The Role of Doulas in Addressing Disparities, Barriers, and Potential Solutions to Navigating Reproductive Loss

Abstract

Reproductive loss can take many forms. Common experiences include abortions, stillbirths, or miscarriages. Especially in a post-Roe time and space, the health disparities and stigmas that exist surrounding reproductive loss and those experiencing pregnancy loss have become even more apparent. Health disparities continue to exist through sociodemographic factors such as ethnicity, gender, race, and socioeconomic status. As found in existing literature on individuals’ experiences with reproductive health care, each person’s experiences strongly correlate with their identities. The level of reproductive care and compassion received vary dramatically as a result, with people of color and lower socioeconomic statuses receiving lower quality of care when seeking it out. Trends in unintended pregnancies and access to support resources also reinforce the idea that health disparities are at play. Additionally, intersectionality, or the overlapping of an individual’s multiple identities, plays an important role in the disparities seen within reproductive healthcare as discrimination and other structural factors are designed to benefit certain groups of individuals while putting others at disadvantages. Studies and surveys of individuals who have experienced pregnancy loss have addressed the existence of these inequalities within reproductive health care. Through a reproductive justice perspective, this literature review aims to bring attention to the disparities present in reproductive healthcare and how the work of reproductive loss doulas, which are full-spectrum doulas who honor all reproductive experiences, may address these disparities with sensitive and compassionate care. While addressing nationwide disparities in pregnancy loss, this literature review uses the state of Michigan to also analyze the current legislative efforts designed to expand access to critical reproductive health care services.