Department of Family Medicine, Center for Health Workforce Studies, University of Washington, Seattle, Washington, USA.
Department of Anthropology, Center for Health Workforce Studies, University of Washington, Seattle, Washington, USA.
Perspect Sex Reprod Health. 2022 Sep;54(3):99-108. doi: 10.1363/psrh.12203. Epub 2022 Jul 7.
Community-based birth doulas support pregnant women, transgender men, and gender non-binary individuals during the perinatal period and provide essential services and expertise that address health inequities, often taking on additional roles to fill systemic gaps in perinatal care in the United States (US). Despite the benefits that community-based birth doulas provide, there is little research exploring the work-related conditions and stressors community-based doulas experience. To address this gap, we examined the work experiences, related stressors, and stress management strategies of individual community-based birth doulas.
In this qualitative, descriptive study we conducted 18 interviews in March through June 2021 with individuals who self-identified as community-based doulas working in underserved communities in the US. We analyzed the interviews for themes, which we defined and finalized through team consensus.
The doulas reported engaging in specific strategies in their work to address perinatal inequities. They also described facing several work-related stressors, including witnessing discrimination against clients, experiencing discrimination in medical environments, and struggling with financial instability. To mitigate these stressors and job-related challenges, interviewees reported they relied on doula peer support and reconnected with their motivations for the work.
Community-based doulas provide essential services and expertise which address inequities and systemic gaps in perinatal care. However, as they work to improve perinatal health, doulas themselves are providing equity work amidst an inequitable system and with insufficient political or financial support. Increased compensation and systemic support which acknowledges the breadth of services provided is needed to strengthen and sustain this critical part of the perinatal workforce.
社区助产士在围产期为孕妇、跨性别男性和性别非二元个体提供支持，并提供解决健康不平等问题的基本服务和专业知识，他们经常承担额外的角色，以填补美国围产期护理系统中的空白。尽管社区助产士提供了很多好处，但很少有研究探讨社区助产士所经历的工作相关条件和压力源。为了解决这一差距，我们研究了个体社区助产士的工作经历、相关压力源和压力管理策略。
在这项定性、描述性研究中，我们于 2021 年 3 月至 6 月期间对在美国服务不足社区工作的自称为社区助产士的 18 人进行了访谈。我们对访谈内容进行了主题分析，通过团队共识对主题进行了定义和最终确定。
助产士报告称，他们在工作中采取了特定策略来解决围产期的不平等问题。他们还描述了面临的几个与工作相关的压力源，包括目睹客户受到歧视、在医疗环境中受到歧视以及努力应对财务不稳定。为了减轻这些压力源和工作相关的挑战，受访者报告说，他们依赖助产士同行的支持，并重新联系他们从事这项工作的动机。
社区助产士提供了基本服务和专业知识，解决了围产期护理中的不平等和系统差距问题。然而，当他们努力改善围产期健康时，助产士本身就在不平等的系统中并在缺乏政治或财政支持的情况下进行公平工作。需要增加补偿和系统支持，承认所提供服务的广度，以加强和维持围产期劳动力的这一重要组成部分。
