Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study
Background: Community-based doula support for women and gender-diverse birthing people has a range of benefits in improving maternal outcomes and experiences. However, there is limited research on how doula services operate in Australia. Birth for Humankind is an Australian community-based volunteer...
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Elsevier
2024-12-01
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| Series: | SSM: Qualitative Research in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321524001100 |
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| author | Sarah Min-Lee Khaw Caroline S.E. Homer Red Dearnley Kerryn O'Rourke Meghan A. Bohren |
| author_facet | Sarah Min-Lee Khaw Caroline S.E. Homer Red Dearnley Kerryn O'Rourke Meghan A. Bohren |
| author_sort | Sarah Min-Lee Khaw |
| collection | DOAJ |
| description | Background: Community-based doula support for women and gender-diverse birthing people has a range of benefits in improving maternal outcomes and experiences. However, there is limited research on how doula services operate in Australia. Birth for Humankind is an Australian community-based volunteer doula service, which provides free doula support for women and gender diverse birthing people experiencing social discrimination and financial disadvantage. The aim of this study was to understand facilitators and barriers to implementation and sustainability of a community-based doula service delivered to clients concurrently receiving care at a major maternity hospital in Melbourne, Australia. Methods: We conducted a qualitative study consisting of 30 in-depth interviews with doulas and managers of the community-based doula service Birth for Humankind, and midwives, doctors and social workers from a maternity hospital. Data were inductively thematically analysed, and themes were then deductively categorised using the Capability, Opportunity, and Motivation (COM-B) model and Theoretical Domains Framework (TDF) to understand behavioural influences and facilitators and barriers to implementing and sustaining the doula service within a hospital setting. Results: Facilitators to implementation of the doula service included: collaborative relationships; having sound knowledge of referral processes; and being a valued professional doula service with dedicated volunteers. Barriers to implementation included: limited knowledge of the doula service from hospital staff; difficulty in retaining volunteer doulas; being a small non-profit doula service; and limited capacity of hospitals to financially support the doula service. Advocacy for renumerating doulas may be one means to strengthen and sustain existing doula-provider service relationships. Conclusion: Consideration of establishing strategic partnerships between the doula service and hospitals may create financially-sustainable pathways to enable provision of high-quality, community-based doula support for women and gender diverse birthing people to continue. |
| format | Article |
| id | doaj-art-5b4afe1cdbff4f6385bc8c31f28f5229 |
| institution | OA Journals |
| issn | 2667-3215 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-5b4afe1cdbff4f6385bc8c31f28f52292025-08-20T01:59:34ZengElsevierSSM: Qualitative Research in Health2667-32152024-12-01610050110.1016/j.ssmqr.2024.100501Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative studySarah Min-Lee Khaw0Caroline S.E. Homer1Red Dearnley2Kerryn O'Rourke3Meghan A. Bohren4Gender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC, 3053, Australia; Molly Wardaguga Institute for First Nations Birth Rights, Faculty of Health, Charles Darwin University, Casuarina Campus, Darwin, Northern Territory, 0810, Australia; Corresponding author. Gender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC, 3053, Australia.Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, AustraliaBirth for Humankind, 552 Victoria Street, North Melbourne, VIC, 3051, AustraliaRealist Research Evaluation and Learning Initiative, Northern Institute, Faculty of Arts and Society, Charles Darwin University, Ellengowan Drive, Brinkin, NT, 0909, AustraliaGender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC, 3053, AustraliaBackground: Community-based doula support for women and gender-diverse birthing people has a range of benefits in improving maternal outcomes and experiences. However, there is limited research on how doula services operate in Australia. Birth for Humankind is an Australian community-based volunteer doula service, which provides free doula support for women and gender diverse birthing people experiencing social discrimination and financial disadvantage. The aim of this study was to understand facilitators and barriers to implementation and sustainability of a community-based doula service delivered to clients concurrently receiving care at a major maternity hospital in Melbourne, Australia. Methods: We conducted a qualitative study consisting of 30 in-depth interviews with doulas and managers of the community-based doula service Birth for Humankind, and midwives, doctors and social workers from a maternity hospital. Data were inductively thematically analysed, and themes were then deductively categorised using the Capability, Opportunity, and Motivation (COM-B) model and Theoretical Domains Framework (TDF) to understand behavioural influences and facilitators and barriers to implementing and sustaining the doula service within a hospital setting. Results: Facilitators to implementation of the doula service included: collaborative relationships; having sound knowledge of referral processes; and being a valued professional doula service with dedicated volunteers. Barriers to implementation included: limited knowledge of the doula service from hospital staff; difficulty in retaining volunteer doulas; being a small non-profit doula service; and limited capacity of hospitals to financially support the doula service. Advocacy for renumerating doulas may be one means to strengthen and sustain existing doula-provider service relationships. Conclusion: Consideration of establishing strategic partnerships between the doula service and hospitals may create financially-sustainable pathways to enable provision of high-quality, community-based doula support for women and gender diverse birthing people to continue.http://www.sciencedirect.com/science/article/pii/S2667321524001100DoulasCommunity-based doulasHealth equityMaternity careQualitative research |
| spellingShingle | Sarah Min-Lee Khaw Caroline S.E. Homer Red Dearnley Kerryn O'Rourke Meghan A. Bohren Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study SSM: Qualitative Research in Health Doulas Community-based doulas Health equity Maternity care Qualitative research |
| title | Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study |
| title_full | Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study |
| title_fullStr | Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study |
| title_full_unstemmed | Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study |
| title_short | Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study |
| title_sort | factors affecting the implementation and sustainability of an australian community based doula service a qualitative study |
| topic | Doulas Community-based doulas Health equity Maternity care Qualitative research |
| url | http://www.sciencedirect.com/science/article/pii/S2667321524001100 |
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