Guarding the Black Womb: A Qualitative Case Study Exploring Improving Black Maternal Health Through Increased and Equitable Doula Support

Black maternal health is a critical topic in health care. Black women are at a disproportionately high risk of maternal death and morbidity compared to their White counterparts, highlighting the need for change in healthcare systems (Declercq & Zephyrin, 2020). Research also shows that supporting Black mothers with Black doulas can improve the mother’s birth outcomes and disrupt the racial inequities of maternal health (Horton & Hall, 2020). This qualitative case study explored the lived experiences of 11 Black women who utilized doula support and the perspectives of the doulas and program administrators. The primary objective was to evaluate the advantages of doula services, assess their accessibility, and determine if they promote equity for Black women. In order to obtain insight into the experiences of Black women associated with doula support, focus groups and interviews were conducted to examine the lived experiences of these women. Three themes emerged from the analysis from each group. For the doulas, the themes were (a) change agents, (b) doula care, and (c) motivations for becoming a doula. For the Black mothers, the themes were (a) access to care, (b) disparities in the healthcare system, and (c) support. For program administrators, the themes were (a) resources (b) impact on communities, and (c) Medicaid. This study highlighted doulas as a vital yet underutilized resource in addressing maternal health disparities, promoting policy reforms, and revitalizing community-based care for families of color. The findings of this study demonstrate that doulas are vital players in addressing systemic inequities in maternal healthcare. By empowering mothers, advocating for cultural competence, and reviving ancestral birthing traditions, doulas are agents of systemic change. In their doula journey, many of the doulas were inspired and motivated by their own challenging experiences. Moreover, the study's findings reinforce the importance of support in understanding doula care.