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1.
J Midwifery Womens Health ; 67(6): 696-700, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36480019

RESUMO

Access to safe and dignified pregnancy, childbirth, and postpartum experiences is a fundamental right for all pregnant and postpartum people. In the United States, systemic racism fuels distrust and disengagement in a health care system that continues to dehumanize the Black community. The respectful maternity care literature explains how these systemic, structural, and institutional failings produce maternal health disparities and expose a pattern whereby Black women receive less adequate maternity care. The implementation of trustworthy policies and practices is urgently needed because no single intervention has or will substantially reduce maternal disparities. The purpose of this article is to describe a multicomponent maternity care innovation, Melanated Group Midwifery Care (MGMC). MGMC was codesigned with community partners and is responsive to the needs and desires of Black women, making MGMC a culturally adapted and patient-centered model. Racial concordance among care providers and patients, group prenatal care, perinatal nurse navigation, and 12 months of in-home postpartum doula support are 4 evidence-based interventions that are bundled in MGMC. We posit that a model that restructures maternity care to increase health system accountability and aligns with the needs and desires of Black pregnant and postpartum people will increase trust in the health care system and result in better clinical, physical, emotional, and social outcomes.


Assuntos
Doulas , Serviços de Saúde Materna , Tocologia , Feminino , Humanos , Gravidez , Estados Unidos , Parto , Parto Obstétrico
2.
PLoS One ; 17(11): e0277533, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36399476

RESUMO

OBJECTIVES: To evaluate the effectiveness of community-based bilingual doula (CBD) support for improving the intrapartum care experiences and postnatal wellbeing of migrant women giving birth in Sweden. DESIGN: Randomised controlled trial. SETTING: Six antenatal care clinics and five hospitals in Stockholm, Sweden. PARTICIPANTS: 164 pregnant Somali-, Arabic-, Polish-, Russian- and Tigrinya-speaking women who could not communicate fluently in Swedish, were ≥18 years and had no contra-indications for vaginal birth. INTERVENTION: In addition to standard labour support, women were randomised to CBD support (n = 88) or no such support during labour (n = 76). Trained CBDs met with women prior to labour, provided support by telephone after labour had started, then provided emotional, physical and communication support to women throughout labour and birth in hospital, and then met again with women after the birth. PRIMARY OUTCOMES: Women's overall ratings of the intrapartum care experiences (key question from the Migrant Friendly Maternity Care Questionnaire) and postnatal wellbeing (mean value of Edinburgh Postnatal Depression Scale) at 6-8 weeks after birth. RESULTS: In total, 150 women remained to follow-up; 82 women (93.2%) randomised to receive CBD support and 68 women (89.5%) randomised to standard care (SC). Of women allocated CBD support, 60 (73.2%) received support during labour. There were no differences between the groups regarding women's intrapartum care experiences (very happy with care: CBD 80.2% (n = 65) vs SC 79.1% (n = 53); OR 1.07 CI 95% 0.48-2.40) or emotional wellbeing (EPDS mean value: CBD 4.71 (SD 4.96) vs SC 3.38 (SD 3.58); mean difference 1.33; CI 95% - 0.10-2.75). CONCLUSIONS: Community-based doula support during labour and birth for migrant women neither increased women's ratings of their care for labour and birth nor their emotional well-being 2 months postpartum compared with receiving standard care only. Further studies on the effectiveness of CBD powered to evaluate obstetric outcomes are needed. TRIAL REGISTRATION: Trial registration at ClinicalTrial.gov NCT03461640 https://www.google.com/search?client=firefox-b-d&q=NCT03461640.


Assuntos
Doulas , Serviços de Saúde Materna , Migrantes , Humanos , Feminino , Gravidez , Suécia , Parto
3.
Prof Case Manag ; 28(1): 1-2, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36394853

RESUMO

Death doulas are people who help people at the end of life with dying, just like birth doulas help at the beginning of life. Views of traditions surrounding death, such as funerals and other ways to memorialize loved ones, are shifting. Death doula associations are seeing an increased interest from people who are seeking death doulas and those who wish to become death doulas.


Assuntos
Doulas , Humanos , Morte
4.
BMC Pregnancy Childbirth ; 22(1): 765, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36224541

RESUMO

BACKGROUND: While maternal health is a priority in international goals, maternal health outcomes remain poor in many regions of the world. In Brazil, maternal mortality has decreased over the past decades, but the country's maternal mortality ratio is higher than over half of all countries at 59 deaths per 100,000 live births. The Brazilian maternal health care model facilitates high rates of medical interventions during labor and childbirth; 56% of births are by cesarean birth. Doula support is considered a potential strategy to reduce medically unnecessary interventions during childbirth that contribute to maternal mortality. METHODS: The cross-sectional study analyses associations with use of doula support and normal birth among Brazilian women who participated in a health education intervention named the Senses of Birth (SoB). The SoB intervention, implemented in five cities from 2015 to 2017, was developed to educate about normal birth and to evidence-based practices (EBP) reduce medically in childbirth. Chi-Square tests were performed to identify the relationship between doula support during childbirth and sociodemographic characteristics, childbirth information, perceived knowledge, and use of EBPs during labor. Logistic regression was performed to identify associations in adjusted analysis. RESULTS: Controlling for covariates, doula support was associated with vaginal delivery (OR 2.47, 95% CI: 1.37-4.45.) Findings also suggest that women who had doula support were more likely to use non-pharmacological pain relief methods during labor (OR 9.68, 95% CI: 2.67-34.61), deliver in a public hospital (OR 2.02, 95% CI: 1.09-3.72), and be low and mid-level income compared to women with high income. CONCLUSION: This study's findings suggest that doula support is significantly associated with vaginal birth. The results may be useful for advocating for changes to the childbirth care model in Brazil. Incorporating EBPs, such as doula support, for all women who desire may improve maternal and child outcomes.


Assuntos
Doulas , Educação em Saúde , Apoio Social , Brasil , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Gravidez
5.
Ecol Food Nutr ; 61(5): 638-648, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36031931

RESUMO

Women living below the federal poverty level have low breastfeeding rates and historically have lacked access to doula care. This disparity is particularly evident among African American women. The objective of this pilot study was to assess doulas' experiences delivering lactation education to racially/ethnically diverse, primarily Medicaid-eligible pregnant women and describe doulas' perceptions of client barriers to breastfeeding. We also wanted to understand doulas' views of infant feeding and lactation education during their participation in a quality improvement intervention that trained doulas to provide lactation education and breastfeeding support at 4 clinics serving low-income clients. Two focus groups were conducted with 7 doulas. Focus group data were transcribed, coded, and analyzed using qualitative thematic analysis. Doulas reported close relationships with their clients and provided consistent breastfeeding support and education to women in prenatal, birth, and postpartum phases of care. Doulas emphasized the need for more lactation education, especially to overcome clients' perceived milk insufficiency and early termination due to breastfeeding barriers. Doula-led breastfeeding education and support may improve breastfeeding outcomes for diverse women from underserved areas.


Assuntos
Doulas , Aleitamento Materno , Feminino , Humanos , Lactação , Projetos Piloto , Pobreza , Gravidez , Relatório de Pesquisa
6.
BMJ Glob Health ; 7(7)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35902203

RESUMO

BACKGROUND: Community-based doulas share the same cultural, linguistic, ethnic backgrounds or social experiences as the women they support. Community-based doulas may be able to bridge gaps for migrant and refugee women in maternity settings in high-income countries (HICs). The aim of this review was to explore key stakeholders' perceptions and experiences of community-based doula programmes for migrant and refugee women during labour and birth in HICs, and identify factors affecting implementation and sustainability of such programmes. METHODS: We conducted a mixed-method systematic review, searching MEDLINE, CINAHL, Web of Science, Embase and grey literature databases from inception to 20th January 2022. Primary qualitative, quantitative and mixed-methods studies focusing on stakeholders' perspectives and experiences of community-based doula support during labour and birth in any HIC and any type of health facility were eligible for inclusion. We used a narrative synthesis approach to analysis and GRADE-CERQual approach to assess confidence in qualitative findings. RESULTS: Twelve included studies were from four countries (USA, Sweden, England and Australia). There were 26 findings categorised under three domains: (1) community-based doulas' role in increasing capacity of existing maternity services; (2) impact on migrant and refugee women's experiences and health; and (3) factors associated with implementing and sustaining a community-based doula programme. CONCLUSION: Community-based doula programmes can provide culturally-responsive care to migrant and refugee women in HICs. These findings can inform community-based doula organisations, maternity healthcare services and policymakers. Further exploration of the factors that impact programme implementation, sustainability, strategic partnership potential and possible wider-reaching benefits is needed.


Assuntos
Doulas , Trabalho de Parto , Refugiados , Migrantes , Feminino , Humanos , Parto , Gravidez
7.
Perspect Sex Reprod Health ; 54(3): 99-108, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35797066

RESUMO

CONTEXT: Community-based birth doulas support pregnant women, transgender men, and gender non-binary individuals during the perinatal period and provide essential services and expertise that address health inequities, often taking on additional roles to fill systemic gaps in perinatal care in the United States (US). Despite the benefits that community-based birth doulas provide, there is little research exploring the work-related conditions and stressors community-based doulas experience. To address this gap, we examined the work experiences, related stressors, and stress management strategies of individual community-based birth doulas. METHODS: In this qualitative, descriptive study we conducted 18 interviews in March through June 2021 with individuals who self-identified as community-based doulas working in underserved communities in the US. We analyzed the interviews for themes, which we defined and finalized through team consensus. RESULTS: The doulas reported engaging in specific strategies in their work to address perinatal inequities. They also described facing several work-related stressors, including witnessing discrimination against clients, experiencing discrimination in medical environments, and struggling with financial instability. To mitigate these stressors and job-related challenges, interviewees reported they relied on doula peer support and reconnected with their motivations for the work. CONCLUSIONS: Community-based doulas provide essential services and expertise which address inequities and systemic gaps in perinatal care. However, as they work to improve perinatal health, doulas themselves are providing equity work amidst an inequitable system and with insufficient political or financial support. Increased compensation and systemic support which acknowledges the breadth of services provided is needed to strengthen and sustain this critical part of the perinatal workforce.


Assuntos
Doulas , Feminino , Humanos , Motivação , Parto , Gravidez , Pesquisa Qualitativa , Estados Unidos
8.
Med Anthropol ; 41(5): 560-573, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35819827

RESUMO

At 32.3%, Switzerland ranks among countries with the highest rates of cesarean deliveries in Europe. Because cesareans generally negatively influence the birth experience, parents turn to holistic therapists to heal somatic and emotional disorders not addressed by standard biomedical follow-ups. Doula care is still emerging in Switzerland. Although doulas are not allowed in the operation rooms, they support parents before birth and during the postpartum period. They aim at improving the birth experience by restoring intimate, "sacred" elements of birth through symbolic and spiritual practices. Based on interviews with doulas, I explore their experiences and practices regarding surgical birth.


Assuntos
Doulas , Antropologia Médica , Cesárea , Doulas/psicologia , Feminino , Humanos , Parto , Gravidez , Suíça
9.
Qual Health Res ; 32(10): 1477-1486, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35739081

RESUMO

Birth doulas were deemed "non-essential" personnel during the COVID-19 pandemic and were generally excluded from attending hospital births in person. This study documents the impacts of pandemic-related contextual factors on birth doula care in the San Francisco Bay Area, examines how doulas adapted their services, and explores implications for policy and practice. We employed a contextually bound qualitative case study methodology driven by social action theory and conducted interviews with 15 birth doulas. The pandemic disrupted physical settings, the social environment, communication modalities, contractual arrangements, and organizational level factors. The historical context also amplified awareness of institutionalized racism in birth settings and highlighted birth doulas' advocacy role. Striking deficits exist in birth doulas' integration into US healthcare systems; this made their services uniquely vulnerable to the pandemic circumstances. Birth doulas' value ought to be more formally recognized within health policy, health insurance, and hospital systems as complementary care to that provided by medical providers to improve access to high-quality perinatal care.


Assuntos
COVID-19 , Doulas , COVID-19/epidemiologia , Feminino , Humanos , Pandemias , Distanciamento Físico , Gravidez , São Francisco/epidemiologia
10.
Birth ; 49(4): 823-832, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35652195

RESUMO

BACKGROUND: Despite the tenets of rights-based, person-centered maternity care, racialized groups, low-income people, and people who receive Medicaid insurance in the United States experience mistreatment, discrimination, and disrespectful care more often than people with higher income or who identify as white. This study aimed to explore the relationship between the presence of a doula (a person who provides continuous support during childbirth) and respectful care during birth, especially for groups made vulnerable by systemic inequality. METHODS: We used data from 1977 women interviewed in the Listening to Mothers in California survey (2018). Respondents who reported high levels of decision making, support, and communication during childbirth were classified as having "high" respectful care. To examine associations between respectful care and self-reported doula support, we conducted multivariable logistic regressions. Interactions by race/ethnicity and private or Medi-Cal (Medicaid) insurance status were assessed. RESULTS: Overall, we found higher odds of respectful care among women supported by a doula than those without such support (odds ratios [OR]: 1.4, 95% CI: 1.0-1.8). By race/ethnicity, the association was largest for non-Hispanic Black women (2.7 [1.1-6.7]) and Asian/Pacific Islander women (2.3 [0.9-5.6]). Doula support predicts higher odds of respectful care among women with Medi-Cal (1.8 [1.3-2.5]), but not private insurance. CONCLUSIONS: Doula support was associated with high respectful care, particularly for low-income and certain racial/ethnic groups in California. Policies supporting the expansion of doulas for low-income and marginalized groups are consistent with the right to respectful care and may address disparities in maternal experiences.


Assuntos
Doulas , Serviços de Saúde Materna , Feminino , Estados Unidos , Gravidez , Humanos , Medicaid , Respeito , Parto Obstétrico
11.
Can Rev Sociol ; 59(3): 395-411, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35689564

RESUMO

Doulas offer emotional support to women during pregnancy, childbirth, and the early postpartum period. In hospitals, doulas support their clients without holding formal status as employees or as a regulated profession. Drawing on interviews with 26 doulas in Toronto, Canada, along with analyses of the legacy of medical dominance in maternity care, I examine how doulas accomplish their work in hospitals. I find that doulas face challenges accessing physical resources and struggle to provide their model of care in light of routine hospital procedures and interventions. In response, many doulas develop strategies to address the constraints imposed by their work contexts. These findings suggest that the medical model of birth is resistant to even minor modifications or perspectives that view birth holistically rather than solely dependent on medical intervention.


Les doulas offrent un soutien émotionnel aux femmes pendant la grossesse, l'accouchement et le début de la période postnatale. Dans les hôpitaux, les doulas soutiennent leurs clients sans avoir un statut officiel d'employées ou de profession réglementée. À partir d'entretiens avec 26 doulas à Toronto, au Canada, et d'analyses de l'héritage de la domination médicale dans les soins de maternité, j'examine comment les doulas accomplissent leur travail dans les hôpitaux. Je constate que les doulas ont du mal à accéder aux ressources physiques et à fournir leur modèle de soins à la lumière des procédures et interventions hospitalières habituelles. En réponse, de nombreuses doulas développent des stratégies pour faire face aux contraintes imposées par leur contexte de travail. Ces résultats suggèrent que le modèle médical de l'accouchement résiste à des modifications même mineures ou à des perspectives qui considèrent l'accouchement de manière holistique plutôt que de dépendre uniquement d'une intervention médicale.


Assuntos
Doulas , Serviços de Saúde Materna , Parto Obstétrico , Feminino , Hospitais , Humanos , Parto , Gravidez
12.
PLoS One ; 17(6): e0270755, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35771881

RESUMO

How women are cared for while having a baby can have lasting effects on their lives. Women value relational care with continuity-when caregivers get to know them as individuals. Despite evidence of benefit and global policy support, few maternity care systems across the world routinely offer relational continuity. Women experiencing socioeconomic adversity have least access to good quality maternity care. Community-based doula support programs offer complementary care for these women and are known to, on average, have positive outcomes. Less understood is how, when, and why these programs work. A realist evaluation of an Australian volunteer doula program explored these questions. The program provides free social, emotional, and practical support by trained doulas during pregnancy, birth, and early parenting. This paper reports the testing and refinement of one program theory from the larger study. The theory, previously developed from key informant interviews and rapid realist review of literature, hypothesised that support increased a woman's confidence via two possible pathways-by being with her and enabling her to see her own strength and value; and by praising her, and her feeling validated as a mother. This study aimed to test the theory in realist interviews with clients, focus groups with doulas, and with routinely collected pre-post data. Seven English-speaking and six Arabic-speaking clients were interviewed, and two focus groups with a total of eight doulas were conducted, in January-February 2020. Qualitative data were analysed in relation to the hypothesised program theory. Quantitative data were analysed for differential outcomes. Formal theories of Recognition and Relational reflexivity supported explanatory understanding. The refined program theory, Recognition, explains how and when a doula's recognition of a woman, increases confidence, or not. Five context-mechanism-outcome configurations lead to five outcomes that differ by nature and longevity, including absence of felt confidence.


Assuntos
Doulas , Serviços de Saúde Materna , Austrália , Doulas/psicologia , Feminino , Humanos , Gravidez , Fatores Socioeconômicos , Voluntários/psicologia
13.
Sociol Health Illn ; 44(7): 1059-1076, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35524362

RESUMO

Sociological scholars of healthcare professions are becoming increasingly aware of the organisational dimension of professionalism, including how professionals as institutional actors are exposed to and influence organisational transformation. By tracing the ground-level professional efforts of Russian doulas-a caring profession that has been plunged into a reforming health system-in this article I explore how meaning-making activities and professionals' emotional labour build into and advance institutional changes in post-socialist maternity care. Drawing on qualitative research materials, I define three ways through which doulas' institutional efforts engage with emotions in clinical settings: (1) redefining emotional labour as a compound of maternity care; (2) grounding emotional labour in the context of reforming institutions; (3) using emotional labour to bridge discrepancies within organisational arrangements in healthcare. My research findings provide new insights into how marketisation influences professional care, as well as about caring professionalism in post-socialist maternity care. Attention to doulas' professional efforts allows for the affective transformation and inequality in the context of healthcare reforms to be analytically grasped. In particular, I trace how doulas' institutional agency embodied in emotional labour constructs the neo-liberal patient's identity.


Assuntos
Doulas , Serviços de Saúde Materna , Obstetrícia , Doulas/psicologia , Emoções , Feminino , Humanos , Inovação Organizacional , Gravidez
14.
Womens Health Issues ; 32(5): 440-449, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35610121

RESUMO

INTRODUCTION: Racial inequities in birth outcomes persist in the United States. Doula care may help to decrease inequities and improve some perinatal health indicators, but access remains a challenge. Recent doula-related state legislative action seeks to improve access, but the prioritization of equity is unknown. We reviewed recent trends in doula-related legislation and evaluated the extent to which new legislation addresses racial health equity. METHODS: We conducted a landscape analysis of the LegiScan database to systematically evaluate state legislation mentioning the word "doula" between 2015 and 2020. We identified and applied nine criteria to assess the equity focus of the identified doula-related legislative proposals. Our final sample consisted of 73 bills across 24 states. RESULTS: We observed a three-fold increase in doula-related state legislation introduced over the study period, with 15 bills proposed before 2019 and 58 proposed in 2019-2020. Proposed policies varied widely in content and scope, with 53.4% focusing on Medicaid reimbursement for doula care. In total, 12 bills in 7 states became law. Seven of these laws (58.3%) contained measures for Medicaid reimbursement for doula services, but none guaranteed a living wage based on the cost of living or through consultation with doulas. Only two states (28.6%; Virginia and Oregon) that passed Medicaid reimbursement for doulas also addressed other racial equity components. CONCLUSIONS: There has been an increase in proposed doula-related legislation between 2015 and 2020, but racial health equity is not a focus among the laws that passed. States should consider using racial equity assessments to evaluate proposed doula-related legislation.


Assuntos
Doulas , Equidade em Saúde , Feminino , Humanos , Medicaid , Parto , Gravidez , Grupos Raciais , Estados Unidos
15.
Nurs Educ Perspect ; 43(3): 196-197, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35482404

RESUMO

ABSTRACT: Following COVID-19-related closures of clinical and simulation learning sites, a Jesuit college of nursing made a two-week pivot from in-person to virtual clinical learning. In response, the simulation team reinvented their role to provide extensive support in the Jesuit pedagogical tradition. These self-titled "simulation doulas" removed all nonteaching tasks from faculty, remained available for questions and concerns, and became experts on the simulation platforms. The simulation doulas' success in facilitating such rapid transition relied on remaining transparent in communication, anticipating needs, embracing adaptability, and conveying a spirit of empowerment to stakeholders.


Assuntos
COVID-19 , Doulas , Comunicação , Simulação por Computador , Humanos , Aprendizagem
16.
J Perinat Neonatal Nurs ; 36(2): 99-102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476759

RESUMO

OBJECTIVES: The purpose of this commentary is to provide an overview of the current landscape for childbearing families and pregnancy-capable people and a call to action toward the courage to align health and human services that support improved health outcomes. The commentary is broken into 3 parts. RESEARCH: The framework of retrofit, reform, and reimagine is developed to provide a conceptual framework that supports a shared language. METHODS: The current landscape is juxtaposed on the framework of retrofit, reform, and reimagine to connect the dots for health equity. CONCLUSIONS: The commentary ends with a call to action that demonstrates a bold roadmap for birth workers, clinicians, nurses, doulas, physicians, and other clinical health services providers to coconstruct paths to human services that should resolve health inequities.


Assuntos
Doulas , Equidade em Saúde , Humanos
17.
Womens Health (Lond) ; 18: 17455057221093928, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35438029

RESUMO

OBJECTIVES: To interview representatives from Indigenous doulas across Canada in order to document how they manage the logistics of providing community-based doula care and understand their challenges. These objectives inform the development of an Indigenous doula pilot programme as part of the project, 'She Walks With Me: Supporting Urban Indigenous Expectant Mothers Through Culturally Based Doulas'. METHODS: In 2020, semi-structured interviews were conducted with members of five Indigenous doula collectives across Canada. Interview transcripts were approved by participants and subsequently coded by the entire research team to identify key themes. RESULTS: Our article explores one of the main themes that emerged from these interviews: sustainable funding for Indigenous doula services. Within this theme we identified two sub-themes: (1) limitations on and regulations for available funding and (2) negative impacts of limited funding on doula service. CONCLUSION: A major challenge to providing Indigenous community-based doula services is sustainable funding. Current models of funding for this work often do not provide livable wages and are bound by limited durations and regulations that are unsustainable and can be culturally inappropriate. Due to this lack of sustainable funding, Indigenous doula service in Canada faces challenges that include high staff turnover and burnout and lack of time and resources to provide culturally safe care, pursue professional development and additional training, and keep their services affordable for the families who need them. Future research is needed to ascertain potential programmes and funding streams for sustainable Indigenous doula support in Canada, including possible integration of doula care into the universal public health care system despite the jurisdictional challenges in providing health care for Indigenous peoples.


Assuntos
Doulas , Canadá , Atenção à Saúde , Feminino , Humanos
18.
Palliat Med ; 36(5): 795-809, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35272515

RESUMO

BACKGROUND: Death doulas have gained greater attention recently by offering psychosocial, spiritual and other non-clinical support for patients with time-limiting diseases, including their families, with the potential to complement existing end-of-life care services. However, their roles, scope of practice and care impact remain poorly understood. AIM: To describe existing knowledge on death doulas regarding their roles, care impact, training and regulation. DESIGN: This scoping review utilised Levac et al.'s framework and textual narrative synthesis to summarise the findings. DATA SOURCES: PubMed, Scopus, CINAHL, PsycINFO, ProQuest, Google Scholar were searched for relevant articles from inception to 20 May 2021. Empirical studies, narrative reports, unpublished theses and studies in English were included. RESULTS: Thirteen articles were included. Death doulas take on diverse roles in end-of-life care. Their roles include providing psychosocial, spiritual, practical support, companionship and resource navigation. The positive impacts of engaging a death doula include continuous presence, holistic service and flexible payment regime. The negative aspects include role inconsistencies and confusion among healthcare professionals and the public. CONCLUSIONS: Death doulas can augment existing end-of-life care services by providing holistic and personalised care services at home or hospital settings. Their roles are still evolving and remain mostly unregulated, with little evidence about their impact. There is a need for more rigorous studies to explore healthcare professionals' views about this role and examine the clinical outcomes among dying persons and their families.


Assuntos
Doulas , Cuidados Paliativos na Terminalidade da Vida , Assistência Terminal , Amigos , Pessoal de Saúde/psicologia , Humanos
19.
Int J Qual Stud Health Well-being ; 17(1): 2043527, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35212612

RESUMO

PURPOSE: Migrating women, have an overall increased risk of adverse outcomes and poorer health during pregnancy and childbirth. In addition, they do not participate in planned antenatal care to the same extent as natives. These disparities among migrants and native pregnant women point to the need for interventions to improve equal health and care during pregnancy and childbirth. This study aimed to explore the experiences of participating in a lifestyle intervention, named "Dancing for birth," focusing on integration and physical activity, from the perspectives of the participating pregnant women, midwives, and cultural interpreter doulas. METHOD: Qualitative interviews were conducted from March 2019 to December 2020, with ten women who participated in a lifestyle intervention in Sweden: four pregnant women, three midwives, and three cultural interpreter doulas. Thematic analysis was used to analyse the data. RESULTS: The lifestyle intervention "Dancing for birth" provided positive shared Health-promoting experiences among the participants with social inclusivness and a commitment to supporting each other. This seemed to encourage the sense of strength as a woman- a strengthboth for the individual woman and as a kind of women´s power. CONCLUSIONS: Interventions targeting physical activity, social inclusiveness, and health literacy are of utmost importance in promoting positive pregnancy experiences and equal healthcare during pregnancy. Further research is needed on how to implement antenatal education that includes all women in society.


Assuntos
Doulas , Tocologia , Exercício Físico , Feminino , Promoção da Saúde , Humanos , Estilo de Vida , Parto , Gravidez , Gestantes , Cuidado Pré-Natal , Pesquisa Qualitativa
20.
Matern Child Health J ; 26(4): 872-881, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35072868

RESUMO

INTRODUCTION: Increasingly, community-based models of doula care are receiving attention as possible interventions to address racial inequities in maternal health care experiences and outcomes. In 2018, community-based organization SisterWeb launched to provide free culturally congruent community doula care to advance birth equity for Black and Pacific Islander pregnant people, with funding from the San Francisco Department of Public Health. We conducted a process evaluation of SisterWeb's first 1.5 years of existence to identify multilevel barriers and facilitators to implementation of their programs. METHODS: Guided by the Equitable Evaluation Framework™, we conducted 46 in-depth interviews with individuals from 5 groups: SisterWeb leadership, doulas, doula mentors, and clients, and external stakeholders. RESULTS: Barriers included having diverse clientele groups with unique needs, an ineffective payment model, and simultaneously building an organization and developing and implementing programs. Facilitators included the presence of established strategic partnerships, positive reception of services due to an unmet need for culturally and linguistically congruent pregnancy and birth support among SisterWeb's clients, a clear organizational vision and mission, and a unique doula cohort model. DISCUSSION: Our findings suggest developing community doula programs pay close attention to the difference between launching a program versus an organization, including the required resources of each, the sustainability of payment models for community doulas, and the provision of culturally relevant, needed services within priority communities. Furthermore, strategic partnerships with maternal health stakeholders in birthing sites, particularly hospitals, are vital to the success of a community doula program.


Assuntos
Doulas , Serviços de Saúde Materna , Feminino , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Parto , Gravidez , São Francisco
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