The Doula's Role in Reducing Postpartum Depression: A Narrative Review

Postpartum depression (PPD) affects 10% to 20% of mothers, with higher rates among marginalized communities. Mental health issues contribute to 22.7% of pregnancy-related deaths. Doulas provide continuous emotional, physical, and informational support throughout the perinatal continuum.

This narrative review synthesized data from articles published from 2020-2025 that examined the impact doula support had on PPD. PubMed, CINAHL, and Google Scholar were searched in February 2025. Search terms included "Depression, Postpartum," "Social Support," "Maternal Health Services," "Doula," "Birth Support," and "Perinatal Mental Health."

Nine articles met inclusion criteria and were included in the review. Qualitative, quantitative, and review articles were represented in this narrative review. Women receiving doula support had lower odds of developing PPD or postpartum anxiety. Outcomes for women who had doula participation during and after pregnancy include enhanced social support, reduced stress, improved birth experiences, and increased maternal self-efficacy.

Doulas show promise for PPD prevention. Barriers exist for marginalized and underresourced populations of patients in accessing doula care, yet these are the populations who report maternal mental health disorders disproportionately compared with nonmarginalized women. We recommend focusing on the protective value of doulas in preventing PPD, overcoming barriers for patient access to doulas, and standardized mental health education for doulas. Integrating doula support into maternity care requires alignment with the health care team to ensure continuity and effectiveness. Nurses are critical in this partnership through assessment and collaborative care coordination.