• Katy B Kozhimannil, Carrie A Vogelsang, Rachel R Hardeman, and Shailendra Prasad.
• From the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis (KBK, CAV); the Division of Health Care Policy & Research, Mayo Clinic College of Medicine, Rochester, MN (RRH); and the Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis (SP). kbk@umn.edu.
• J Am Board Fam Med. 2016 May 1; 29 (3): 308317308-17.

PurposeThe goal of this study was to assess perspectives of racially/ethnically diverse, low-income pregnant women on how doula services (nonmedical maternal support) may influence the outcomes of pregnancy and childbirth.MethodsWe conducted 4 in-depth focus group discussions with low-income pregnant women. We used a selective coding scheme based on 5 themes (agency, personal security, connectedness, respect, and knowledge) identified in the Good Birth framework, and we analyzed salient themes in the context of the Gelberg-Anderson behavioral model and the social determinants of health.ResultsParticipants identified the role doulas played in mitigating the effects of social determinants. The 5 themes of the Good Birth framework characterized the means by which nonmedical support from doulas influenced the pathways between social determinants of health and birth outcomes. By addressing health literacy and social support needs, pregnant women noted that doulas affect access to and the quality of health care services received during pregnancy and birth.ConclusionsAccess to doula services for pregnant women who are at risk of poor birth outcomes may help to disrupt the pervasive influence of social determinants as predisposing factors for health during pregnancy and childbirth.© Copyright 2016 by the American Board of Family Medicine.

20 keywords...

hide…