Community‐Based Doulas' Roles Within the Birth Support System: Young Black Mothers’ Perspectives

Abstract

IntroductionDoulas have been found to be beneficial to pregnant adolescents during childbirth, but little is known about their role within the larger system of people providing birth support, including family and health care providers. The purpose of this study was to examine, from the perspectives of young mothers, the role of the doula within their broader birth support system.MethodsOne hundred pregnant Black adolescents and young women (aged 13 to 21) who were provided perinatal community‐based and racially concordant doula services at no cost to them were interviewed after the birth of their newborn, prior to hospital discharge. Interviews generated birth story narratives and responses to focused questions about their experiences of birth support. Thematic analysis was conducted to examine the role of the doula within the context of the broader system of birth support.ResultsDoulas functioned in 2 primary ways within the birth support system by (1) providing tandem support alongside family and health care providers and (2) filling gaps in health care not provided by family and providers. Laboring adolescents sometimes described their family members and doulas working in tandem to provide multiple types of support such as comfort measures, coaching, and help with pushing. They also identified gaps in their care or support filled by the doula, in particular gaps due to family members’ physical or emotional unavailability or health care providers’ many responsibilities.DiscussionThe findings highlight the ways in which doulas support pregnant adolescents during childbirth through their deft navigation of the existing support system. Well‐being was enhanced by the inclusion of the doula in the birth support system. The findings align with existing research that underscores the valuable role doulas play in supporting individuals during childbirth, particularly for those most affected by processes of marginalization.

“She’s a Family Member”: How Community Health Workers Impact Perinatal Mothers’ Stress Through Social-Emotional Support and Connections to Programs and Resources

“… 17 This research parallels important findings from scholars that study patient perspectives on doula care and its positive impacts for patients and birth outcomes. 18 , 19 …”

“… 10 Similar to the literature on patient perspectives in doula care, these findings demonstrate that additional support for perinatal mothers can reduce stress, provide emotional support, and fill gaps in the medical and social support systems. 18 , 19 …”