Expanding Birth Work Into Perinatal Behavioral Health Support: A Doula’s PBHC Journey

Lila Aguilar, Doula and Perinatal Behavioral Health Coach FamilyWell

Over years of supporting families through pregnancy, birth, and the postpartum transition, many doulas begin to notice a pattern. Alongside the physical recovery and practical adjustments of caring for a newborn, many parents are navigating something less visible: anxiety that won’t quiet down, intrusive thoughts that feel frightening, or the disorienting identity shift that comes with becoming a parent.

For Lila Aguilar, a certified birth and postpartum doula and Perinatal Behavioral Health Coach (PBHC), these moments became an important part of the work she was already doing. As she supported families through birth and early parenthood, it became increasingly clear how often emotional struggles accompanied the transition.

Her interest in perinatal mental health, she explains, began long before it became a professional focus. “My path into perinatal mental health started long before it became my career—it really began with my own transition into motherhood,” she says.

Today, Lila integrates behavioral health coaching into her work with perinatal patients, helping parents navigate anxiety, intrusive thoughts, and the emotional realities of early parenthood. Her story reflects a broader shift within birth work, as more doulas seek additional training to support the mental and emotional health of the families they serve.

From Art History to Birth Work and Beyond

Like many professionals who eventually find their way into perinatal care, Lila did not originally plan this career path. She studied Art History with a minor in Psychology and began her professional life working in the arts. “I studied Art History with a minor in Psychology and began my career working at an art gallery in New York City,” she explains.

Becoming a parent, however, reshaped her professional direction. “After becoming a parent, my focus shifted. I eventually trained as a certified birth and postpartum doula and spent years supporting families through pregnancy, birth, and the postpartum transition.”

Her path reflects a common pattern in birth work. Many doulas enter the field after their own experiences with pregnancy and postpartum spark a deeper interest in supporting other families through the same transition.

For Lila, the work also carries a deeply personal dimension. “This work is deeply personal for me,” she says. “I’ve lived with anxiety for much of my life, and during my pregnancies and postpartum periods, I experienced postpartum anxiety, depression, OCD, as well as pregnancy loss and PTSD.”

Her connection to birth work also reaches back another generation. “My mother was a midwife at The Farm community in Tennessee during the revival of the home birth movement,” she explains, recalling how the values of community-centered care and supporting women through major life transitions were part of the environment she grew up around.

Over time, Lila began to see how her personal experiences and professional training could come together more intentionally. “Through my work as a postpartum doula, I realized my own experiences could help me connect with and support other parents in a meaningful way.” That realization eventually led her to expand her work through training as a Perinatal Behavioral Health Coach (PBHC), allowing her to support families not only through birth and postpartum recovery but also through the emotional and mental health challenges that often arise during the perinatal period.

Why Mental Health Support Matters in Birth Work

Birth workers and Doulas are often among the first professionals to witness the emotional realities of pregnancy and early parenthood. In addition to supporting families through labor, recovery, and newborn care, doulas frequently see the quieter challenges that emerge during this transition—anxiety, overwhelm, self-doubt, and the profound identity shift that comes with becoming a parent.

As Lila explains, “Becoming a parent is one of the biggest identity shifts a person can go through. It’s meaningful—but it can also be incredibly hard.” While many parents experience moments of joy and connection, they may also struggle with exhaustion, changing relationships, and the pressure to meet expectations about what early parenthood should feel like.

Because doulas often spend extended time with families during pregnancy and postpartum, they are uniquely positioned to notice these emotional shifts. For many parents, simply feeling understood can be an important turning point. As Lila describes it, “One of the most powerful moments in this work is when someone realizes they’re not alone.”

Recognizing these emotional needs has led many birth workers to expand their knowledge of perinatal mental health, seeking additional training and tools that allow them to better support the families they serve.

How Behavioral Health Coaching Supports Perinatal Patients

As Lila’s work with families deepened, she began to see how practical mental health support could complement the care parents were already receiving. While therapy plays an essential role in treating perinatal mental health conditions, many parents also need tools they can use in the moment—especially during the demanding early months of caring for a newborn.

Perinatal Behavioral Health Coaches (PBHCs) are trained professionals who provide skills-based mental health support during pregnancy and the postpartum period. While they do not diagnose or treat mental health conditions, PBHCs help parents build coping strategies, navigate emotional challenges, and connect with additional care when needed.

“Therapy provides essential clinical support,” Lila explains. “Coaching complements that by focusing on practical tools people can use in everyday life.” Behavioral health coaching often centers on helping parents recognize anxiety patterns, develop coping strategies, and create small routines that support emotional well-being during a period when daily life can feel unpredictable.

For many perinatal patients, this kind of guidance fills an important gap. As Lila notes, “Many perinatal patients want both a space to talk and guidance on what to do in the moment—how to manage intrusive thoughts, cope with anxiety, or take care of themselves while caring for a baby.”

By focusing on practical strategies and everyday problem-solving, behavioral health coaching can help parents build confidence as they navigate the emotional and logistical challenges of early parenthood.

What a Week Looks Like as a PBHC

One of the aspects Lila appreciates most about behavioral health coaching is the variety each week. While the core of the work involves supporting perinatal patients through one-on-one sessions, the rhythm of the role often adapts to families’ needs and the evolving stages of pregnancy and early parenthood.

“My weeks vary depending on my caseload, but I typically meet with five to ten patients a day,” she says. These sessions often focus on helping patients work through challenges such as anxiety, intrusive thoughts, identity shifts, and the emotional adjustments that come with caring for a new baby.

The flexibility of the work also allows Lila to integrate her professional and family life. “I work remotely, which allows me to balance my work with life at home with my husband, our two kids, and our Bernedoodle, Obi,” she explains. Like many professionals working in the perinatal space, she understands firsthand the ongoing process of navigating work, caregiving, and personal well-being.

As she puts it, “Like most parents, I’m always working on finding that balance.”

Advice for Doulas Interested in Mental Health Training

For doulas who feel drawn to supporting the emotional side of the perinatal experience, Lila emphasizes that the most important starting point is often simple presence. “Lead with compassion and curiosity,” she says. “Listening and validating someone’s experience can be incredibly powerful.”

Birth workers frequently witness the emotional complexity of pregnancy, birth, and early parenthood—from anxiety and identity shifts to the pressures of sleep deprivation and changing family dynamics. Because of this, many doulas choose to expand their skill set through additional training in perinatal mental health and behavioral health support.

Continuing education in this area can help birth workers feel more confident in recognizing common mental health challenges, offering supportive tools, and knowing when and how to refer patients to clinical providers. For many, integrating mental health training into birth work becomes a natural extension of the support they are already providing to families.

The Future of Perinatal Mental Health Care

As awareness of maternal mental health grows, many professionals working in the perinatal space are hopeful that emotional support will become a more integrated part of routine care. “I’m excited about the growing awareness around perinatal mental health,” Lila says. In recent years, more clinicians, birth workers, and community organizations have begun recognizing how common emotional challenges can be during pregnancy and the postpartum period.

Still, access to support remains uneven, and many families struggle to find the help they need. For Lila, the long-term goal is clear: a system that treats emotional well-being as a core component of maternal care. As she puts it, “Perinatal mental health support should be a standard part of care—not something parents have to struggle to find.”

Final Thoughts on Supporting the Emotional Side of Birth Work

As awareness of perinatal mental health continues to grow, many birth workers and healthcare professionals are expanding their roles to better support the emotional well-being of parents during pregnancy and the postpartum period. Training in areas such as perinatal behavioral health coaching can help professionals recognize common mental health challenges, offer practical support, and connect families with appropriate care when needed. For those interested in building these skills, learning more about Perinatal Behavioral Health Coaching (PBHC) is one way to deepen their ability to support families through one of life’s most transformative transitions.