Birth doula support is widely recognized as an effective strategy to improve perinatal outcomes and reduce health care costs. However, in many states where families suffer some of the worst infant and maternal morbidity and mortality rates in the United States, birth doulas are underutilized. Furthermore, in states like Alabama, there is no Medicaid or insurance reimbursement for doula support services, making doula support available almost exclusively to pregnant families with more financial resources. In this session, Dalia Abrams and Holly Horan discuss results from their community-based research examining barriers and facilitators to increasing access to doula support in Alabama, and by extension, in the US South-East. They discuss their efforts to build coalitions within the local doula community, sharing their honest experiences about the successes and challenges of this work and the multi-level effort necessary to make doula care a more accessible and sustainable profession for doulas in Alabama and similar states.