Supporting in solidarity: An examination of social support, advocacy, and barriers among birthing doulas

ABSTRACT

Doula assistance before, during, and after childbirth can reduce infant mortality, improve birth outcomes, and ensure a birthing person’s physical and emotional needs are met. However, doula care in the U.S. remains underutilized. Both birthing persons and medical providers may be unaware of the support roles doulas fulfill. The goal of this study is to examine how birth doulas communicate about their role as advocates through the provision of social support and describe the barriers they encounter when doing so. In-depth interviews with 10 doulas showed evidence of indirect advocacy through network, emotional, and tangible support as well as direct advocacy through informational and esteem support. Further, doulas discussed barriers related to the hospital setting, compensation, and accessibility. This study aims to cast light on the ways interpersonal health advocacy and support are intertwined in doula work and consider how doula assistance can be optimized and expanded.

KEYWORDS:

• Social support
• doulas
• health communication
• childbirth
• advocacy

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. It should be noted that using the term “mother” could be considered controversial, as not all “mothers” give birth and some birthing persons may not self-identify as “mothers” (International Association of Maternal Action and Scholarship, 2022).

2. The authors of this paper recognize that the term “women” as a descriptor for childbearing persons is not inclusive. While much research about childbearing/birthing, as well as most participants in this study, used terms like “women” and “mothers” interchangeably, we realize that “all kinds of people give birth” (Malone-Franklin, 2019). In this paper, we tried to alter such language in our own writing yet did not alter the wording of others.

3. The Kent State University Institutional Review Board reviewed and approved this study, #16-548, as Level I/Exempt from Annual review research.

4. We contemplated using member checks after the findings of this report were written. Due to the fact that two years had passed since the interviews occurred (COVID-19 pandemic delays) and that there is “no evidence that routine member checks enhance the credibility or trustworthiness of qualitative research” (Thomas, 2017, p. 37), we decided against using them here.

Additional information

Notes on contributors

Ginger Bihn-Coss

Ginger Bihn-Coss (Ph.D., Bowling Green State University) is an Assistant Professor at Kent State University, Tuscarawas. Her research centers on gender and health communication across various settings. In particular, she is interested in how disenfranchisement, power, and resistance impact health decision-making and work-life decisions. Bihn-Coss is passionate about teaching, community-involvement, and how communication can be used to empower oneself.

Nichole Egbert

Nichole Egbert (Ph.D., University of Georgia) holds the rank of Professor in the School of Communication Studies at Kent State University. Dr. Egbert is interested in social support in any health context, but specifically on family caregiving. Other research interests include health literacy, as well as spirituality/religiosity in health-related contexts. She actively collaborates with a wide range of researchers, including those in the fields of nursing, public health, medicine, and family studies.