Publications by authors named "Marna Armstead"
Purpose: In an effort to address persistent inequities in maternal and infant health, policymakers and advocates have pushed to expand access to doula care. Several states, including California, now cover doula services through Medicaid. As coverage expands, research on the impact of doula care will likely increase.
View Article and Find Full Text PDFBackground: Beginning in March 2020, health care systems in the United States restricted the number of support people who could be present during pregnancy-related care to reduce the spread of COVID-19. We aimed to describe how SisterWeb, a community-based doula organization that employs Black, Pacific Islander, and Latinx doulas in San Francisco, California, adapted to the COVID-19 pandemic.
Methods: As part of process and outcome evaluations conducted through an academic-community partnership, we interviewed SisterWeb doulas, mentors, and leaders in 2020, 2021, and 2022 (=26 interviews).
Article Synopsis
- Community doulas provide essential, culturally sensitive support during pregnancy and postpartum, helping to advance birth equity by offering low or no-cost services.
- A study analyzed the activities and time use of full-time doulas at SisterWeb in San Francisco, revealing that they spend about half their time on direct client care and significantly more time on other supportive activities.
- The findings emphasize the diverse roles of community doulas and highlight the need for recognition and fair compensation for their comprehensive contributions to healthcare equity.
Problem: In the United States, Black women are disproportionately impacted by inequities in maternal health.
Background: Community doula support may improve birth outcomes and experiences, including lower rates of preterm birth and low birthweight and increases in positive birthing experiences. Few studies have explored client experiences with doula care, specifically community doula care.
Introduction: Increasingly, community-based models of doula care are receiving attention as possible interventions to address racial inequities in maternal health care experiences and outcomes. In 2018, community-based organization SisterWeb launched to provide free culturally congruent community doula care to advance birth equity for Black and Pacific Islander pregnant people, with funding from the San Francisco Department of Public Health. We conducted a process evaluation of SisterWeb's first 1.
View Article and Find Full Text PDF"My 9 to 5 Job Is Birth Work": A Case Study of Two Compensation Approaches for Community Doula Care.
Int J Environ Res Public Health
October 2021
Article Synopsis
- There’s a growing push in the U.S. for doula care to improve birth equity, highlighting the need for fair compensation for community doulas, especially those assisting clients with significant barriers to healthy pregnancies.
- A case study of SisterWeb in San Francisco evaluated two payment methods: a flat fee per client (contractor approach) and hourly employment with benefits.
- Findings showed that the contractor model left doulas undercompensated and without health benefits, while the hourly model provided better financial stability and support, emphasizing the need for structural changes to ensure fair compensation and enhance birth equity.