1. Bridging the Cultural Gap: Analyzing the Supportive Role of Doulas
Department of History
and Women’s and Gender Studies
Student Researcher: Sojourner White ‘16
Faculty Mentor: Amy Scott, PhD
In collaboration with: Wisconsin Doulas of Color Collective (WDCC)
Introduction
Childbirth in hospitals has been normalized at the expense of traditional practices that relied on more support from family and friends than modern medicine
“Doula” means a woman who cares for another woman
Doulas build a relationship and rapport with their expectant mothers to understand their needs
Doulas are non-medical birthing professionals who provide emotional, physical and mental support for expectant mothers
The type of support doulas provide include:
Attendance and transportation to prenatal appointments and birthing classes
Clear and detailed medical knowledge in a way for a mother to understand
Rubbing the mother’s back and feet to ease physical pain during labor
Educational resources for a healthy pregnancy and effective parenting
Breastfeeding assistance
Post-partum visits to the home
Yet, there are still racial and ethnic disparities between positive birth outcomes when analyzing women of color to Caucasian women.
Based on the research I hypothesize that:
Assistance from doulas during pregnancy and childbirth carries immense material and psychological value of doulas for low SES women of color
By learning from community-based programs that emphasize the importance of doulas for low SES women of color, hospitals and clinics can create more supportive spaces for pregnant women
Such programs are essential in order for women – regardless of race, ethnicity and economic situation – to have excellent prenatal care and a positive birth experience   
Conclusion and Steps Toward Advocacy
This study found that doulas are beneficial for low SES women of color to generate positive birth experiences:
Doulas can connect with underrepresented populations and help them attain higher birth satisfaction
Doulas have a cultural awareness and sensitivity to understand personal, societal, and economic hardships such as language barriers and lack of medical knowledge
Doulas value the presence of everyone involved in a birth, including a partner and medical professionals
Doulas help the mothers feel more in control of their birthing experience
Decrease of Cesarean Sections
Doula-mother bonding prior to labor helps the doula understand a mother’s wishes when given the option of a cesarean section without feeling pressured
Increase in Breastfeeding Initiation
Doula-supported mothers have more confidence in their breastfeeding abilities due to practicing and learning techniques with their doula
Higher Level of Mother-Baby Bonding
Doula-supported mothers spend more time with their babies initially after birth due to parenting tips given by a doula
Advocacy
Support hospitals, community clinics and centers with doula programming
Participate in a doula training
Volunteer with DONA to gather more information
Become a member of Doulas of North America (DONA)
Donate to DONA or an organization that funds doulas
Aim
The aims of this study are:
To understand the role of doulas and their value in community and medical settings
To determine if their emotional, informational and physical support of expectant mothers can provide positive birth outcomes for low SES women of color
To analyze how cultural differences impact the birthing experience
Discussion
In my paper I am expanding on these ideas with three conceptual points:
While doulas do not have a traditional medical background, the training they receive and support they provide offers a more interpersonal experience for an expectant mother
- Childbirth educators are advocates for childbearing women by analyzing the perinatal needs of their communities and creating opportunities to fill those gaps (Breedlove, 2005)
Doulas can teach and exchange ideas with other nurses, midwives and partners to create a dynamic birthing space that combines a social, emotional, physical and cultural support with modern medicine
- Doulas provide extra help for a nurse who is busy attending to multiple deliveries (Ballen and Fulcher, 2006).
- With Nursing Care Partnerships, doulas, midwives, and mothers can work together to create supportive, efficient and progressive opportunities for incarcerated women to understand community health (Schroeder and Bell, 2005)
A mother, her partner and a doula: Photo from Vicki Beauchamp/Hera’s Gift
Methods
This is an interdisciplinary narrative study
Scholarly research previously conducted on doulas and their involvement with women of color in the fields of Women’s and Gender Studies and Psychology was read and analyzed
Ethnographic research was conducted by interviewing two doulas from the WDCC in Milwaukee, WI
The interview questions for the doulas were:
What was your motivation for becoming a doula?
What kind of training did you receive to become a doula? Are there any practices that are emphasized or discussed in detail while assisting a birth?
How do you describe your role as a doula? What are the important characteristics of your position?
How does culture influence a birth?
How do you separate yourself from the mother after the baby is delivered? Is that the end of your contact with your clients?
What has been your experience with nurses, midwives and doctors?
References
Ballen, L. E., & Fulcher, A. J. (2006). Nurses and Doulas:
Complementary Roles to Provide Optimal Maternity Care. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(2),
Breedlove, G. (2005). Perceptions of Social Support from Pregnant and Parenting Teens Using Community-Based Doulas. Jpe Journal of Perinatal Education, 14(3),
Kozhimannil, K. B., Attanasio, L. B., Hardeman, R. R., & O'brien, M. (2013). Doula Care Supports Near-Universal Breastfeeding Initiation among Diverse, Low-Income Women. Journal of Midwifery & Women's Health, 58(4),
Schroeder, C., & Bell, J. (2005). Doula Birth Support for Incarcerated Pregnant Women.
Public Health Nursing Public Health Nurses, 22(1),
Shi, L., Stevens, G. D., Wulu, J. T., Politzer, R. M., & Xu, J. (2004). America's Health Centers: Reducing Racial and Ethnic Disparities in Perinatal Care and Birth Outcomes. Health Serv Res Health Services Research, 39(6p1),
Tyanna, a doula from the WDCC
Community-based doula programs have made strides to adhere to the societal and community health needs of expectant mothers by working with marginalized populations such as teen moms, imprisoned mothers and immigrants, but funding is often a big issue for their expansion with doulas
- Perinatal care in general is publicly funded, doulas are
not included in health care packages (Breedlove, 2005).
- Medicaid programs can offer the coverage needed for doulas that are cost-efficient and promote positive birth outcomes (Kozhimannil et al. 2013).
- CHCs have offered transportation, child-care and translation options to remove cultural and economic gaps disadvantaged populations face (Shi et al., 2004).
Alida, a doula from the WDCC, and her child