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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 1/2017

Open Access 01-12-2017

Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population

Authors: Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Published in: Maternal and Child Health Journal | Special Issue 1/2017

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Abstract

Purpose

Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description

To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along with prenatal and postpartum visits. Between 2010 and 2015, 489 infants were born to women enrolled in the program.

Assessment

Data indicate that By My Side is a promising model of support for Healthy Start projects nationwide. Compared to the project area, program participants had lower rates of preterm birth (6.3 vs. 12.4%, p < 0.001) and low birthweight (6.5 vs. 11.1%, p = 0.001); however, rates of cesarean birth did not differ significantly (33.5 vs. 36.9%, p = 0.122). Further research is needed to explore possible reasons for this finding, and to examine the influence of doula support on birth outcomes among populations with high rates of chronic disease and stressors such as poverty, racism, and exposure to violence. However, feedback from participants indicates that doula support is highly valued and helps give women a voice in consequential childbirth decisions.

Conclusion

Available evidence suggests that doula services may be an important component of an effort to address birth inequities.
Footnotes
1
For the purposes of this publication, “Latino/a” includes persons of Hispanic, Latino, and Spanish origin.
 
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Metadata
Title
Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population
Authors
Mary-Powel Thomas
Gabriela Ammann
Ellen Brazier
Philip Noyes
Aletha Maybank
Publication date
01-12-2017
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue Special Issue 1/2017
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-017-2402-0

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