Community-based Doulas’ and Hospital Providers’ Relationships: What Enhances and Limits Relations in the Birth Space

Background: There is limited research into the working relationships between Australian community-based doulas and hospital care providers in maternity settings. This study explored what supported and limited doula-provider relationships when providing labour and birth support for migrant women.

Methods: A qualitative interpretive phenomenological approach using 23 in-depth interviews with doulas from a community-based volunteer doula service Birth for Humankind and a maternity hospital in Melbourne, Australia. Thematic analysis was used for data analysis, findings were mapped to a Capability, Opportunity, and Motivation (COM-B) framework to understand behaviours.

Results: We found what may enhanced and limit doula-provider collaborative working relationships. Facilitators included: provider valuing and understanding doula roles, doula-provider rapport; respectful care facilitated by doulas; doulas enhanced migrant women-provider communication and relationships; and community-based doulas perceived differently from private practice doulas. Barriers included: limited provider knowledge of doula service and scope of practice; challenging doula-provider relationships; and limited opportunities for doulas and providers to interact and build rapport.

Conclusions: Doula-provider relationships are relevant to other models of doula care (e.g. private practice doulas and hospital-based doulas). These collaborative working relationships are essential in providing high quality doula support to underserved community such as migrant women in hospital settings.