Story Circles of Black Doulas, Cultural Brokers for Birthing People in Healthcare

Doula care services (in-person, hybrid, and virtual) during the COVID-19 pandemic may vary. The purpose of this study was to explore doulas' experiences as birthing professionals and epistemological resources assisting Black birthing families during the pandemic. Virtual qualitative story circles were conducted with 11 Black doulas who attended births as doulas from January 2020 to December 2021. Participants were recruited in California. The story circles were audio recorded and transcribed verbatim. Transcripts were analyzed using content analysis, with attention to the influence of epistemic injustice (types of injustices inflicted on marginalized groups) on service provision. Additionally, we employed Patricia Hill Collins' Black Feminist Theory which describes "Black women's ways of knowing" that disrupts and challenges existing epistemologies. Narrative data revealed (1) doulas are positioned as possessors of epistemic influence in birthing spaces with intersecting social identities, (2) a pervasive oppression of doulas' knowledge, (3) epistemological resilience and disruption, and (4) a commitment to Black indigenous practices. Despite these epistemic unfair structures, systems, and experiences, Black doulas reimagine and establish pathways for birthing families to navigate the healthcare system during intrapartum care.