Evaluating the Implementation and Outcomes of a Community-Based Doula Program in Washington State: A Mixed-Methods...

Area of Science:

• Perinatal Health
• Health Equity
• Community Health Programs

Background:

• Community-based doulas offer nonclinical support, aiming to reduce racial disparities in perinatal health.
• Understanding the implementation and sustainability of these programs is crucial but limited.

Purpose of the Study:

• To examine the implementation and health outcomes of a community-based doula program.
• To identify barriers and facilitators influencing program success.

Main Methods:

• Explanatory sequential mixed methods design.
• Analysis of programmatic and health outcome data (2016-2022).
• Thematic analysis of listening sessions with direct service providers.

Main Results:

• Over 1800 low-income families served, primarily from diverse racial/ethnic backgrounds.
• Significant provision of home visits, direct funds, and material items.
• Positive outcomes including low preterm birth rates (4-9%) and high breastfeeding initiation (>94%).
• Facilitators: holistic, culturally-matched care and "doula-ing the doula" support.
• Barriers: systemic oppression, lack of resources, power imbalances, and provider burnout.

Conclusions:

• Community-based doula programs demonstrate a positive impact on perinatal health outcomes.
• Findings support increased compensation and structural support for doulas.