Volunteer doulas' experiences supporting cesarean births: A qualitative analysis for preliminary program evaluation

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Doula Care Research

Background:

• Cesarean birth is a prevalent procedure in the US, often linked to maternal complications and dissatisfaction.
• Doula support is known to enhance maternal and newborn outcomes but is typically limited to vaginal births.
• This study investigates the experiences of doulas providing support during cesarean deliveries.

Purpose of the Study:

• To explore the experiences of volunteer doulas supporting women during cesarean births.
• To understand the dynamics of doula support within the operating room (OR) environment.
• To identify perceived strengths, weaknesses, and areas for improvement in OR-based doula programs.

Main Methods:

• A qualitative research design was employed.
• Semi-structured interviews were conducted with nine doula volunteers.
• Interviews focused on their experiences supporting clients during cesarean births in the operating room.

Main Results:

• Doulas described their experiences through four relational themes: client relationships, environmental interactions (OR/labor & delivery), interprofessional team dynamics, and program culture.
• Participants identified strengths and limitations of the OR-based doula program.
• Suggestions for program improvements and future development were provided.

Conclusions:

• Volunteer doulas highly value their role in cesarean birth care.
• Doulas reported facilitating evidence-based practices, including skin-to-skin contact (SSC) and early breastfeeding initiation in the OR.
• Doulas successfully navigated the challenging OR environment and collaborated with the interprofessional team.