Volunteer doulas’ experiences supporting cesarean births: A qualitative analysis for preliminary program evaluation

Background: Cesarean birth is common in the United States and associated with increased incidence of medical complications and maternal dissatisfaction. Doula support is associated with improved maternal and newborn outcomes but is often restricted to vaginal birth. The aim of this scoping study was to explore the experiences of volunteer doulas who provide support to women during cesarean birth.

Methods: Qualitative study using semi-structured interviews with nine doula volunteers from one program to assess their experiences caring for clients in the operating room (OR).

Results: Doulas described their experiences supporting cesarean births in relation to four different relationship-level themes, relationships between: doulas and their clients (and clients’ support persons); doulas and the physical environment (OR, labor and delivery unit); doulas and the OR interprofessional team; and doulas and the program culture. Doulas described perceived strengths and weaknesses of the OR-based program, and suggested improvements and future development opportunities.

Conclusion: Doulas volunteering within this program highly valued their perceived role in the care of women experiencing cesarean birth, including reports of increasing evidence-based practices such as SSC and early breastfeeding initiation in the OR. These doulas reported successfully working around the physically challenging OR environment and alongside the cesarean interprofessional team.