“Part mother, part sister, part champion, part coach”: Doulas’ perspectives on their roles in supporting lactation and hospital birth Restricted; Files Only
Crosier, Shelby (Spring 2024)
Abstract
Birth doulas provide continuous support to their clients throughout the perinatal period. They improve health outcomes for birthing people, including facilitating near-universal breastfeeding initiation and reducing instances of medical interventions like emergency c-sections during birth. These outcomes are consistent regardless of sociodemographic factors like a client’s racial or ethnic background. Despite this, doulas often do not feel accepted by healthcare providers and able to fully perform their jobs when working in the hospital setting. This study aims to understand doulas’ perceptions of their role in supporting lactation and working alongside healthcare providers to support births in the hospital setting. Data were collected through 14 semi-structured in-depth interviews with doulas currently living and working in the Atlanta Metro Area, which were recorded, transcribed, and de-identified. Themes were generated using a thematic analysis approach. Three major themes were identified: the role of the doula in lactation support, the role of the doula in supporting hospital births, and the effect of doula-healthcare provider relationships. These themes were explored and described through the lens of person-centered care outcomes as presented in the Person-Centered Care Framework for Reproductive Health Equity. Doulas provide person-centered, compassionate care to birthing people. However, they face barriers to providing their vital services in the hospital setting. Hospital systems should explore ways to increase acceptance of doulas by providers and incorporate doulas into their birth teams. Legislators and advocates should continue to push for greater structural support for doulas, such as Medicaid reimbursement of doula services.
Table of Contents
Table of Contents
Chapter 1: Introduction. 1
Introduction and Rationale. 1
Purpose Statement 3
Research Aims. 4
Significance Statement 4
Theoretical Framework Overview.. 5
Definition of Terms. 6
Chapter 2: Review of the Literature. 8
Introduction. 8
The Role of the Doula. 8
The State of Lactation in the United States. 10
Doulas’ Effects on Health Outcomes. 13
Doulas and the Healthcare System.. 14
The Person-Centered Care Framework for Reproductive Health Equity. 15
Chapter 3: Methodology. 19
Introduction. 19
Study Design. 19
Sampling and Recruitment 19
Data Collection Procedures. 20
Data Analysis. 21
Chapter 4: Results. 23
The Role of the Doula in Lactation Support 23
Person-Centered Care. 25
Perspectives on Barriers and Facilitators of Lactation. 28
The Role of the Doula in Supporting Hospital Births. 28
Person-Centered Care. 30
The Effect of Doula-Healthcare Provider Relationships. 32
Chapter 5: Conclusions, Implications, and Recommendations. 35
Lactation Support 35
Attending Hospital Births. 37
Healthcare Provider Interactions. 38
Strengths and Limitations. 39
Implications and Recommendations. 41
References. 43
Appendices. 56
Appendix A: In-Depth Interview Guide. 56
Appendix B: Recruitment Email 59
Appendix C: Screening Survey. 60
About this Master's Thesis
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File download under embargo until 20 May 2025 | 2024-04-24 12:58:13 -0400 | File download under embargo until 20 May 2025 |
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