Birth for Humankind Volunteer Doula Service: Factors Which Facilitates and Limits Sustaining and Implementing the Service in an Australian Maternity Hospital Setting

Background: Birth for Humankind is the only Australian community-based volunteer doula service which provides free doula support for underserved communities facing financial hardship. Despite commencing in 2014, there is limited research surrounding community-based doula services in an Australian context. Our study explored the factors which may limit or facilitate the implementation and sustainability of an Australian community-based doula service.

Methods: A qualitative interpretive phenomenological using 30 qualitative video-call interviews with 30 Birth for Humankind doulas and maternity care hospital providers based in Melbourne, Australia. Data analysis using thematic analysis was deductively mapped to a Capability, Opportunity, and Motivation (COM-B) framework was conducted for data analysis using NVivo software.

Results: We found how community-based doula services may be sustained and implemented highlighting facilitators across three COM-B domains and identifying limiting factors. Facilitators included: providers’ knowledge of the doula service and referral processes, continuing positive managerial working relationships; professionalisation of the doula service and volunteer doula workforce; building upon existing relationships, and consideration of paid doula services. Barriers included: limited provider knowledge of scope of doula service, pandemic response; limited capacity of non-profit doula service, volunteer workforce; limited hospital capacity in financially backing doula service; and limited higher-level relationships.

Conclusions: Well-established working relationships between the doula-service and hospital contributed to positive relations, however, the doula service remained limited by its volunteer workforce and hospital understandings of the scope of the doula service. Considerations into formalising organisational partnerships is necessary to ensure the longevity of an essential complementary community-based doula service.