Descriptive Study of the Views of Obstetricians and Doulas in New York City

Poor childbirth outcomes, and the disparities they highlight, continue to be of great concern in the United States. Birth doulas, professionals who provide support for pregnant people during the perinatal period, have been identified as a way to improve maternity outcomes while combating disparities in birth faced by marginalized groups of people. While existing research supports the positive benefits of doula care, limited research exists on the views and experiences of maternity care teams, specifically the relationship between obstetricians and doulas. This project aimed to explore the views, knowledge, and experiences of both obstetricians and birth doulas in New York City. The data for this study comprised a sample of all obstetricians attending births in Manhattan, New York City (response rate 125 of 220, 57%) and interviews with a purposive sample of 27 experienced birth doulas. The positive themes that emerged centered on the benefits a supportive doula could provide, specifically assistance to people wanting a natural childbirth and those lacking support. Negative themes included the comparatively high cost of a doula as well as unprofessional doula behavior, most notably interfering with medical recommendations and acting out of their scope of practice. Doulas reported that the obstetricians who do value their care are a “self-selecting” group, whereas those who do not tended to be controlling and unknowledgeable regarding the role of a doula. In addition to further exploration into the relationship between obstetricians and doulas, these findings indicate the need for more education in both groups, particularly if the goal is for a cooperative, integrated model of effective maternity care in which doula care is a component.