Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 113b Haviland Hall, MC 7400, Berkeley, CA 94720-7400, USA.
Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 113b Haviland Hall, MC 7400, Berkeley, CA 94720-7400, USA.
Women Birth. 2023 May;36(3):257-263. doi: 10.1016/j.wombi.2022.08.007. Epub 2022 Sep 9.
In the United States, Black women are disproportionately impacted by inequities in maternal health.
Community doula support may improve birth outcomes and experiences, including lower rates of preterm birth and low birthweight and increases in positive birthing experiences. Few studies have explored client experiences with doula care, specifically community doula care.
To explore Black doula clients' motivations for seeking and experiences with community doula care.
Data are from a mixed methods process evaluation of an organization providing free community doula services in San Francisco, California. We conducted two rounds of qualitative interviews with doula clients who identified as Black or Pacific Islander between August 2019 and March 2020. Interviews explored clients' knowledge of, experiences with, and motivations for seeking doula care and their perceptions of the services they received. We utilized a Rapid Assessment Process to synthesize findings and thematic analysis.
Clients' motivations for seeking doula care included general lack of support and knowledge of mistreatment experienced by Black women in hospital settings. Doulas provided support in the form of information about the perinatal period and clients' rights, advocacy in hospital settings, and connection to resources beyond pregnancy and birth. Some clients described doulas as helping them stay focused and make decisions during difficult labor experiences and described positive birth experiences despite experiencing complications.
Community doulas play an instrumental role in the birth experiences of Black women and birthing people. Efforts should be made to expand access to this needed support via policy and hospital practices.
在美国，黑人女性受到孕产妇健康不平等的不成比例影响。
社区导乐支持可能会改善分娩结果和体验，包括降低早产和低体重儿的比率，并增加积极的分娩体验。很少有研究探讨客户对导乐护理的体验，特别是社区导乐护理。
探讨黑人导乐客户寻求社区导乐护理的动机和体验。
数据来自于加利福尼亚州旧金山的一个组织为提供免费社区导乐服务的混合方法过程评估。我们在 2019 年 8 月至 2020 年 3 月期间对自称为黑人或太平洋岛民的导乐客户进行了两轮定性访谈。访谈探讨了客户对导乐护理的了解、经验和寻求动机，以及他们对所接受服务的看法。我们利用快速评估过程来综合研究结果和进行主题分析。
客户寻求导乐护理的动机包括对黑人女性在医院环境中受到虐待的普遍缺乏支持和了解。导乐以提供有关围产期和客户权利的信息、在医院环境中提供倡导以及在怀孕和分娩之外提供资源联系的形式提供支持。一些客户描述导乐帮助他们在困难的分娩经历中保持专注并做出决策，并描述了积极的分娩体验，尽管经历了并发症。
社区导乐在黑人女性和分娩者的分娩体验中发挥了重要作用。应通过政策和医院实践努力扩大对这种必要支持的获取。
