Community Care in Action

Scaling Doula Support Through a Health Department–Community Partnership

Bibliographic Data

ID22158755
AuthorsMonique Baumont (0000-0001-9166-0466, New York City Department of Health and Mental Hygiene, corresponding author), Sara Gelb (New York City Department of Health and Mental Hygiene), Isabel DoCampo (New York City Department of Health and Mental Hygiene), Gabriela Ammann (New York City Department of Health and Mental Hygiene), Monique Jaques (Flow Analysis (United States)), Nataly Jasso Morales (Richmond University Medical Center), Mary‐Powel Thomas (New York City Department of Health and Mental Hygiene), Mary-Powel Thomas (New York City Department of Health and Mental Hygiene)
Year2026
Volume10
Pages24731242261462522-24731242261462522
Publication date2026-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Equity (JOURNAL)
Journal identifiersISSN: 2473-1242 • E-ISSN: 2473-1242
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/24731242261462522
PMID42534754
OpenAlexW7166845665
LanguageEN
References cited27

Introduction: Doula support is increasingly recognized as a promising strategy to address racial inequities in maternal health. The New York City Health Department launched the Citywide Doula Initiative (CDI) in March 2022 to expand access to free, community-based doula support in disinvested neighborhoods. Methods: To evaluate the program’s first year of implementation, we conducted semi-structured interviews with 44 clients, doulas, doula-organization staff, and Health Department staff between November 2022 and April 2023. We coded interview notes using template analysis (a thematic analysis approach) and grouped barriers and facilitators according to the Practical Robust Implementation and Sustainability Model. Results: Facilitators included high perceived value of the CDI, a shared commitment to community, open communication, and policymaker support for doula work. Barriers included insufficient time for planning, cumbersome bureaucratic processes, and cultural and capacity differences between the Health Department and community partners. Additional factors, such as—variation in hospital treatment of doulas, doula-organization capacity, doula skills and experiences, and client needs and circumstances—had mixed effects on program implementation. Discussion: Findings indicate that community-based doula models, which have been shown to improve birth outcomes in disinvested communities, can be successfully scaled in an urban setting. Programs seeking to expand access to doula support should prioritize time for planning, allocate sufficient resources for administrative support, and work to establish efficient and responsive payment and contracting processes. Having mission-driven staff at all levels of the program and prioritizing relationships with community-based organizations and doulas are vital for success

Bureaucracy · Community health · Emergency department · General partnership · Health care · Payment · Thematic analysis · Work (physics) · Global Maternal and Child Health · Maternal and fetal healthcare · Maternal and Perinatal Health Interventions

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