BACKGROUND: The United States maternal mortality ratio (MMR) has increased in the past few decades and disparities that negatively impact birthing individuals of color persist. While there are many potential causes for health inequity, distinct factors such as obstetric racism, lack of informed and shared decision-making approaches, and lack of continuous birthing support can prevent positive birthing outcomes. The present study investigates the impact of doula support on perinatal mood disorders while also evaluating potential differences in racial/cultural concordance and cultural competence in the context of the doula-patient relationship, in a Northeastern U.S. urban setting. METHODS: Seven focus group discussions (FGDs) were conducted amongst prenatal and postpartum patients (n=9) and actively practicing doulas (n=18). Participants shared their thoughts and lived experiences related to doula support during the perinatal period through open-ended questions. Researchers transcribed qualitative data from FGDs and analyzed them using a modified grounded theory approach. RESULTS: Five major themes emerged from qualitative data analysis: (1) doula support can reduce stress during the perinatal period, (2) doulas can make the process of seeking out mental health support more efficient, (3) cultural competency in doula care is a learning process (4) racial concordance does not guarantee successful doula-patient relationships, and (5) doulas play an important role in the decision-making process. CONCLUSIONS: The presence of doula support can combat perinatal mood disorders through two pathways identified in the present study. Although there may be distinct differences between culturally competent versus culturally congruent doula-patient relationships, matching by race or culture is not the solution to a fulfilling relationship. Doulas practicing cultural competence and cultural humility – regardless of client background – can make a meaningful impact on the perinatal experience and long-term mental health outcomes. / 2022-11-10T00:00:00Z