Hospital-based maternity care practitioners' perceptions of doulas

Area of Science:

• Maternal Health
• Healthcare Integration
• Obstetrics

Background:

• Birth doulas offer continuous support during pregnancy, labor, and postpartum.
• Evidence on doula benefits, particularly for underserved populations, lacks insight into practitioner recommendation factors.
• Integrating doulas into hospital maternity care is crucial for improving maternal health outcomes.

Purpose of the Study:

• To describe best practices for integrating birth doulas into hospital-based maternity care teams.
• To understand how and why individual practitioners recommend doula care.
• To facilitate access to evidence-based doula services for enhanced maternal health.

Main Methods:

• Semi-structured interviews with 47 maternity care practitioners (OB/GYNs, family physicians, RNs, nurse-midwives) across three hospitals.
• Qualitative analysis using the Template Organizing Style approach.
• Open-ended questions explored practitioners' experiences and perspectives on doula care.

Main Results:

• Practitioner support for doulas varied based on personal experiences, with positive feedback highlighting doulas' supportive roles and patient relationships.
• Potential conflicts arise from cultural differences between mainstream obstetrics and natural birth advocacy.
• Key themes for successful collaboration include mutual respect, education on doula training, and clear role definition.

Conclusions:

• Some practitioners express frustration with doulas, stemming from inadequate training and unclear roles.
• Effective integration requires adequate staff training on the doula model of care.
• Explicit role definition and increased practitioner exposure to doulas can foster better collaboration and integration into maternity care teams.