The role of doulas and community birth workers in abortion and contraception care: An international scoping review

Objectives Equitable and safe access to abortion and contraception is essential to protecting reproductive autonomy. Despite this, barriers to access remain. “Doulas”, non-clinical support people providing supporting throughout the perinatal period, may be able to facilitate access to abortion and contraception services and care, but evidence on the scope and efficacy of doulas in abortion and contraception care is lacking. The aim of this scoping review was to synthesize what is known about the role of doulas in abortion and contraception care. Study Design We followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. A clinical librarian performed an initial search of all relevant databases. Three reviewers independently screened the titles and abstracts for assessment against the inclusion and exclusion criteria. The populations of interest included doulas, non-clinical and/or untrained birth attendants and birth companions, and patients who use doula services. The concept of interest was the doula role and the context was access to abortion or contraception care Results Our review identified thirty-three relevant studies conducted in sixteen different countries, published between 1976 and 2023. Studies broadly focused on three key themes: doulas performing procedural abortions, doulas supporting abortion care, and doulas supporting contraception. Outcomes of interest included client outcomes, barriers to access, and doula training, roles and attitudes. Conclusions Doulas have the potential to improve client satisfaction and mitigate barriers to accessing abortion and contraception services. Further research is needed to identify the training needs of doulas, the potential for their integration into interdisciplinary abortion and contraception care teams, and the doula role in supporting medication abortion. Data availability statement Data sharing is not applicable to this article as no new data were created or analyzed in this study.