Restricted accessResearch articleFirst published online 2023-10
Providing Emotional Support and Physical Comfort During a Time of Social Distancing: A Thematic Analysis of Doulas' Experiences During the Coronavirus Pandemic
Doulas are trained, non-clinical professionals that provide a continuum of support for mothers. An interpretive phenomenological approach was used to explore the professional experiences of doulas (n = 17) during the COVID-19 pandemic in the US. Data were collected using brief intake surveys, in-depth semi-structured interviews, and an online discussion group. After a list of significant statements was created and grouped during emergent themes analysis, the reflections were summarized into three themes, (1) Doula Resilience, (2) Experiencing Vulnerability, and (3) Concern for Client Vulnerability that encapsulate the experiences of doulas during the COVID-19 pandemic. We conclude that as part of the COVID-19 recovery process, policy makers should look to non-clinical interventions for improving maternal health, such as promoting and supporting synergy between doulas and other maternal health service providers.
TikkanenRGunjaMZFitzGeraldM, et al.Maternal mortality and maternity care in the united states compared to 10 other developed countries. New York, NY: Commonwealth Fund Issue Briefs; 2020, DOI: 10.26099/411v-9255.
MartinJAHamiltonBEOstermanMJ, et al.Births: final data for 2019. Natl Vital Stat Rep From Centers Dis Control Prev Natl Cent Health Stat Natl Vital Stat Syst2021; 70(2): 1–51.
4.
World Health Organization. WHO statement on caesarean section rates. Geneva: World Health Organization; 2015.
5.
MeadowSL. Defining the doula's role: fostering relational autonomy. Health Expect2015; 18(6): 3057–3068, DOI: 10.1111/hex.12290.
6.
BohrenMAHofmeyrGJSakalaC, et al.Continuous support for women during childbirth. Cochrane Database Syst Rev2017; 2017(7): CD003766, DOI: 10.1002/14651858.CD003766.pub6.
7.
HodnettEDGatesSHofmeyrGJ, et al.Continuous support for women during childbirth. Cochrane Database Syst Rev2013; 7(7): CD003766, DOI: 10.1002/14651858.CD003766.pub5.
8.
KozhimannilKBHardemanRRAttanasioLB, et al.Doula care, birth outcomes, and costs among Medicaid beneficiaries. Am J Public Health2013; 103(4): e113–e121, https://dx.doi.org/10.2105%2FAJPH.2012.301201
PeahlAFSmithRDMonizMH. Prenatal care redesign: Creating flexible maternity care models through virtual care. Am J Obstet Gynecol2020; 223(3): 389–e1389. DOI: 10.1016/j.ajog.2020.05.029.
LantzPMLowLKVarkeyS, et al.Doulas as childbirth paraprofessionals: results from a national survey. Womens Health Issues2005; 15(3): 109–116.
15.
RaifmanMARaifmanJR. Disparities in the population at risk of severe illness from COVID-19 by race/ethnicity and income. Am J Prev Med2020; 59(1): 137–139.
16.
EllisP. The language of research (part 8): phenomenological research. Wounds UK2016; 12(1): 128–129.
17.
GillilandAL. After praise and encouragement: emotional support strategies used by birth doulas in the USA and Canada. Midwifery2011; 27(4): 525–531, DOI: 10.1016/j.midw.2010.04.006.
CreswellJWPothCN. Five qualitative approaches to inquiry. In: Qualitative inquiry & research design: Choosing among 5 approaches. Thousand Oaks, CA: Sage Publications, 2018, pp. 65–110.
20.
NeubauerBEWitkopCTVarpioL. How phenomenology can help us learn from the experiences of others. Perspect Med Education2019; 8(2): 90–97, DOI: 10.1007/s40037-019-0509-2.
AdamsC. Pregnancy and birth in the United States during the COVID-19 pandemic: the views of doulas. Birth2021; 00: 1–7, DOI: 10.1111/birt.12580.
23.
AdamsCCurtin-BowenM. Countervailing powers in the labor room: the doula–doctor relationship in the United States. Social Sci Med2021; 285: 114296.
24.
RiveraM. Transitions in Black and Latinx community-based doula work in the US During COVID-19. Front Sociol2021; 6: 1–8.
25.
SearcyJJCastañedaAN. On the outside looking in: a global doula response to COVID-19. Front Sociol2021; 6: 1–9.
26.
SkinnerDDelobellePPappinM, et al.User assessments and the use of information from MomConnect, a mobile phone text-based information service, by pregnant women and new mothers in South Africa. BMJ Glob Health2018; 3(Suppl 2): e000561.
27.
NeelKGoldmanRMarteD, et al.Hospital‐based maternity care practitioners’ perceptions of doulas. Birth2019; 46(2): 355–361.
28.
MaraniMKatulGGPanWK, et al.Intensity and frequency of extreme novel epidemics. Proc Natl Acad Sci2021; 118(35): e2105482118.
29.
VedamSStollKMacDormanM, et al.Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PloS one2018; 13(2): e0192523.
30.
KozhimannilKBHardemanRR. Coverage for doula services: how state Medicaid programs can address concerns about maternity care costs and quality. Birth2016; 43(2): 97–99.
CastenadaASearcyJ. My role is to walk the tightrope. In: CastenadaASearcyJ. (eds). Doulas and intimate labour: Boundaries, bodies, and birth. Demeter Press, 2015.
33.
SteelAFrawleyJAdamsJ, et al.Trained or professional doulas in the support and care of pregnant and birthing women: a critical integrative review. Health social Care Community2015; 23(3): 225–241.
34.
DeWildeCCarringtonJAbbateA, et al.Structural stress and otherness: how do they influence psychological stress?J Transcultural Nurs2019; 30(5): 478–491.
35.
HolzmanCSenagorePTianY, et al.Maternal catecholamine levels in midpregnancy and risk of preterm delivery. Am journal epidemiology2009; 170(8): 1014–1024.
