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Objective: to evaluate the design and impact of a doula program in rural Vermont by exploring client demographics and perspectives on the doula care received. This research aims to better understand the population the program serves, the specific challenges they face, and how to mitigate these challenges in the perinatal and post-partum period with a social work model of doula care.

Design: a qualitative, descriptive study giving voice to the client experience of a doula program steeped in a social work model of care.

Methods: semi-structured interviews carried out in July and August of 2021. Interviews were coded and analyzed thematically.

Setting: A doula program offered by a mental health agency, offering doula services for clientele with a mental health diagnosis and qualifications for VT Medicaid.

Results: Significant portions of participants reported life challenges due to lack of resources, abuse, and mental health concerns, of which having a social-work focused doula was helpful in terms of logistical and emotional support. Without a doula, access and experience of healthcare during the prenatal, birthing, and post-partum period would have been more challenging for the population interviewed. Themes that arose included doula as logistical support, the doula’s role in emotional/mental health support, and the doula as educator and advocate for a socioeconomically high-risk population.

Key conclusions and implications for practice: The WCMHS Doula Program is serving a high-risk population which would be beyond the reaches of more typical doula models. Doula work that is within the field of social work increases access and mitigates challenges that other doula models do not. Placing doula services within a community mental health agency and offering case management style doula care allows the services to make great impact on the lives and wellbeing of people who would otherwise face significant challenges in accessing healthcare. This has large implications for increasing equity of doula offerings and makes great strides in improving birth outcomes and experiences for an at-risk population. This study indicates the value of a social work model of doula care and the importance of bringing doula services to populations that have historically been left without access.

Key words: doula, case management, at-risk population, rural health, pregnancy, childbirth support, advocacy, health equity

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.