Birth equity on the front lines: Impact of a community‐based doula program in Brooklyn, NY

Background We assessed whether participation in Healthy Start Brooklyn's By My Side Birth Support Program—a maternal‐health program providing community‐based doula support during pregnancy, labor and delivery, and the early postpartum period—was associated with improved birth outcomes. By My Si...

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Bibliographic Details
Published in:Birth (Berkeley, Calif.) Calif.), 2023-03, Vol.50 (1), p.138-150
Main Authors: Thomas, Mary‐Powel, Ammann, Gabriela, Onyebeke, Chinelo, Gomez, Tanya K., Lobis, Samantha, Li, Wenhui, Huynh, Mary
Format: Article
Language:English
Subjects:
Autonomy
Birth certificates
birth justice
Birth Weight
Cesarean section
Childbirth & labor
Cultural competence
Decision making
doula support
Doulas
Ethnicity
Female
Health education
health equity
Health services
Health status
Healthy Start
Humans
Inequality
Infant, Newborn
Infants
Labor, Obstetric
Low birth weight
low birthweight
Maternal and infant welfare
Maternal characteristics
Mothers
Obstetrics
Participation
Parturition
Postpartum period
Poverty
Pregnancy
Premature Birth
Prenatal care
preterm birth
Race
Random sampling
Support services
Well being
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Summary:Background We assessed whether participation in Healthy Start Brooklyn's By My Side Birth Support Program—a maternal‐health program providing community‐based doula support during pregnancy, labor and delivery, and the early postpartum period—was associated with improved birth outcomes. By My Side takes a strength‐based approach that aligns with the doula principles of respecting the client's autonomy, providing culturally appropriate care without judgment or conditions, and promoting informed decision making. Methods Using a matched cohort design, birth certificate records for By My Side participants from 2010 through 2017 (n = 603) were each matched to three controls who also lived in the program area (n = 1809). Controls were matched on maternal age, race/ethnicity, education level, and trimester of prenatal‐care initiation, using the simple random sampling method. The sample was restricted to singleton births. The odds of preterm birth, low birthweight, and cesarean birth were estimated, using conditional logistic regression. Results By My Side participants had lower odds of having a preterm birth (5.6% vs 11.9%, P 
ISSN:0730-7659
1523-536X
DOI:10.1111/birt.12701