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MA/PhD Theses Abstracts of Current Students & Alumni |
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Deitrick, Lynn M. 2001. Supporting the Mother: A Preliminary Evaluation of the Central Hillsborough Healthy Start Doula Program.
Abstract: An area of interest to medical anthropologists is the need for new approaches to health care delivery for pregnant women. Gaps in health care utilization continue in some parts of the US, particularly among the poor and minorities. Of special note are holistic strategies that meet their biological, social, and cultural needs. A doula, a woman trained to comfort and support women during labor and delivery, can help fill this niche.
This dissertation examines the role of the doula in the Central Hillsborough Healthy Start Doula Program. The CHHS program provided Healthy Start and doula services from May to December 1999 to at-risk pregnant women in 17 census tracts in Tampa, Florida. The research examined doula support in three areas--medical outcomes of pregnancy, client satisfaction with doula services received, and the role of the doula in providing support before, during and after labor.
Data was obtained through the use of data collection forms, personal interviews and medical record reviews. Results from doula clients were compared with those of a control group of women who delivered at the two project hospitals during the same time period.
Findings indicate that women who used doulas prenatally delivered infants who were heavier than the controls. Women who used a doula during labor had a vaginal delivery rate that was 10% higher than with the controls. The c-section rate among doula clients showed a corresponding 10% reduction. This reduction in c-sections could represent a substantial cost savings to Medicaid. Of 142 women who used a doula for labor, 91% reported that having a doula resulted in a better birth experience for them. The supportive role of doulas was found to include four types of support, including physical comfort measures, physical assistance, emotional/social support, and verbal support. Results from this research indicate that the use of the doula in public health programs such as the Central Hillsborough Healthy Start project has the potential to improve the birth outcomes for pregnant women in high-risk populations such as the one served here.
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