A qualitative study on community-based doulas’ roles in providing culturally-responsive care to migrant women in Australia

Background: There is limited exploration into how culturally-responsive care may be provided to migrant women through community-based doulas. Aim: We aim to explore the roles of community-based doulas in providing culturally-responsive care to migrant women in Australian maternity settings, from the perspectives of maternity care providers and doulas. Methods: We used an interpretive phenomenological qualitative approach with in-depth interviews with 30 maternity care providers and Birth for Humankind doulas, in Victoria, Australia. All interviews were conducted over video-call and inductive thematic analysis was performed using NVivo software. Findings: Doulas were seen to support and enhance migrant women's maternity care experiences through numerous ways, strengthening cultural-responsive care provision. There were three domains which described the role of doulas in providing migrant women with culturally-responsive care: 1) enhanced care; 2) respectful care; and 3) supportive relationships with providers. The three domains included seven themes: 1) continuous individualised support; 2) social connectedness; 3) creating safe spaces; 4) cultural facilitator; 5) non-judgemental support; 6) enhancing communication and rapport with providers; and 7) making connections. Discussion: Doulas appeared to counter negative factors that impact migrant women's maternity care experiences. Doulas with previous professional birth support qualifications and trauma-informed care training were equipped to create safe spaces and increase emotional safety for migrant women. Doulas may also have more responsibilities expected of them by providers when connecting migrant women with additional services in situations that may be missed through hospital care. Conclusion: Birth for Humankind doulas in Victoria play an important role in providing culturally-responsive care to migrant women. Employment models may be the next steps in acknowledging their valuable contribution as a complementary service to maternity settings.