A postpartum borderland: doulas as relational border crossers

In the United States, the postpartum period is often treated as a brief clinical phase. However, this thesis argues that the postpartum period functions as a structurally intensified borderland for undocumented immigrant mothers*, shaped by legal precarity, linguistic marginalization, and institutional fragmentation between obstetric and pediatric care. Drawing on qualitative insights from the Esperanza Contigo project, I argue that community-based doulas operate as institutional and cultural “border crossers”, mediating this liminality through relational accompaniment, translation, and advocacy across medical hierarchies. While existing literature has documented improved maternal outcomes associated with doula support, this project advances a new claim: that doulas model an ethical infrastructure capable of bridging the artificial divide between maternal and infant care. By reframing pediatrics as a continued site of border crossing rather than a discrete transfer of responsibility, this thesis proposes a doula-informed framework for pediatric practice that centers trust, relational continuity, and structural awareness. Ethically, this matters because it challenges the prevailing separation of maternal and child health and exposes how institutional design, rather than individual failure, produces vulnerability in the most precarious months of family life. * This thesis uses the term “mothers” and “women” primarily when referring to birthing individuals; however, it is important to denote that this thesis simultaneously recognizes the spectrum of identities that birthing individuals possess, and that all may not identify with these terms.