"I live in a doula desert": Doula Experiences in Rural Georgia Open Access
Comstock, Sydney (Spring 2023)
Published
Abstract
Background: Rural maternal and child health outcomes in Georgia are dismal, and there are fewer rural hospitals and providers every year. Doula care (or non-clinical perinatal support) can improve birth experiences and outcomes and reduce infant and maternal morbidity.
Methods: The community-engaged Georgia Doula Study, co-led by a university doula-researcher and a community-based doula organization, surveyed, and interviewed 22 doulas across the state. Descriptive analyses were conducted in Stata v. 14, and the interview transcripts were analyzed using coding, memo-ing, and diagramming in Dedoose.
Results: Of the 22 doulas interviewed,16 served rural populations. Five themes emerged: at baseline, 1) Rual childbirth education disparities, knowledge gaps, and opportunities, 2) Poor access to full spectrum of childbirth options in rural areas, 3) Insufficient perinatal support and social service gaps, 4) Far distances between doulas, rural clients, and healthcare settings, and 5) Rural poverty impedes doula access through long travel times and economic barriers. These findings emphasize the facilitators and barriers to doulas providing care to people in rural Georgia. The protective factors of education, knowledge, advocacy that doulas implement into their practice are essential to providing care.
Conclusion: Doulas face challenges in their work with rural communities, and their rural clients also face numerous barriers to doula and other holistic perinatal care. However, doulas carry numerous benefits and opportunities for rural communities including perinatal education, empowerment and advocacy, and connection to care.
Table of Contents
Table of Contents
Title Page i
Table of Contents ii
Chapter I: Introduction and Statement of the Problem and Purpose 1
Research Question 4
Chapter II: Literature Review 6
Chapter III: Methodology 16
Chapter IV: Results 22
Rural Childbirth Education Differences, Knowledge Gaps, and Opportunities 23
Poor Access to Full Spectrum of Childbirth Options in Rural Areas 28
Insufficient Perinatal Support and Social Service Gaps 34
Far Distances Between Doulas, Rural Clients, and Healthcare Settings 36
Rural Poverty Impedes Doula Access 41
Chapter V: Conclusions, Implications, and Recommendations 46
References 54
Appendices 62
Appendix I: Interview Guide 62
Appendix II: Screener 66
Appendix III: Demographic Survey 67
Appendix IV: Codebook 92
About this Master's Thesis
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