To meet the unique cultural needs of Somali childbearing women in the United States, a doula support program was implemented at a major midwestern teaching hospital in the spring of 2002. To date, 123 Somali women who have been served by a Somali doula have given birth to live infants at this hospital. Cesarean birth rates in Somali women who had a doula present at birth were lower than the cesarean birth rate for Somali women not attended by a doula. Surveys with the nursing staff indicate that the nurses who have worked with a doula 3 or more times felt more confident caring for Somali women than nurses who have not worked with a doula at least 3 times. Patient feedback indicates positive attitudes about the doula service. Further research needs and suggestions for establishing such a program in other institutions are included.