Experiences of Community Doulas Working with Low-Income, African American Mothers

Wint, Kristina; Elias, Thistle I.; Mendez, Gabriella; Méndez, Dara D.; Gary-Webb, Tiffany L.

doi:10.1089/heq.2018.0045

Cited by 52 publications

(59 citation statements)

References 36 publications

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“…Forcing patients to choose one person, who often is a partner and not always the primary source for support and advocacy, limits their ability to get what they need from their providers in their care (Simon et al, 2016). The role of support people is often seen as an essential safety measure, not just a comforting presence, in which the presence of another person may make a significant difference in how the patient experiences their care (Davis, 2018; Wint et al, 2019). The restriction of visitors likely plays a role in exacerbating disparities in experience of care for BIPOC patients, both through the actual policy itself and through biased enforcement of the policies by nurses and other health care personnel (Niles et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Mistreatment includes being shouted at, ignored, or refused or delayed response to a request for help. Doulas and other support people can help recognize and counteract bias and mistreatment of birthing people (Wint et al, 2019). Given the disparate impact of COVID‐19 on marginalized communities, the intersectionality of existing racism with responses to the COVID‐19 pandemic needs to be assessed (Lemke & Brown, 2020; Niles et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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The impact of COVID‐19 visitor policy restrictions on birthing communities of colour

Altman

Eagen-Torkko

Mohammed

et al. 2021

Journal of Advanced Nursing

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Aims To explore the experiences of care for pregnant and birthing people, and the nurses who cared for them, during the COVID‐19 pandemic, with special emphasis on the impact of visitor restrictions policies. Design Qualitative study using critical thematic analysis. Methods We conducted semi‐structured interviews with 15 community members who were pregnant and/or gave birth and 14 nurses who worked in the perinatal setting between April and August 2020. Participants were recruited via purposive and snowball sampling, and interviews were conducted virtually via the Zoom platform. The research team used critical thematic analysis methods informed by other interpretive methodologies to arrive at resultant themes. Results Participants described experiences pertaining to how visitor restriction policies are not equitable and disproportionately impact Black, Indigenous, and People of Color (BIPOC) families, and the direct impacts of not having support people, and also provided recommendations for how to adapt current policies to be more equitable. Conclusions Visitor restriction policies have had a disproportionately harmful effect on BIPOC patients and families, leading some patients to make decisions that increase their physical risks to alleviate their risk of labouring and birthing without desired support. Impact While this pandemic is nearing the end, these results can guide structuring of policy not only for the next pandemic, but also for universal policy development. Mitigating the effects of racism in policies, by including diverse stakeholders in decision‐making, should be an inherent part of hospital administration procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of COVID‐19 visitor policy restrictions on birthing communities of colour

Altman

Eagen-Torkko

Mohammed

et al. 2021

Journal of Advanced Nursing

View full text Add to dashboard Cite

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“…The incorporation of community doula programs to health care systems may provide doula support for free or at a reduced cost while we await policy changes for insurance coverage. 51 …”

Section: Concluding Thoughtsmentioning

confidence: 99%

Working Agenda for Black Mothers

Bond

Gaither²,

Nasser

et al. 2021

Circ: Cardiovascular Quality and Outcomes

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Following decades of decline, maternal mortality began to rise in the United States around 1990—a significant departure from the world’s other affluent countries. By 2018, the same could be seen with the maternal mortality rate in the United States at 17.4 maternal deaths per 100 000 live births. When factoring in race/ethnicity, this number was more than double among non-Hispanic Black women who experienced 37.1 maternal deaths per 100 000 live births. More than half of these deaths and near deaths were from preventable causes, with cardiovascular disease being the leading one. In an effort to amplify the magnitude of this epidemic in the United States that disproportionately plagues Black women, on June 13, 2020, the Association of Black Cardiologists hosted the Black Maternal Heart Health Roundtable—a collaborative task force to tackle the maternal health crisis in the Black community. The roundtable brought together diverse stakeholders and champions of maternal health equity to discuss how innovative ideas, solutions and opportunities could be implemented, while exploring additional ways attendees could address maternal health concerns within the health care system. The discussions were intended to lead the charge in reducing maternal morbidity and mortality through advocacy, education, research, and collaborative efforts. The goal of this roundtable was to identify current barriers at the community, patient, and clinician level and expand on the efforts required to coordinate an effective approach to reducing these statistics in the highest risk populations. Collectively, preventable maternal mortality can result from or reflect violations of a variety of human rights—the right to life, the right to freedom from discrimination, and the right to the highest attainable standard of health. This is the first comprehensive statement on this important topic. This position paper will generate further research in disparities of care and promote the interest of others to pursue strategies to mitigate maternal mortality.

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“…23 , 25 Factors such as cultural perspectives and trust in the health care system may impact use of and experience with doula services. 26 Although several studies have explored doulas' perspectives on the value of the care they provide, 26–28 few U.S. studies have explored community members' perceptions of doulas and assessed how previously unmet support needs might be met through doula services. This study examined perspectives on doula care from members of a lower-income community of color with the goal of generating recommendations for a hospital-based doula program.…”

Section: Introductionmentioning

confidence: 99%

Community Perspectives on the Creation of a Hospital-Based Doula Program

et al. 2021

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Objective: Racial and ethnic inequities in perinatal health outcomes are pervasive. Doula support is an evidence-based practice for improving maternal outcomes. However, women in lower-income populations often do not have access to doulas. This study explored community perspectives on doula care to inform the development of a hospital-based doula program to serve primarily low-income women of color. Methods: Four focus groups and four individual interviews were conducted with: (1) women who were pregnant or parenting a child under age 2 ( n =20); (2) people who had provided support during a birth in the previous 2 years ( n =5); and (3) women who had received doula training ( n =4). Results: Participants had generally positive perceptions of doula services. Many aspects of doula support desired by participants are core to birth doula services. Participants identified ways that doulas could potentially address critical gaps in health care services known to impact outcomes (e.g., continuity of care and advocacy), and provide much-needed support in the postpartum period. Responses also suggested that doula training and hospital-based doula programs may need to be adapted to address population-specific needs (e.g., women with substance use disorder and younger mothers). Novel program suggestions included “on call” informational doulas. Conclusions: Findings suggested that women in racial/ethnic minority and lower income groups may be likely to utilize a hospital-based doula program and identified adaptations to traditional doula care that may be required to best meet the needs of women in groups with higher risk of poor maternal health and birth outcomes.

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Experiences of Community Doulas Working with Low-Income, African American Mothers

Cited by 52 publications

References 36 publications

The impact of COVID‐19 visitor policy restrictions on birthing communities of colour

The impact of COVID‐19 visitor policy restrictions on birthing communities of colour

Working Agenda for Black Mothers

Community Perspectives on the Creation of a Hospital-Based Doula Program

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