Community doulas can help build trust and support with low-income African American women navigating health care systems.

Background

Low-income African American women face significant barriers to equitable maternity care and experience disproportionately poor maternal health outcomes. Doulas provide non-clinical physical, emotional, and informational support before, during, and after childbirth, yet cost can be a major barrier to accessing doula services. Community doula programs address community needs by providing free or reduced cost services, with doulas usually working within their own communities. This qualitative study explored perspectives of community doulas who work with low-income African American women.

Findings

Researchers interviewed 10 community doulas in the Pittsburgh, Pennsylvania area to better understand their experiences and perspectives. Community doulas reported that shared race, culture, and lived experience supported the development of trusting relationships with clients. The study also found that community doulas recognize institutional biases that impact health and can intervene when appropriate, which may help to reduce the negative effects of these stressors for people giving birth. Community doulas also reported providing supports after delivery, such as home visiting and breastfeeding assistance.

Program/Policy Takeaways

This study suggests that community doulas may play an important role in supporting populations that experience health disparities, particularly low-income African American women. States and health care organizations can consider the functions and contributions of community doulas when designing, funding, and implementing doula programs.