A new study from the University of Minnesota School of Public Health found that support from a doula during pregnancy and childbirth could help improve health and well-being for women of color and potentially reduce longstanding racial and ethnic disparities in birth outcomes. Doulas are trained professionals who provide continuous non-medical physical, emotional, and informational support to mothers during pregnancy, childbirth, and the postpartum period.
[Photo: Dr. Katy Kozhimannil]
The study findings were published in the Journal of the American Board of Family Medicine’s special issue on social determinants of health.
The researchers conducted focus groups with racially and ethnically diverse, low-income pregnant women and gathered their perspectives on how care from a doula may influence the outcomes of pregnancy and childbirth. Specifically, they looked at how doula support relates to non-medical factors that influence health, sometimes called “social determinants of health,” including economic stability, level of education, neighborhood and environment, and social relationships.
“Prior research shows a clear connection between doula support and positive birth outcomes. In this study, we talked with women of color to better understand how doula support translated to better outcomes.” said study lead author and associate professor Dr. Katy Kozhimannil. “Women told us that having a doula increased feelings of security, empowerment, and connection to others, and helped them participate in shared decision-making with their clinicians during pregnancy and childbirth.”
By addressing health literacy and social support needs, doulas helped women identify their needs, communicate more openly, and gain access to quality health care services. These supportive services outside of the medical care system may influence important clinical outcomes such as preterm birth, which has a higher prevalence among African-American women and is the leading cause of infant mortality.
The study showed that doulas helped women prepare emotionally for the birth, have a sense of physical and emotional safety, understand the birthing process, and translate the advice of doctors during clinical appointments. Doulas also helped women feel more connected to the resources available to them.
The researchers point out that the support of doulas is particularly crucial when the doula is aware of cultural knowledge unknown to the clinic team.
Minnesota is one of two states where the Medicaid program covers doula services. The results of this analysis suggest that greater access to doula services among diverse women may contribute to efforts to reduce racial/ethnic disparities that occur during pregnancy and childbirth.