© 2019 by SisterWeb

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Doulas are critical to building healthy communities

Doulas complement the conventional medical system by providing individuals and families with continuous emotional, physical, and informational support throughout pregnancy, birth, and postpartum. Doulas can also provide support for individuals and families experiencing pregnancy loss or termination.  Recent research shows that, when combined with routine medical care, a doula helps people achieve healthy and satisfying birth experiences. Individuals who have doulas are less likely to have a cesarean birth, require pain medication, or experience postpartum depression. They also have higher rates of breastfeeding.  

 

Communities of color, in particular, benefit from doula care. A recent article by the New York Times on racial inequities in maternal health underscored the importance of doulas for pregnant women of color – a community that continues to face a maternal health crisis due to longstanding institutionalized racism. The exposé noted that a doula’s cultural competency, strong client relationship, and patient advocacy increases a woman’s odds of receiving prompt prenatal care to address pregnancy complications, decreases the likelihood that a birth complication will go unnoticed, and ensures she receives necessary emotional support to have a satisfying birth and postpartum experience.

 

Despite California’s recent efforts to reduce maternal mortality, the Bay Area is not immune to maternal health disparities. Women of color and low-income women disproportionately experience serious health conditions during pregnancy, birth complications, and maternal death. Yet low-income families, who are also more likely to be racial minorities due to the inextricable link between racism and wealth inequality, often lack access to the comprehensive, continuous care and support they need to have physically and emotionally healthy pregnancies and births. Although public programs, such as Medi-Cal, provide low-income people access to medical care, they do not cover doulas. Other community programs may provide financial or in-kind contributions to low-income families, but those donations are often limited in amount or time (or both). Pro bono and volunteer doula programs are scarce and cannot meet community demand. As a result, doulas, while prevalent in the Bay Area and essential for improving maternal health outcomes, are often only accessible to the economically privileged.

 

SisterWeb Meets Community Need Through a Sustainable Model of Care

SisterWeb’s community doula model is different from other community doula programs because it ensures that participating doulas are paid for their services rather than requiring doulas to volunteer their time and expertise. The end result is that more individuals from diverse backgrounds are able to enter into and remain in the doula profession, ultimately ensuring that more families can find a doula they feel comfortable working with to achieve their ideal pregnancy and birth experiences.

 

Doula care currently operates on a client-fee system. Professional doulas have to both seek out clients and charge fees that enable them to make a living wage. As a result, access to doulas is often limited to those who can afford to pay their fees. Doulas who are not economically privileged (who are also more likely to be women of color) typically find volunteer doula care to be cost-prohibitive. Indeed, the few volunteer doula programs that exist are often unable to recruit a sufficient number of doulas to meet community demand; those they recruit frequently experience high burnout and dropout rates. SisterWeb contends that paying doulas a livable wage will increase the likelihood that more doulas stay in the profession and that more women from different walks of life will enter into and stay in the profession, ultimately ensuring that the community has access to doulas who reflect the Bay Area’s diversity and improving the likelihood that families receive culturally competent birth care.