A case study of a community-designed doula model successfully integrated into NYC hospitals.

Background

Persistent racial and ethnic disparities in maternal morbidity and mortality continue to affect Black, Latina, and other underserved populations. Community-based doulas can help address these inequities by providing continuous emotional, physical, and informational support during pregnancy, childbirth, and the postpartum period while also helping to connect to practical resources to address social determinants of health. Because community-based doulas also often share the cultural, linguistic, and lived experiences of the women they serve, they can provide culturally responsive care. This case study describes how New York City’s HOPE Doula Program integrated community-based doula services into a public hospital system serving predominantly publicly insured patients.

About this Resource

This case study outlines the development and implementation of the HOPE Doula Program in two New York City public hospitals, which provides free community-based doula services for up to one-year post-partum. The article describes three major components of the model: community engagement, doula workforce development, and doula integration into clinical care teams. The authors report that the program trained 30 community-based doulas, received 326 referrals between 2022 and 2024, and improved participating hospitals’ ratings on measures of doula-friendliness. The case study also discusses challenges and solutions related to workforce capacity, hospital integration, and Medicaid reimbursement.

Program/Policy Takeaways

Health systems, policymakers, and maternal health stakeholders may benefit from reviewing this model when expanding doula services. The program demonstrates how workforce development, strong community partnerships, and integration of doulas into clinical care teams can support equitable access to doula services for Medicaid members.