Doula Support as a Strategy to Improve Health Equity for Black Birthing People: A Formative Qualitative Analysis [ID 986]

INTRODUCTION: Black birthing people have worse maternal outcomes than others, and doulas are increasingly recommended as part of the solution to mitigate racial inequities. This qualitative study explored the experience of doula care for Black doula clients. METHODS: Interviews were conducted with five doulas (four Black, one White) and six Black doula clients. Interviews explored reasons for using doulas specific to the Black birthing experience, how support for Black clients differs from support provided to other clients, and views on doula/client racial concordance. Transcripts were coded in Dedoose and thematically analyzed. RESULTS: Foremost, clients were concerned about the Black maternal mortality rate and wanted a doula to help mitigate their risk. Participants noted Black clients had greater support needs due to systemic racism within the medical system. Doulas primarily supported clients by identifying situations that required care escalation, and advocating on behalf of their client’s safety and birth preferences. Doulas reported providing different support for Black clients compared to non-Black clients (eg, more advocacy, education on mitigating systemic racism). Clients and doulas thought racial concordance improves relatability and support. CONCLUSIONS/IMPLICATIONS: The need for doulas to provide tailored support for Black birthing people highlights the systemic racism in our health care system. As we work toward building an equitable health care system free of systemic racism, it is important that doulas are trained on how to best support Black birthing people, who are confronted with disproportionate maternal risk today.