Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Collaborative Initiatives between Social Workers and Doulas

Background and Purpose: Perinatal mood and anxiety disorders (PMADs) are the most common complications of pregnancy, yet fewer than half of affected individuals seek mental health treatment (Woolhouse et al., 2015). Doulas, who provide support during pregnancy, childbirth, and the postpartum period, are well-positioned to recognize early signs of PMADs and facilitate referrals. Despite this potential, limited research has examined doulas’ training and practices related to mental health assessment and prevention. This study explored doulas’ capacity to identify PMADs, provide appropriate support, and collaborate with mental health providers. Specifically, it addressed three questions: (1) Do doula training programs adequately prepare doulas to recognize and support clients with PMADs? (2) Do doulas follow structured protocols for screening and referral? (3) What are doulas’ experiences supporting clients with PMADs, and to what extent do they engage in collaborative care?

Method: An explanatory sequential mixed methods design was used. A total of 157 doulas completed a survey assessing their training, experience, and PMAD-related practices. Follow-up semi-structured interviews were conducted with 30 participants to further explore their experiences.

Results: Most participants agreed that identifying PMADs and referring clients to appropriate services is part of their professional role. However, only 49% reported receiving sufficient training on PMADs. While 70% expressed confidence in supporting clients with symptoms, just 29% reported using standardized screening tools consistently. Qualitative findings revealed four key themes: (1) Lack of care coordination—participants reported difficulty collaborating with medical and mental health providers; (2) Uncertainty around screening—doulas expressed mixed opinions about using diagnostic tools like the Edinburgh Postnatal Depression Scale; (3) Training gaps—many called for enhanced PMADs content in certification programs; and (4) Need for mentorship—participants emphasized the importance of peer learning and ongoing professional development to strengthen their support for clients with PMADs.

Conclusions: While doulas are committed to supporting clients with PMADs, many feel underprepared to assess symptoms and facilitate referrals. The study highlights the need for a targeted training curriculum that includes (1) PMADs recognition and assessment, (2) brief intervention strategies, and (3) protocols for coordinated referral and interdisciplinary care. Strengthening doulas’ role in PMAD prevention could enhance maternal mental health outcomes through earlier identification and improved access to care.