Substance Use Challenges in the Rural Deep South: A
Madison D Haiman1, Karen A Johnson2, Holly Horan3
1Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA.
The Journal of Perinatal Education
|November 20, 2025
Summary
Doulas support rural mothers facing mental health and substance use issues, a growing crisis. This study highlights doulas
Area of Science:
- Maternal Health
- Public Health
- Qualitative Research
Background:
- Maternal mental health and substance use significantly contribute to the U.S. maternal health crisis.
- Rural women face greater risks for these challenges.
- Doulas offer potential support for rural birthing persons.
Purpose of the Study:
- To examine the experiences of doulas supporting rural clients with mental health and substance use challenges.
- To explore how doulas address these issues within the rural context.
- To expand existing frameworks on doula support.
Main Methods:
- Qualitative research approach.
- Semistructured interviews with nine actively practicing doulas in Alabama.
- Deductive and inductive coding of interview transcripts.
Main Results:
- Doulas actively assist clients with mental health and substance use concerns.
- A conceptual framework can be expanded to illustrate doula support mechanisms.
- Rural residency presents significant barriers to maternal care, including mental health and substance use services.
Conclusions:
- Doulas are a valuable resource for rural birthing persons in Alabama.
- Doulas can play a role in mitigating the maternal mental health and substance use crisis in rural areas.
- Addressing rural barriers is crucial for improving maternal health outcomes.
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