Other Titles

Rapid Presentation Round

Abstract

The project is a Doctor of Nursing practice quality improvement project addressing the barriers to collaboration between BIPOC prenatal patients, clinicians, and doulas. Maternal mortality and morbidity are a crisis in our nation with black women dying three times more than their white counterparts (Harris, n.d.). BIPOC prenatal patients are suffering from maternal mortality and morbidity. Stemming from such as historical racism, racial inequalities, implicit bias and structural determinants of health. The Doula can give cultural congruent care, impower BIPOC prenatal patients, while providing emotional and physical support. The utilization of a doula as continuous labor support is shown to decrease the rate of cesarean births, decrease low-birth weights, increase initiation of breastfeeding as well as shorter duration of labor, and decrease the usage of analgesia during birth (Ogunwole et al., 2022). However, many BIPOC patients have been unable to afford Doula services. The passing of California SB65 solved the financial burden by covering Doula services for Medi-Cal recipients. Yet, collaborative barriers still exist. The project aims to assess the barrier to clinician collaboration with community-based doulas (CBD), having clinicians communicate with BIPOC prenatal patients about CBD services, and subsequently determine the utilization of doula services in BIPOC patients. The purpose of this DNP project is to improve clinician apprehension of the evidence-based practice of CBD utilization and improvement in maternal mortality and morbidity in BIPOC populations: causing clinicians to increase patient literacy of CBD and utilization. This project is a two-part study to assess and improve clinician collaborative barriers with CBD and assess BIPOC patients’ utilization of doula services in a combined retrospective and prospective cohort. It asks the question in BIPOC (Black, Indigenous, and People of Color) patients receiving prenatal care, does the implementation of a doula toolkit for clinicians compared to current practice impact patient requests for doula services during childbirth?

Notes

References:

Adams, C., & Curtin-Bowen, M. (2021). Countervailing powers in the labor room: The doula-doctor relationship in the United States. Social Science and Medicine, 285. https://doi.org/10.1016/j.socscimed.2021.114296
Approaches to limit intervention during labor and birth. (2024). ACOG. Retrieved March 29, 2024, from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth

Collins, C., Bai, R., Brown, P., Bronson, C., & Farmer, C. (2023). Black women's experiences with professional accompaniment at prenatal appointments. Ethnicity and Health, 28(1), 61–77. https://doi.org/10.1080/13557858.2022.2027880

Cooper Owens, D., & Felt, S. (2019). Black maternal and infant health: Historical legacies of slavery. American Journal of Public Health, 109(10). https://doi.org/10.2105/AJPH.2019.305243

Davis, D. (2019). Obstetric racism: The racial politics of pregnancy, labor and birthing. Medical Anthropology, 38(7), 560–573. https://doi.org/10.1080/01459740.2018.1549389

Fisherman, S., Hummer, R., Sierra, G., Hargrove, T., Powers, D., & Rogers, R. (2020). Race/ethnicity, maternal education attainment, and infant mortality in the United States. Biodemography Social Biology, 66(1), 1–26. https://doi.org/10.1080/19485565.2020.1793659

Harris, K. (n.d.). White House brief for addressing the maternal health crisis. White House. https://www.whitehouse.gov/wp-content/uploads/2022/06/Maternal-Health-Blueprint.pdf

Josiah, N., Russell, N., Devaughn, L., Dorcelly, N., Charles, M., & Shoola, H. (2023). Implicit bias, neuroscience and reproductive health amid increasing maternal mortality rates among black birthing women. Nursing Open, 10(9). https://doi.org/10.1002/nop2.1759

Kang, E., Stowe, N., Burton, K., & Ritchwood, T. (2024). Characterizing the utilization of doula support services among birthing people of color in the United States: A scoping review. BMC Public Health, 24(1588), 1–12. https://doi.org/10.1186/s12889-024-19093-6

Knocke, K., Chappel, A., Sugar, S., De Lew, N., & Sommers, B. (2022). Doula care and maternal health: An evidence review. Assistant Secretary for Planning and Evaluation: Issue Brief, 1–14.

Ogunwole, S., Bennett, W., Williams, A., & Bower, K. (2022). Community-based Doulas and covid-19: Addressing structural and institutional barriers to maternal health equity. Perspective on Sexual and Reproductive Health, 52(4), 199–204.
Preventing pregnancy-related deaths [CDC Maternal Mortality Prevention]. (2024, September 25). CDC. https://www.cdc.gov/maternal-mortality/preventing-pregnancy-related-deaths/index.html#:~:text=What%20is%20a%20pregnancy%2Drelated,makes%20an%20unrelated%20condition%20worse.

Thomas, K., Quist, S., Peprah, S., Riley, K., Mittal, P., & Nguyen, B. (2023). The experiences of black community-based doulas as they mitigate systems of racism: A qualitative study. Journal of Midwifery and Women's Health, 68(4), 466–472. https://doi.org/10.1111/jmwh.13493

Description

The project assesses the barrier to clinician collaboration with CBD for prenatal BIPOC patients. Addressing the research question in BIPOC (Black, Indigenous, and People of Color) patients receiving prenatal care: Does the implementation of a doula toolkit for clinicians, compared to current practice, impact patient requests for doula services during childbirth?

Author Details

Tasha Chatman MSN, APRN, FNP-C, DNP student

Sigma Membership

Mu Nu

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Conference Name

Patient Clinician Collaborations, BIPOC Prenatal Patients, Doulas

Conference Host

Sigma Theta Tau International

Conference Location

Phoenix, Arizona, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Bridging the Gap of BIPOC Patients, Clinicians, and Doulas

Phoenix, Arizona, USA

The project is a Doctor of Nursing practice quality improvement project addressing the barriers to collaboration between BIPOC prenatal patients, clinicians, and doulas. Maternal mortality and morbidity are a crisis in our nation with black women dying three times more than their white counterparts (Harris, n.d.). BIPOC prenatal patients are suffering from maternal mortality and morbidity. Stemming from such as historical racism, racial inequalities, implicit bias and structural determinants of health. The Doula can give cultural congruent care, impower BIPOC prenatal patients, while providing emotional and physical support. The utilization of a doula as continuous labor support is shown to decrease the rate of cesarean births, decrease low-birth weights, increase initiation of breastfeeding as well as shorter duration of labor, and decrease the usage of analgesia during birth (Ogunwole et al., 2022). However, many BIPOC patients have been unable to afford Doula services. The passing of California SB65 solved the financial burden by covering Doula services for Medi-Cal recipients. Yet, collaborative barriers still exist. The project aims to assess the barrier to clinician collaboration with community-based doulas (CBD), having clinicians communicate with BIPOC prenatal patients about CBD services, and subsequently determine the utilization of doula services in BIPOC patients. The purpose of this DNP project is to improve clinician apprehension of the evidence-based practice of CBD utilization and improvement in maternal mortality and morbidity in BIPOC populations: causing clinicians to increase patient literacy of CBD and utilization. This project is a two-part study to assess and improve clinician collaborative barriers with CBD and assess BIPOC patients’ utilization of doula services in a combined retrospective and prospective cohort. It asks the question in BIPOC (Black, Indigenous, and People of Color) patients receiving prenatal care, does the implementation of a doula toolkit for clinicians compared to current practice impact patient requests for doula services during childbirth?