Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States
Birth doulas support pregnant people during the perinatal period. Evidence of doulas' positive impacts on pregnancy and birth outcomes, particularly among underserved populations, supports expanding access. However, health workforce-related barriers challenge the development of robust doula ser...
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Veröffentlicht in: | Health equity 2022-02, Vol.6 (1), p.98-105 |
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description | Birth doulas support pregnant people during the perinatal period. Evidence of doulas' positive impacts on pregnancy and birth outcomes, particularly among underserved populations, supports expanding access. However, health workforce-related barriers challenge the development of robust doula services in the United States. This study examined the various approaches organizations have taken to train, recruit, and employ doulas as well as their perspectives on what system-level changes are needed to redress health inequities in underserved communities and expand access to birth doula services.
In addition to literature and policy reviews, we conducted 16 semistructured interviews from March to August 2020 with key informants from organizations involved in training, certifying, advocating for, and employing doulas, and informants involved in state policy making. We analyzed data using qualitative analysis software to identify cross-cutting themes.
The landscape of organizations involved in doula training and certification is diverse. In discussing their training and curriculum, interviewees from large organizations and community-based organizations (CBOs) stressed the importance of incorporating a focus on structural racism in maternal health into training curricula. CBOs specifically offered three areas of systems-level change that can help equitably grow doula services: the importance of addressing structural racism, changing the balance of power in decision making and policy making, and a cautious approach to Medicaid reimbursement.
This study provides evidence of how doula organizations move the field toward better serving the specific needs of underserved populations. It recognizes the expertise of CBOs in developing policy to expand doula services to communities in need. The information from this study highlights the complexities of facilitating consistency across doula training and certification requirements and implementing a sustainable funding mechanism while also meeting communities' unique needs. |
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In addition to literature and policy reviews, we conducted 16 semistructured interviews from March to August 2020 with key informants from organizations involved in training, certifying, advocating for, and employing doulas, and informants involved in state policy making. We analyzed data using qualitative analysis software to identify cross-cutting themes.
The landscape of organizations involved in doula training and certification is diverse. In discussing their training and curriculum, interviewees from large organizations and community-based organizations (CBOs) stressed the importance of incorporating a focus on structural racism in maternal health into training curricula. CBOs specifically offered three areas of systems-level change that can help equitably grow doula services: the importance of addressing structural racism, changing the balance of power in decision making and policy making, and a cautious approach to Medicaid reimbursement.
This study provides evidence of how doula organizations move the field toward better serving the specific needs of underserved populations. It recognizes the expertise of CBOs in developing policy to expand doula services to communities in need. The information from this study highlights the complexities of facilitating consistency across doula training and certification requirements and implementing a sustainable funding mechanism while also meeting communities' unique needs.</description><identifier>ISSN: 2473-1242</identifier><identifier>EISSN: 2473-1242</identifier><identifier>DOI: 10.1089/heq.2021.0033</identifier><identifier>PMID: 35261936</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Certification ; Discrimination ; Doulas ; Employment ; Health disparities ; Interviews ; Original Research ; Qualitative analysis ; Racism ; Reimbursement ; Systemic racism ; Training</subject><ispartof>Health equity, 2022-02, Vol.6 (1), p.98-105</ispartof><rights>Marieke S. Van Eijk et al., 2022; Published by Mary Ann Liebert, Inc.</rights><rights>Marieke S. Van Eijk et al., 2022; Published by Mary Ann Liebert, Inc. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Marieke S. Van Eijk ., 2022; Published by Mary Ann Liebert, Inc. 2022 Marieke S. Van Eijk et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-433309eea207c539da79b2b9dc5cefa1bd3bf4abb51af40e3dba58206005c66b3</citedby><cites>FETCH-LOGICAL-c415t-433309eea207c539da79b2b9dc5cefa1bd3bf4abb51af40e3dba58206005c66b3</cites><orcidid>0000-0003-0184-7062 ; 0000-0001-5212-4978</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8896213/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8896213/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35261936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Eijk, Marieke S</creatorcontrib><creatorcontrib>Guenther, Grace A</creatorcontrib><creatorcontrib>Kett, Paula M</creatorcontrib><creatorcontrib>Jopson, Andrew D</creatorcontrib><creatorcontrib>Frogner, Bianca K</creatorcontrib><creatorcontrib>Skillman, Susan M</creatorcontrib><title>Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States</title><title>Health equity</title><addtitle>Health Equity</addtitle><description>Birth doulas support pregnant people during the perinatal period. Evidence of doulas' positive impacts on pregnancy and birth outcomes, particularly among underserved populations, supports expanding access. However, health workforce-related barriers challenge the development of robust doula services in the United States. This study examined the various approaches organizations have taken to train, recruit, and employ doulas as well as their perspectives on what system-level changes are needed to redress health inequities in underserved communities and expand access to birth doula services.
In addition to literature and policy reviews, we conducted 16 semistructured interviews from March to August 2020 with key informants from organizations involved in training, certifying, advocating for, and employing doulas, and informants involved in state policy making. We analyzed data using qualitative analysis software to identify cross-cutting themes.
The landscape of organizations involved in doula training and certification is diverse. In discussing their training and curriculum, interviewees from large organizations and community-based organizations (CBOs) stressed the importance of incorporating a focus on structural racism in maternal health into training curricula. CBOs specifically offered three areas of systems-level change that can help equitably grow doula services: the importance of addressing structural racism, changing the balance of power in decision making and policy making, and a cautious approach to Medicaid reimbursement.
This study provides evidence of how doula organizations move the field toward better serving the specific needs of underserved populations. It recognizes the expertise of CBOs in developing policy to expand doula services to communities in need. The information from this study highlights the complexities of facilitating consistency across doula training and certification requirements and implementing a sustainable funding mechanism while also meeting communities' unique needs.</description><subject>Certification</subject><subject>Discrimination</subject><subject>Doulas</subject><subject>Employment</subject><subject>Health disparities</subject><subject>Interviews</subject><subject>Original Research</subject><subject>Qualitative analysis</subject><subject>Racism</subject><subject>Reimbursement</subject><subject>Systemic racism</subject><subject>Training</subject><issn>2473-1242</issn><issn>2473-1242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpdkU1LHTEUhkOxVLEuuy0BN27mepJM5k42BT9aFYSCt65DPs54I_PhTTKC_95ctKKuEnifvOSch5AfDBYMWnW8xs2CA2cLACG-kD1eL0XFeM133t13yUFK9wDAoVaMi29kV0jeMCWaPeJOvI-YUhjv6OopZRyCozfGhTTQMNLTEPOank9zb-gK42NwmGie6A362SG9RNOX_GrEzRxyKFl5k9dIb8eQ0dNVNhnTd_K1M33Cg9dzn9z--f3v7LK6_ntxdXZyXbmayVzVQghQiIbD0kmhvFkqy63yTjrsDLNe2K421kpmuhpQeGtky6EBkK5prNgnv156H2Y7oHc45mh6_RDDYOKTnkzQH5MxrPXd9KjbVjWciVJw9FoQp82MKeshJId9b0ac5qR5I5aylZxDQQ8_offTHMcyXqHK6kG1QhWqeqFcnFKK2L19hoHeGtTFoN4a1FuDhf_5foI3-r8v8Qwre5fH</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Van Eijk, Marieke S</creator><creator>Guenther, Grace A</creator><creator>Kett, Paula M</creator><creator>Jopson, Andrew D</creator><creator>Frogner, Bianca K</creator><creator>Skillman, Susan M</creator><general>Mary Ann Liebert, Inc</general><general>Mary Ann Liebert, Inc., publishers</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0184-7062</orcidid><orcidid>https://orcid.org/0000-0001-5212-4978</orcidid></search><sort><creationdate>20220201</creationdate><title>Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States</title><author>Van Eijk, Marieke S ; Guenther, Grace A ; Kett, Paula M ; Jopson, Andrew D ; Frogner, Bianca K ; Skillman, Susan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-433309eea207c539da79b2b9dc5cefa1bd3bf4abb51af40e3dba58206005c66b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Certification</topic><topic>Discrimination</topic><topic>Doulas</topic><topic>Employment</topic><topic>Health disparities</topic><topic>Interviews</topic><topic>Original Research</topic><topic>Qualitative analysis</topic><topic>Racism</topic><topic>Reimbursement</topic><topic>Systemic racism</topic><topic>Training</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Eijk, Marieke S</creatorcontrib><creatorcontrib>Guenther, Grace A</creatorcontrib><creatorcontrib>Kett, Paula M</creatorcontrib><creatorcontrib>Jopson, Andrew D</creatorcontrib><creatorcontrib>Frogner, Bianca K</creatorcontrib><creatorcontrib>Skillman, Susan M</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health equity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Eijk, Marieke S</au><au>Guenther, Grace A</au><au>Kett, Paula M</au><au>Jopson, Andrew D</au><au>Frogner, Bianca K</au><au>Skillman, Susan M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States</atitle><jtitle>Health equity</jtitle><addtitle>Health Equity</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>6</volume><issue>1</issue><spage>98</spage><epage>105</epage><pages>98-105</pages><issn>2473-1242</issn><eissn>2473-1242</eissn><abstract>Birth doulas support pregnant people during the perinatal period. Evidence of doulas' positive impacts on pregnancy and birth outcomes, particularly among underserved populations, supports expanding access. However, health workforce-related barriers challenge the development of robust doula services in the United States. This study examined the various approaches organizations have taken to train, recruit, and employ doulas as well as their perspectives on what system-level changes are needed to redress health inequities in underserved communities and expand access to birth doula services.
In addition to literature and policy reviews, we conducted 16 semistructured interviews from March to August 2020 with key informants from organizations involved in training, certifying, advocating for, and employing doulas, and informants involved in state policy making. We analyzed data using qualitative analysis software to identify cross-cutting themes.
The landscape of organizations involved in doula training and certification is diverse. In discussing their training and curriculum, interviewees from large organizations and community-based organizations (CBOs) stressed the importance of incorporating a focus on structural racism in maternal health into training curricula. CBOs specifically offered three areas of systems-level change that can help equitably grow doula services: the importance of addressing structural racism, changing the balance of power in decision making and policy making, and a cautious approach to Medicaid reimbursement.
This study provides evidence of how doula organizations move the field toward better serving the specific needs of underserved populations. It recognizes the expertise of CBOs in developing policy to expand doula services to communities in need. The information from this study highlights the complexities of facilitating consistency across doula training and certification requirements and implementing a sustainable funding mechanism while also meeting communities' unique needs.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>35261936</pmid><doi>10.1089/heq.2021.0033</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0184-7062</orcidid><orcidid>https://orcid.org/0000-0001-5212-4978</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Certification Discrimination Doulas Employment Health disparities Interviews Original Research Qualitative analysis Racism Reimbursement Systemic racism Training |
title | Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States |
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