<p>Birth doulas help women plan for and carry out the most &ldquo;satisfactory birth&rdquo; possible. The purpose of this study was to explore the roles of privately hired doulas serving women in the St. Louis and St. Louis Metro East region and their influence on patient-provider interactions before, during, and after childbirth, within the framework of patient-centered communication. This study is based on in-depth interviews with six doulas offering support to childbearing women giving birth at hospitals. The findings of this study suggest that doulas believe they enhance communication between patients and their providers, by taking on the roles of advocates and liaisons. Aspects of the training and scope of practice of participant doulas, the type of clients seeking their services and their motivations, as well as common misconceptions and challenges arising when communicating with clients and providers, are also discussed. </p><p> <i>Keywords</i>: doulas, patient-provider communication, patient-centered communication, childbirth, decision-making, advocacy </p>