Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 21;18(1):23.
doi: 10.1186/s13006-023-00558-0.

The role of doulas in providing breastfeeding support during the COVID-19 pandemic

Monica Ochapa  1 , Kesha Baptiste-Roberts  2 , Sharon E Barrett  1 , Adeola Animasahun  1 , Yvonne Bronner  1
Affiliations

The role of doulas in providing breastfeeding support during the COVID-19 pandemic

Monica Ochapa et al. Int Breastfeed J. .

Abstract

Background: Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, we examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic.

Methods: A systematic review was conducted following the PRISMA guidelines. Thirteen scientific databases and twenty peer-reviewed journals were searched for journal articles published in English between January 2020 and March 2022 using key search terms (e.g., Doula, Breastfeeding, COVID-19). Studies evaluating the role of doulas in providing breastfeeding support during COVID-19, and the impact of COVID-19 Guidelines on doula services, were included. Two reviewers independently performed the risk of bias assessment and data extraction. Summative content analysis was used to analyze the data.

Results: The majority of studies were conducted in developed nations. This systematic review includes eight articles, four qualitative, one survey, two mixed-methods studies, and one prospective research study. Seven of the eight studies were conducted in the United States, and the eighth was conducted in multiple countries. These studies have three main themes: (1) virtual breastfeeding support provided by doulas during the pandemic; (2) remote social support provided by doulas to breastfeeding mothers during the pandemic; and (3) barriers to doula service delivery due to COVID-19 restrictions, primarily the exclusion of doulas as essential workers. The eight studies showed that doulas found innovative ways to serve the needs of birthing and nursing mothers during the difficulties brought on by the pandemic.

Conclusion: Doulas provided breastfeeding support during the COVID-19 pandemic by utilizing innovative service delivery methods while navigating changes in COVID-19 guidance. However, system-level integration of doulas' work and the acknowledgment of doulas as essential healthcare providers are needed to enhance doula service delivery capacity, especially during a pandemic, to help improve maternal health outcomes.

Keywords: Birthing; Breastfeeding support; COVID-19; COVID-19 Guidelines; Doulas; Lactation Support; Maternal and Child Health; Nursing Mothers.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA Flow Chat
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization & United Nations Children's Fund. Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative. World Health Organization; 2018. Available from: https://apps.who.int/iris/handle/10665/272943.
    1. Guidance for covid-19. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/coronavirus/2019-ncov/communication/guidance.html
    1. DONA International. Covid-19 & doulas - dona international recommendations. DONA International. Available from: https://www.dona.org/covid-19-and-doulas/
    1. Calil V, Krebs VLJ, Carvalho WB. Guidance on breastfeeding during the Covid-19 pandemic. . Rev Assoc Med Bras (1992) . 2020;66(4):541–546. doi: 10.1590/1806-9282.66.4.541. - DOI - PubMed
    1. Castañeda AN, Searcy JJ. Shifting landscapes of belonging: Birth doulas and COVID-19. Pract Anthropol. 2020;42(4):5–10. doi: 10.17730/0888-4552.42.4.5. - DOI

Publication types