“The Blurred Boundaries of Care: A Qualitative Analysis of Nurse–Doula Role Conflict”

Through qualitative interviews with nurses and doulas, we identified three key themes shaping nurse–doula collaboration in maternity care:
🔹 Structural invisibility of doulas
Doulas are often not formally recognized within healthcare systems, with inconsistent policies shaping how (and if) they are integrated into care teams.
🔹 Territorialism and power dynamics
Tensions emerge around ownership of the care space, reflecting deeper hierarchies within clinical settings.
🔹 Blurred boundaries of advocacy vs. scope of practice
Differences in training and expectations can create confusion—particularly during high-stakes clinical moments.

To move the field forward, we developed a layered conceptual framework showing how these challenges operate across:
✔️ Structural (health system and policy)
✔️ Interpersonal (team dynamics and communication)
✔️ Role-level (scope, expectations, and identity)

This framework highlights a critical insight:
👉 Nurse–doula conflict is not just interpersonal—it is produced and reinforced by the systems in which care is delivered.
As part of the broader effort to reimagine perinatal care, this work points to actionable strategies to support more collaborative, equitable, and patient-centered models of care.
Proud to contribute to this work with an incredible team.

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