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Components and experiences of doulas working with disadvantaged mothers

Wint, Kristina (2017) Components and experiences of doulas working with disadvantaged mothers. Master's Thesis, University of Pittsburgh. (Unpublished)

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African-American women have significantly poorer birth outcomes compared to their white peers; African-American women are more likely to give birth to a preterm baby and to have a baby with low birth weight. Additionally, African-American infants are more likely to die within their first year of life than white infants. Further, this health disparity between African-American and white women in infant mortality rates persists, the gap between groups showing little sign of closing. Thus, modifications are needed to tailor interventions to better suit the needs of African- American women. A potential enhancement is the inclusion of doula or doula-like services in existing home-visiting systems and the expansion of community doula programs. By providing support from a paraprofessional such as a doula, potentially the birth outcomes of African- American women and their children may be positively influenced. The goal of this research is to learn from doulas what components of their services might best serve low-income African- American women and to explore ways in which training can be modified to better help community doulas when working with this population. Ten doulas were interviewed about their experiences working with women who are low-income, African-American and both. Doulas were recruited from a local community doula program, and via word-of-mouth referrals from participants. Interviews were transcribed verbatim and analyzed using Atlas.ti software to identify emerging themes. The themes that emerged from the interviews included: 1) Doulas work to support mothers during the different phases of pregnancy, 2) Doulas work to advocate for mothers with a special emphasis on helping women self-advocate for themselves and their babies, 3) Doulas often step outside of their role to provide mothers with extra support, and 4) Doulas recognize the institutional biases that exist in the hospital system and try to mediate their effect on mothers. These themes highlight the ways doulas can intervene between the effects of negative social determinants of health, as well as show potential avenues to improve training to help doulas when working with disadvantaged women. The public health significance of this project lies in that it explores a perspective not previously explored in the literature: that of doulas with experience working with low-income African-American women, in an effort to improve the health of this population.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Wint, Kristinakew69@pitt.edukew690000-0001-9981-6082
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGary-Webb,
Committee MemberElias,
Committee MemberMendez,
Date: 29 June 2017
Date Type: Publication
Defense Date: 18 April 2017
Approval Date: 29 June 2017
Submission Date: 3 April 2017
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 46
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: doulas, African-American women, pregnancy, birth outcomes, health equity, birth disparities
Date Deposited: 29 Jun 2017 23:07
Last Modified: 29 Jun 2017 23:07

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