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Doula services to address the gap in infant mortality between blacks and whites in Allegheny County

Horsley, Demia (2018) Doula services to address the gap in infant mortality between blacks and whites in Allegheny County. Master's Thesis, University of Pittsburgh. (Unpublished)

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Infant mortality is defined as the death of an infant before 1 year of age. The United States (U.S.) has a national goal to decrease all-cause infant mortality rates. Despite this, the U.S. has a high rate of infant mortality especially compared to other developed nations. Blacks have dramatically higher rates of infant mortality than their white peers. This difference is rather pronounced in Pittsburgh, Allegheny County, Pennsylvania. Here, black infants are three times more likely than whites to die in their first year of life.
A review of causes and factors of infant mortality was conducted to identify contributors to infant mortality specifically within the black community. Current programming in Allegheny County that addresses many of the causes or factors of infant mortality was also reviewed. The emphasis was placed on doula services that have demonstrated effectiveness in impacting the causes and factors that contribute to infant mortality.
Doula services have been shown to be effective for improving maternal and child outcomes. Although information exists on the effectiveness of doula services in combating infant mortality, there is no research investigating black acceptability to doula services especially in Allegheny County.
Eight face-to-face interviews with African-American moms in Allegheny County collected information on their prenatal and birth experiences, their doula experiences, and consideration for presenting doula services so that they will be acceptable and welcomed by black mothers. Mothers identified some important barriers to acceptability of doula services. These included lack of knowledge about doulas and their services, family concerns, discomfort and lack of trust, established support systems and unaffordability. The mothers offered appropriate information dissemination, relationship building with expectant mothers and supportive others, and affordability as strategies to address these barriers.
This paper is based on interviews with members of a population in need. Based on information from the interviews combined with the existing data about the impact of doula services in other states a recommendation is to begin considering appropriate program and policy steps. These steps would ideally lead to implementation of doula services as an intervention to address the infant mortality gap in Allegheny County. Further research can be conducted to gather more feedback from a greater portion of the population.
Decreasing disparities in health outcomes and decreasing the infant mortality rate in the United States and Allegheny County, PA are both profoundly significant in the field of public health. Providing doulas to support Black mothers during pregnancy and birth could reduce the frequency of adverse maternal and infant outcomes that contribute to infant mortality. Doula services provide the education, support and advocacy that address the causes and factors that contribute to these adverse outcomes. This would have a profound impact on reducing the gap in infant mortality between blacks and whites in the United States and in Allegheny County.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTerry,
Committee MemberSonger,
Committee MemberHawk,
Date: 28 June 2018
Date Type: Publication
Defense Date: 23 April 2018
Approval Date: 28 June 2018
Submission Date: 4 April 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
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: doula, Infant mortality rate,
Date Deposited: 28 Jun 2018 19:44
Last Modified: 28 Jun 2018 19:44


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