Multisite implementation of trained volunteer doula support for disadvantaged childbearing women: a mixed-methods evaluation

Abstract

Our study looked at five schemes in England which offer support to disadvantaged women having babies. The support starts in pregnancy and goes on for 6 weeks after the baby’s birth. It is provided by specially trained volunteers (called ‘doulas’). The idea started with one of the five schemes and was then taken up by the other four, with the help of funding from the Department of Health. The philosophy behind the original doula service was to provide women with the support needed for a positive birth experience and breastfeeding. We looked at impacts on the NHS, on the women and on the volunteers and at how services had started the schemes and kept them running.\ud Participation rates were lower than we had hoped among women and doulas; 167 women and 89 doulas completed questionnaires. However, from those who filled in questionnaires or took part in focus groups we heard that most women really appreciated the service. Where women were less pleased with the service, it was because they had not received as much support as they wanted.\ud There was some evidence that women who had doula support had fewer caesarean sections although the numbers were not sufficient to rule out the possibility that this difference was due to chance. Women supported by doulas were more likely to start and to be continuing breastfeeding when their baby was 6 weeks old.\ud Through questionnaires and telephone interviews we learned that most volunteers enjoyed their role and called it a privilege to support a woman at such an important time. They felt that they had learned a lot and gained confidence and some had gone on to further training.\ud Midwives who took part in focus groups and the heads of midwifery who were interviewed were generally positive about the scheme.\ud Starting the schemes and keeping them running: funding was a major issue that persisted for all the doula services; other challenges included ensuring a steady rate of women referred and available volunteers

Building capacity and wellbeing in vulnerable/marginalised mothers: A qualitative study

“…They offer a range of services to different client groups including peer support and voluntary doula schemes (19,20).…”

Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences

“…We conducted an independent multi-site evaluation, informed by Realistic Evaluation (Pawson & Tilley 1997), which was funded by the National Institute of Health Research. The full report is available (Spiby et al, 2015). One of the aims of the evaluation was to examine the health and psychosocial impacts for women who used the volunteer doula service.…”

“…One of the aims of the evaluation was to examine the health and psychosocial impacts for women who used the volunteer doula service. Analysis of the service databases suggested some clinical outcomes of doula supported women were improved relative to the local population; the caveats around those findings are discussed elsewhere (Spiby et al, 2015). This paper focuses on the experiences of the women who used the service; specifically, the areas of impact and the nature of the relationship that may offer insights into how such outcomes occur.…”

Making the case for innovative reentry employment programs: previously incarcerated women as birth doulas – a case study

“…In contrast, the few community-based doula programs that do exist either train existing doulas to perform essential tasks such as accompanying women to prenatal classes and providing breast-feeding support (Cattelona et al, 2015;Munoz and Collins, 2015;Steel et al, 2013) or serve (but do not train or employ) low-income (Gruber et al, 2013;Kozhimannil et al, 2015;Spiby et al, 2015) or currently incarcerated women (Hotelling, 2008;Shlafer et al, 2015). It is important to note that these programs do not pay the doulas that work in these programs.…”