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Health Equity. 2019 Apr 8;3(1):109-116. doi: 10.1089/heq.2018.0045. eCollection 2019.

Experiences of Community Doulas Working with Low-Income, African American Mothers.

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Department of Behavioral and Community Health Sciences, Pittsburgh, Pennsylvania.
Department of Epidemiology at the University of Pittsburgh Graduate School of Public Health in Pittsburgh, Pittsburgh, Pennsylvania.


Purpose: The aim of this study was to learn from doulas the components of their services that might best serve low-income, African American (AA) women and to show the significance of doulas in helping these women have healthy, positive, birth experiences. Methods: Ten doulas were recruited from a local community doula program and through word-of-mouth referrals from participants and completed in-depth interviews. Interviews were transcribed verbatim and analyzed using Atlas.ti software to identify emerging themes. Thematic saturation was achieved in interviews. Results: Several themes emerged from the interviews including: (1) The influence of similarities of race, culture, and lived experience on doula care; (2) How doulas often provide birthing persons with support and resources beyond birth; and (3) How doulas recognize the institutional biases that exist in the health care system and try to mediate their effect on birthing persons. Conclusions: These themes highlight how doulas can support birthing persons to mitigate the negative effects of social determinants of health, specifically racism and classism, and highlight potential avenues for doulas to consider when working with birthing persons who have low income and are AA.


African American; SES; doulas; health equity; pregnancy; qualitative research

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