What, when, and how long? Doula time use in a community doula program in San Francisco, California

Abstract

Objectives: Community doulas, who provide culturally concordant, nonclinical support during and after pregnancy, are increasingly promoted as an evidence-based intervention to advance birth equity. As valued members of their communities, community doulas often provide extensive physical and emotional pregnancy, birth, and postpartum support at low or no cost to clients. However, neither community doulas’ scope of work nor the distribution of time among their different work activities has been clearly defined or enumerated; therefore, this project sought to describe the work activities and time use of doulas in one community-based doula organization. Methods: In a quality improvement project, we reviewed case management system client data and collected 1 month of time diary data from eight doulas employed full-time at SisterWeb San Francisco Community Doula Network. We calculated descriptive statistics for activities community doulas reported in their time diaries and each visit/interaction logged in the case management system. Results: SisterWeb doulas spent about half of their time in direct client care. For every hour that doulas spent with a client in prenatal and postpartum visits, on average, they spent an additional 2.15 h communicating with and supporting their clients in other ways. Overall, we estimate that SisterWeb doulas spend an average of 32 h providing care for a client receiving the standard course of care, including intake, prenatal visits, support during childbirth, and postpartum visits. Conclusions: Results highlight the wide variety of work that SisterWeb community doulas do beyond direct client care. Acknowledgment of community doulas’ broad scope of work and appropriate compensation for all activities is necessary if doula care is to be advanced as a health equity intervention.

Tweets That Matter: Exploring the Solutions to Maternal Mortality in the United States Discussed by Advocacy Organizations on Twitter

“…Community doulas have been proven to help women feel relaxed and confident during the birthing process [52,53]. This study's findings also discussed the need to recruit doulas for improved maternal health care.…”

“…By advocating for policy changes, improving healthcare access and quality, mobilizing communities, and promoting individual solutions such as self-care and storytelling, maternal health advocates are working toward reducing maternal mortality rates and improving maternal health outcomes. Twitter and other social media platforms have been valuable tools in driving advocacy efforts, building connections, and amplifying the voices of marginalized communities [52,53]. As we continue to work toward solutions for maternal mortality in the United States, it is essential to listen to the voices of advocates and prioritize evidence-based solutions that address the complex and intersectional nature of these critical public health issues.…”

Experiencias de maternidad de mujeres en situación de discapacidad visual en Uruguay

“…Las doulas brindan apoyo y acompañamiento de forma individualizada a las mujeres gestantes en lo físico y emocional durante el trabajo de parto, nacimiento y puerperio inmediato(Arcara et al, 2023).de Lima, F., Rivas, R., Balaguer, C., Rodríguez, A., y. Experiencias de maternidad de mujeres en situación de discapacidad visual en Uruguay. RED Visual: Revista Especializada en Discapacidad Visual, 82, 9-28. https://doi.org/10.53094/RCID5525.…”