In the United States, nearly half of women report that childbirth is traumatic. It’s a sad statistic that highlights a real problem with how women are cared for and educated. It’s no wonder women are stressed about giving birth. It’s a risk in general, but particularly in the United States, where the maternal mortality rate is more than double or triple that of most other high-income countries. And that stress grips many women, especially Latina women.

Hispanic women saw the largest increase in maternal mortality rates between 2020 and 2021, up 54%, according to the Centers of Disease Control and Prevention. (That increase is the largest annual increase seen among any group between 2014 and 2021.) Historically, Hispanic women have had lower maternal mortality rates than Black women, but that doesn’t account for Black Latinos, who face unique challenges that overlap culture and race. Latinos, as a whole, face a host of considerations that can weigh heavily, including language barriers, lack of trust in health (and government) systems, and cultural incompatibility.

“Numerous studies and surveys show that Latina women struggle with communication due to language barriers or don’t feel comfortable sharing concerns with their healthcare providers,” says Asima Ahmad, MD, MPH, FACOG, co-founder and chief medical officer of Carrot Fertility, a global provider of fertility healthcare and family benefits. “CDC data from 2023 showed that 37% of Hispanic women have experienced discrimination and 45% of women have held back from discussing their concerns or answering questions.”

Beyond medical issues, “it’s important to note that a person’s race or ethnicity can also play a huge role in how their pregnancy and postpartum journey will unfold. The culture and expectations of what that journey should be like need to be understood and incorporated into their healthcare experience,” says Dr. Ahmad. “Unfortunately, with the current healthcare model, there are gaps and many cultural nuances that are not understood or addressed.”

Doulas, or non-medical professionals who provide childbirth counseling, can help bridge that gap and alleviate some of the mental stress many Latinas face. “I always like to say that what makes a doula different is that they provide physical support and emotional support, all that kind of support, but they’re also your personal coach slash sister slash grandmother “The doula is your constant,” says Martha Lerner, a Cuban doula based in South Florida with more than 10 years of experience. She notes that the doula is your constant. While a healthcare professional like an OB-GYN or midwife has a scope of practice to ensure you are medically safe and cared for, doulas typically provide more ongoing support before, during, and after labor. They are available for any support you may need, including helping you manage the mental load that comes with the birth journey.

Cultural competence makes a difference

When Cuban-Ecuadorian content creator Lissette Calveiro was looking for extra support while pregnant with her first child, cultural awareness was crucial. “As I was doing all this research, I obviously came across all these sad statistics about maternal mortality that largely affects women of color and how little support they get, usually in the hospital system,” she says. Because of this, and because she wanted as much information as possible (without fearmongering) and as little intervention as possible during a birth, Calveiro decided to hire a doula. “It was important to me that when I was looking for a doula, it was also a woman of color, because that context of understanding that sometimes the hospital system doesn’t treat us (equally) was really important,” she tells PS.

Lerner notes that doulas can also support Latinos in different ways, depending on their culture. Often, doulas can help Latinos advocate for their birth plans to their own families, which can sometimes be different from expected cultural or family practices or go against the best intentions of members, including (and especially) matriarchs. “I feel like I’m a good bridge to try to help both sides understand each other,” she says.

“When you serve someone who is from the same culture as you, you both become different people and you really dive into the core of who you are.”

Educating health care providers about birthing practices is especially helpful for generationally focused families, such as Latinos. As Dr. Ahmad points out, in Latino culture, the first 40 days after birth are the “cuarentena” period. “During this time, women stay home with the baby while their family and support system care for them. This helps optimize their recovery, physical and mental health, and time with their baby,” she says. It’s important for mothers and their medical teams to communicate this expectation to health care professionals (if the parents choose to observe it), and doulas can work to support it. Doulas can also work to support this period in general with scheduled postpartum follow-ups based on the mother’s needs.

And of course, language is a key component. For starters, while many young Latinas are often English speakers, parents and grandparents may need translation services, which doulas can provide (sometimes better or more readily than hospitals, or in a way that’s not rushed). “There’s often a void in the hospital staff who don’t speak Spanish,” Lerner says. “So I translate a little bit for the abuelas and say, OK, this is good. This is what they said, this is what your daughter wants, this is the conversation we’re going to have, so they understand and they’re not afraid.” Second, it’s often important for Latinas in labor to have someone who understands both languages, for moments of pain or celebration. “Spanish is my first language. “So if I’m in a situation where I’m screaming in pain, maybe I want to speak Spanish, maybe I just need someone who’s bilingual,” Calveiro says. “My mom was also there to deliver the baby. And I wanted the doula to be able to communicate with my mom in Spanish. That was really one of the most important things.”

For Latinos, doulas who are culturally competent or part of that culture can help them on another, more intimate level. “When you’re serving someone who’s from the same culture as you, you both become different people and you really dive into who you are,” Lerner says. If a Latina doula is serving a Latino client, they might find themselves speaking Spanish or doing things their mother did to make them feel better when they were a child, Lerner says. “When you’re from that culture and it’s second nature to provide that service in that way, it just comes out and it’s nice to not have to filter it.” She also notes that she works with many birthing parents from all different cultural backgrounds and understands that the comfort level with intimacy or touch is different for each client. “It’s beautiful in itself, it’s wonderful and charming, but it’s very different from what I do instinctively as a Cuban,” she tells PS.

Accessibility can be a deterrent, but there are options

Ultimately, doulas can provide tremendous support—mentally, culturally, physically, and emotionally—but that support can feel out of reach for some. A recent survey by Carrot Fertility found that 35% of Hispanic mothers struggle with the high cost of maternal care, compared to 21% of white mothers, and 43% of Hispanic mothers cite cost as a barrier to seeking mental health support. With doulas offering different rates and levels of support, this can often add a layer of complexity to your birth journey, especially in the quest to find someone with whom you’ll need a level of trust and intimacy. Calveiro notes that she found her doula on social media, searching for Denver-based doulas, which led her to Lucina Rising BirthWork. “I had no idea how much a doula would cost, but because I really interviewed people who had transparent pricing and services, I was able to figure out that it would be a four-figure investment,” she says. She notes that her experience of finding people who are upfront and transparent about pricing isn’t always the norm.

Eventually, she reached out to a doula who was able to provide the emotional support she was looking for, as well as advocacy for her birth plan. Calveiro gave birth at home without medication, so while her husband helped her through painful contractions with hip compressions and other pain-relieving exercises, her doula communicated with the medical team and made sure the environment was conducive to labor. “For example, I had a moment where I was in the bathtub for probably eight hours, honestly, and she brought in these beautiful lights and music and really tried to make the environment as conducive and relaxing as possible,” Calveiro says. Her doula is also a birth photographer, and since Calveiro is a content creator who also wanted photos for her family, she was happy to have them.

Lerner, who is also a birth photographer, notes that Latinas can look for doulas who offer varying rates and can fit your budget. It’s not always an all-or-nothing affair. Dr. Ahmad points out that for many people who have to pay out-of-pocket for doula assistance, it can be seen as a luxury and not something that’s financially accessible. But more and more employers are offering doula assistance as a financial benefit, and in some cases, you can get doula assistance at the state level through Medicaid. “If it’s not currently covered by their employer, sometimes that person is the one who speaks up and advocates for change,” she says. “So I encourage everyone to talk to their employer about this benefit.”

Ultimately, doulas can really help achieve the level of care that Latinas want and deserve, and keep them alive, mentally healthy, and well-supported. “It’s almost like having a friend and an advocate, which is very, very valuable during pregnancy,” Calveiro says. “Having someone you can talk to and lean on, and knowing that they have your back and that you don’t have to worry about it, takes a huge weight off your shoulders.”

Samantha Leal is a lifestyle writer, editor, and editorial consultant. She writes about beauty, wellness, travel, drinks, and more—basically, all the good things in life. She has held editorial roles at The Knot, Latina magazine, Marie Claire, and Well+Good, and has written for PS, Bustle, Vogue, Teen Vogue, Glamour, Travel + Leisure, Byrdie, StyleCaster, The Zoe Report, and more.