What Does the Next Decade of Maternal and Infant Health Research Mean for Doulas?

By Birth & Baby University · Last updated: October 2026 · 7 min read

Forecasting a decade of research is guesswork, so this article does something more modest. It reads what recent reviews and research agendas say is missing, notes which large studies are underway, describes the funding picture as it stands in October 2026, and asks what each of these means for working doulas. The short version: the evidence base for doula support is growing but uneven, the questions researchers say they most need to answer are practical ones, and the money that pays for the answers is not secure.

Key takeaways

Quick answer: reviewers agree that doula research needs better designs, clearer definitions of what doulas deliver, more attention to timing and intensity, and more representation of the communities most affected. Several implementation studies are underway, and a federal research initiative on maternal health exists, but its funding and the wider research environment are uncertain. For doulas, the practical meaning is to document what they do, participate in research where they can, and describe the evidence accurately.

• A 2026 systematic review found moderate-certainty evidence for some outcomes but mostly moderate or high risk of bias and insufficient information on the effects of different types or intensity of doula support.
• A 2026 review of clinical and pilot trials noted limited reporting of how interventions were delivered, underrepresentation of marginalized populations and few studies of postpartum, abortion, fertility or bereavement doula work.
• In a researcher survey ranking implementation priorities in U.S. maternity care, improved postpartum care and perinatal mood disorder screening were among the practices participants most wanted implemented more broadly.
• The NIH IMPROVE initiative included $53.4 million for fiscal year 2025, and a bill to authorize it passed the House in July 2026 according to its sponsor, but no source read confirms Senate action.

What reviewers say is missing

Viswanathan and colleagues (2026) reviewed U.S. randomized and nonrandomized studies. They found that doula support is likely associated with lower preterm birth and cesarean rates, better birth experiences and more postpartum visit attendance (moderate certainty), with low-certainty evidence for other outcomes. They rated most studies at moderate or high risk of bias, noted heterogeneity, and concluded that research on the type (including independent doulas), intensity and timing of support could clarify settings in which doula care improves outcomes and reduces disparities.

Groves and colleagues (2026) reviewed 22 articles on 21 interventions. Findings were most consistent for anxiety, postpartum follow-up and breastfeeding initiation, and more variable for cesarean delivery and pain management. They noted that few studies addressed postpartum, abortion or broader reproductive health contexts such as fertility or bereavement doulas, and they listed methodological gaps: limited reporting of fidelity and implementation, underrepresentation of marginalized populations and failure to account for crossover in control groups. They recommended rigorous designs, equitable representation, full-spectrum care and assessment of implementation.

Related research on measurement points the same way. A systematic review of respectful maternity care (Cantor and colleagues, 2024) found no gold standard and no single best tool, so even defining the outcomes that matter most remains unsettled. See our article on measuring doula quality.

Where the field is heading

• Implementation and policy. The six-state study protocol (Jarlenski and colleagues, 2024) plans to use matching and time-series methods, stratified by race, to learn which ways of implementing Medicaid doula programs improve equity in outcomes such as severe maternal morbidity and respectful care. Results are not yet available in the sources read.
• Delivery modes. Uscher-Pines and colleagues (2026) found that doulas see virtual support as having access advantages and limits, and called for rigorous comparative effectiveness studies to inform policy and coverage decisions.
• Priorities across maternity care. In a modified Delphi study in which 60 U.S. researchers completed at least one survey (Hamm and colleagues, 2023), participants prioritized improved postpartum care, perinatal and postpartum mood disorder screening and standardized management of hypertensive disorders of pregnancy for broader implementation, and reduction of cesarean delivery for low-risk patients and of routine discontinuation of psychiatric medications for de-implementation. Their top methodological priorities were making implementation frameworks and measures address equity and involving patients in implementation research. The respondents were mostly female and White, and the survey is a snapshot of researchers’ opinions from 2023.

The funding picture

The National Institutes of Health’s IMPROVE initiative supports research to reduce preventable causes of maternal deaths and improve health before, during and after pregnancy, with a focus on populations disproportionately affected. The 2026 fact sheet lists $53.4 million for fiscal year 2025, 14 awards for Maternal Health Research Centers of Excellence, and other implementation and dissemination awards. It does not mention doulas by name. A July 2026 press release from Representative Lauren Underwood says the NIH IMPROVE Act, which would authorize $63.4 million annually for six years, passed the House with unanimous support, and that the program lacks a sustained funding source. That is a sponsor’s statement, and the sources read do not show what happened in the Senate.

The wider research environment also matters. NPR reported in August 2025 that the Supreme Court allowed NIH to stop paying about $783 million in grants for projects it had ended, after NIH began terminating grants that did not align with administration policies, including DEI and gender identity research. The sources read do not say whether any doula or maternal health equity study was affected, and it would be wrong to assume either way. The accurate statement is that the funding for future doula research is uncertain.

What this means for doulas

• Your records are part of the evidence. Fidelity and implementation are the gaps reviewers name. Keeping clear, private records of what you deliver, within your agreements, helps programs and researchers describe doula support accurately.
• Take part when it is fair. Studies need doulas’ input. Participation should be voluntary, paid or acknowledged where appropriate, and protective of client privacy.
• Describe evidence accurately. Use language such as “associated with” and cite specific studies. Doing so protects your credibility if findings change.
• Expect findings to refine, not reverse, your role. Research on type, timing and intensity may change what programs fund, but the non-clinical scope of doula work is set by professional standards, not by outcome studies.
• Keep learning. Continuing education helps you read new studies critically. See our article on how continuing education helps doulas maintain evidence-based practice and the guide to evaluating research and recognizing misinformation.

Putting it into practice

1. Choose one or two research questions that matter to your practice, such as timing of postpartum visits or virtual versus in-person support, and follow new studies on them.
2. Set a reminder to check for updates to the key reviews each year.
3. When a new study is reported, read the abstract and methods, note the design and risk of bias, and compare it with the reviews above.
4. Join or form a peer group to discuss new research monthly.
5. If you are asked to participate in research, ask about consent, privacy, data use, compensation and how results will be shared with doulas.

Limits and uncertainty

This is not a forecast. It summarizes recent reviews, one protocol, one researcher survey and public statements about funding. Dates matter: the funding information is current to October 2026 in the sources read, and the NIH fact sheet figure is for fiscal year 2025. The press release is a legislator’s statement. No source here says which doula studies will be funded or what they will find.

The bottom line

Over the next decade, the questions researchers say matter most are practical: what doulas actually deliver, how timing and intensity matter, how virtual and in-person support compare, and which implementation choices narrow disparities. The funding to answer them is uncertain. For doulas, the sensible approach is to document the work, take part in research fairly, and describe what is known and unknown with care.

Birth & Baby University’s For Doulas page outlines its online, self-paced birth and postpartum doula training, recertification and mentorship, for doulas who want to build practice grounded in evidence.

This article is for professional education. It is not medical, legal, financial or tax advice. Check the standards of your certifying organization and the rules where you work.

Sources and further reading

• Viswanathan M, Middleton JC, Sathe NA, et al. Doula support during pregnancy, childbirth, and postpartum: a systematic review and meta-analysis. Obstetrics & Gynecology (2026). Read the source
• Groves P, Williams H, Salter CL, et al. Doula care and health outcomes: a systematic review. JAMA Network Open (2026). Read the source
• Cantor AG, Jungbauer RM, Skelly AC, et al. Respectful maternity care: a systematic review. Annals of Internal Medicine (2024). Read the source
• Jarlenski M, Kennedy S, Johnson A, et al. Study protocol: a mixed-methods study of the implementation of doula care to address racial health equity in six state Medicaid programs. Health Research Policy and Systems (2024). Read the source
• Uscher-Pines L, James KF, Waymouth M, et al. Virtual doula support after the COVID-19 public health emergency: strengths, limitations, and adaptations. Women’s Health Issues (2026). Read the source
• Hamm RF, Moniz MH, Wahid I, Breman RB, Callaghan-Koru JA. Implementation research priorities for addressing the maternal health crisis in the USA: results from a modified Delphi study among researchers. Implementation Science Communications (2023). Read the source
• National Institutes of Health, NICHD. Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) Initiative fact sheet (2026). Read the source
• Representative Lauren Underwood. Another Momnibus bill, Underwood’s bipartisan NIH IMPROVE Act, passes House (press release, July 22, 2026). Read the source
• NPR. Supreme Court allows NIH to stop making nearly $800M in research grants for now (August 21, 2025). Read the source

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