(116) Amplifying the experience: A qualitative analysis of Black birthing people's experiences within a doula program

This qualitative study aimed to understand Black birthing people’s support and experiences during labor after being paired with a doula through a program within an urban academic medical system.

Study Design:

We recruited patients who participated in a program that pairs nulliparous self-identified Black birthing people with community doulas in the third trimester. Patients were eligible if they were >18 years old, delivered within the academic medical center within a year prior to the interview, and were successfully paired with a doula through the program. This study was exempt after IRB review. One on one semi-structured interviews (n=10) were preformed virtually after consent was obtained. Interview questions probed general birth experience, interactions with the doulas, and role of racial concordance among doulas. Interviews were recorded and transcribed. We used a combination of deductive and inductive approaches to group coded excerpts into emergent themes.

Results:

All participants where nulliparous Black birthing people. The median age was 29.5 (range 28-40) and all were privately insured. Themes that emerged were: labor support through advocacy and education, labor support through presence and accessibility, desire for earlier connection with doula, desire for doula support in the future, labor support from multiple sources, value of racial concordance with doula, and cost as perceived barrier to desired doula support. Example quotes for each theme are listed in figures 1 and 2.

Conclusion:

Overall, Black birthing people paired through a system wide program had positive experiences with racially concordant doulas and identified multiple methods of labor and antenatal support from various groups in addition to their paired doula. Many desired increased labor education and contact with their doulas earlier and more frequently, and the rare negative experiences were related to ability to develop a patient-doula relationship. Programs to increase access to doulas should aim to optimize the amount of covered doula meetings and quality of doula care.