Finding My Way: Black Doulas' Communication with Other Birthing Care Providers in an Interprofessional Work Environment.

Abstract

Black women suffer more complications and birthing harms compared to other race-ethnic groups. Even when birthing equity initiatives are implemented, many Black families choose to work with a Black doula to reduce harms linked to obstetric racism. Most Black doulas described their role as helping women have the kind of birth they want; however, problems doulas experience in communicating with other birthing team members are not well understood. Situated in the interprofessional team communication model, this study asked fifty Black doulas to respond to two open-ended questions about their communication experiences with other birthing care providers. Thematic analysis identified six themes including efforts to establish legitimacy as a doula, responding to provider use of power strategies, negotiating roles and responsibilities on the birthing team, conflict from difference in birthing philosophies, impact of hospital regulation of doulas on their practice, and how doula advocacy was conducted. While Black doulas reported successful communication with other providers, they also described microaggressions experienced from members of predominantly White birthing teams. Preemptive communication strategies that doulas used to encourage other birthing team members to accept them onto the team were identified. Suggestions for how Black doulas can be more fully integrated into birthing teams were also presented.