Beyond Birth Work: Addressing Social Determinants of Health With Community Perinatal Support Doulas

Area of Science:

• Public Health
• Sociology
• Maternal Health

Background:

• Adverse maternal and infant health outcomes in African Americans highlight a significant public health crisis.
• Structural racism and social determinants of health (SDOH) create inequities in resources, education, power, and opportunities.
• Understanding the SDOH needs of pregnant Black women is essential for improving health outcomes.

Purpose of the Study:

• To describe the social determinants of health (SDOH) needs and experiences of pregnant Black women.
• To examine these needs from the perspectives of doulas and Birthing Beautiful Communities (BBC) clients.
• To identify how specific SDOH issues create cascading effects impacting maternal and infant health.

Main Methods:

• Qualitative descriptive study using data collected between 2017-2023 in Cleveland and Akron, Ohio.
• Included 58 clients, 26 doulas, and 2 resource intake specialist assistants (RISAs).
• Content analysis of individual interviews, doula focus groups, and RISA interviews to identify SDOH.

Main Results:

• Participants reported issues across all social determinants of health (SDOH).
• Transportation and housing instability emerged as critical issues, causing a cascade of further problems.
• Inability to work due to transportation or health complications led to housing instability.

Conclusions:

• Trusted sources are needed to collect SDOH information and connect clients to resources.
• Policies must protect pregnant women from cascading SDOH effects that contribute to health disparities.
• Addressing SDOH is vital to reducing adverse maternal and infant health outcomes in African American women.