Trent Center for Bioethics, Humanities, and History of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
Trent Center for Bioethics, Humanities, and History of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Med Humanit. 2024 Aug 14;50(2):306-311. doi: 10.1136/medhum-2023-012840.
In the USA, maternal morbidity and mortality is markedly higher for women of colour than for white women. The presence of a doula has been associated with positive birthing outcomes for white individuals, but the experiences of women of colour remain underexplored. The purpose of this qualitative paper is to understand the attitudes of black and Latinx communities towards doula-supported birthing practices.
The perspectives of people of colour, both birthing women and doulas, were investigated through popular media sources, including blogs, magazine articles, podcasts and video interviews. Of 108 popular media sources identified in the initial search, 27 included direct accounts from birthing women or doulas and were therefore included in this paper. Thematic analysis was conducted by the grounded theory method.
Emerging themes reveal that doula presence allows for the experience of ancestral power, connection to the granny midwives, cultural translation in medical settings and physical protection of the birthing woman. When labouring with the support of a doula, women report the emotional and physical presence of their ancestors. Similarly, doulas recognise an ancestral presence within the birthing woman, and doulas experience their occupation as carrying on ancestral tradition and feel a strong vocational tie to the granny midwives of the American South. Lastly, doulas mediate communication between birthing women, their families and medical providers by emphasising the need for consent and patient autonomy.
By connecting women of colour to historic and ancient spaces as well as providing comfort and familiarity in the birthing space, doulas grant their clients the self-advocacy and empowerment needed to survive the present. Doulas serve as protectors of women of colour and have become an important piece to bridging society from the current maternal health crisis to a more equitable future.
在美国，有色人种女性的孕产妇发病率和死亡率明显高于白人女性。导乐的存在与白人个体的积极分娩结果有关，但有色人种女性的相关经历仍未得到充分探索。本文的目的是了解黑人和拉丁裔社区对导乐支持的分娩实践的态度。
通过大众媒体来源，包括博客、杂志文章、播客和视频采访，调查了有色人种（包括分娩妇女和导乐）的观点。在最初的搜索中确定了 108 个大众媒体来源，其中 27 个来源包含了分娩妇女或导乐的直接描述，因此被纳入本文。采用扎根理论方法进行主题分析。
出现的主题表明，导乐的存在允许体验祖先的力量、与老奶奶助产士的联系、在医疗环境中进行文化翻译以及保护分娩妇女的身体。当有导乐的支持分娩时，妇女报告说她们的祖先在情感和身体上都在场。同样，导乐在分娩妇女身上认识到祖先的存在，导乐将她们的职业视为传承祖先的传统，并强烈感受到美国南部老奶奶助产士的职业联系。最后，导乐通过强调同意和患者自主权的必要性，在分娩妇女、她们的家人和医疗提供者之间进行沟通。
导乐将有色人种女性与历史和古老的空间联系起来，并在分娩空间提供舒适和熟悉感，使她们的客户能够自我倡导和赋权，以应对当前的孕产妇健康危机，并走向一个更加公平的未来。导乐是有色人种女性的保护者，已经成为将社会从当前的孕产妇健康危机过渡到更公平的未来的重要一环。
