The Cost‐Effectiveness of Professional Doula Care for a Woman's First Two Births: A Decision Analysis Model

Greiner, Karen S.; Hersh, Alyssa R.; Hersh, Sally; Remer, Jesse M.; Gallagher, Alexandra C.; Caughey, Aaron B.; Tilden, Ellen L.

doi:10.1111/jmwh.12972

Cited by 22 publications

(29 citation statements)

References 33 publications

(44 reference statements)

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“…Doula care is increasingly suggested as a "cost-effective" intervention to improve birth outcomes in the US, particularly for Black women [12,[46][47][48][49]. Our analysis suggests that characterizations of cost-effectiveness neglect the costs borne by community doulas, particularly those from and serving communities at greatest risk of adverse birth outcomes.…”

Section: Discussionmentioning

confidence: 95%

“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

Gómez

Arteaga

Arcara

et al. 2021

IJERPH

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With the increased policy emphasis on promoting doula care to advance birth equity in the United States, there is a vital need to identify sustainable and equitable approaches for compensation of community doulas, who serve clients experiencing the greatest barriers to optimal pregnancy-related outcomes. This case study explores two different approaches for compensating doulas (contractor versus hourly employment with benefits) utilized by SisterWeb San Francisco Community Doula Network in San Francisco, California. We conducted qualitative interviews with SisterWeb doulas in 2020 and 2021 and organizational leaders in 2020. Overall, leaders and doulas reported that the contractor approach, in which doulas were paid a flat fee per client, did not adequately compensate doulas, who regularly attend trainings and provide additional support for their clients (e.g., referrals to promote housing and food security). Additionally, this approach did not provide doulas with healthcare benefits, which was especially concerning during the COVID-19 pandemic. As hourly, benefited employees, doulas experienced a greater sense of financial security and wellbeing from receiving consistent pay, compensation for all time worked, and benefits such as health insurance and sick leave, allowing some to dedicate themselves to birth work. Our study suggests that efforts to promote community doula care must integrate structural solutions to provide appropriate compensation and benefits to doulas, simultaneously advancing birth equity and equitable labor conditions for community doulas.

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Section: Discussionmentioning

confidence: 95%

“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

Gómez

Arteaga

Arcara

et al. 2021

IJERPH

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“…Greiner ve ark. (41) doğumda desteklenen 1.6 milyon kadının incelendiği bir kohort çalışmasında, daha az sezaryen doğum, daha az anne ölümü, daha az uterus rüptürü ve daha az histerektomiye ek olarak, ciddi anlamda maliyet tasarrufu sağlandığını bildirmektedir. Ayrıca literatürde sezaryen oranının düşürülmesinde doğum süresince destek sunulmasının önemli olduğuna yönelik kanıtlar (1,3,9) giderek artmaktadır.…”

Section: Discussionunclassified

Evaluation of the Effect of the Physical Support to the Pregnancy on Birth Outcome

Bingöl¹,

Bal²,

Esencan³

et al. 2020

JAREN

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Objectives: This study was aimed to examine the effects of physical support during the childbirth period on the birth process. Methods: Research is an experimental randomized controlled study. In the study group, each pregnant woman was directly assisted by using non-pharmacological methods without leaving the woman during her birth. Simultaneous evaluations were made to the control group with routine hospital procedures. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-A was applied to all pregnant women before delivery. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-B version and The Scale for Measuring Maternal Satisfaction at Normal and Cesarean Birth were completed to all pregnant women after delivery. Results: The need for induction at birth decreased for women who were offered physical support (p = 0.033). The duration of labor for the study group was 657,93 ± 283.69 min. while the control group had 1062,43 ± 673.11 min. (p = 0.004) and the difference between them is statistically significant were determined (p=0,004). It was determined that the rate of episiotomy (p=0,000), fundal press (p=0,000) and fear of birth (p=0,001) decreased after birth. Also, women were found to have higher birth satisfaction (p = 0.001). Conclusion: It was determined that the physical support applied during the active phase of birth affects the birth process positively.

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“…Despite being a cost‐effective intervention via reductions in cesarean and preterm birth, especially for Medicaid beneficiaries, 25 , 34 , 35 only some states offer coverage for doulas through Medicaid, including the states Oregon and Minnesota. 28 In California, doulas will be added to the list of preventive services and Medi‐Cal will begin to cover doula services starting January 1, 2023.…”

Section: Public Health Implicationsmentioning

confidence: 99%

The role of doulas in respectful care for communities of color and Medicaid recipients

Mallick

Thoma

Shenassa

2022

Birth

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Background Despite the tenets of rights‐based, person‐centered maternity care, racialized groups, low‐income people, and people who receive Medicaid insurance in the United States experience mistreatment, discrimination, and disrespectful care more often than people with higher income or who identify as white. This study aimed to explore the relationship between the presence of a doula (a person who provides continuous support during childbirth) and respectful care during birth, especially for groups made vulnerable by systemic inequality. Methods We used data from 1977 women interviewed in the Listening to Mothers in California survey (2018). Respondents who reported high levels of decision making, support, and communication during childbirth were classified as having “high” respectful care. To examine associations between respectful care and self‐reported doula support, we conducted multivariable logistic regressions. Interactions by race/ethnicity and private or Medi‐Cal (Medicaid) insurance status were assessed. Results Overall, we found higher odds of respectful care among women supported by a doula than those without such support (odds ratios [OR]: 1.4, 95% CI: 1.0–1.8). By race/ethnicity, the association was largest for non‐Hispanic Black women (2.7 [1.1–6.7]) and Asian/Pacific Islander women (2.3 [0.9–5.6]). Doula support predicts higher odds of respectful care among women with Medi‐Cal (1.8 [1.3–2.5]), but not private insurance. Conclusions Doula support was associated with high respectful care, particularly for low‐income and certain racial/ethnic groups in California. Policies supporting the expansion of doulas for low‐income and marginalized groups are consistent with the right to respectful care and may address disparities in maternal experiences.

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The Cost‐Effectiveness of Professional Doula Care for a Woman's First Two Births: A Decision Analysis Model

Cited by 22 publications

References 33 publications

“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

Evaluation of the Effect of the Physical Support to the Pregnancy on Birth Outcome

The role of doulas in respectful care for communities of color and Medicaid recipients

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