Background
Community-Based Doula interventions provide support during pregnancy, labor and delivery, and the postpartum period. Doulas serve as advocates and liaisons between families and healthcare systems. Their goals include offering physical and emotional support, improving prenatal care, reducing the need for medical interventions, and enhancing the overall birthing experience.1
Five local health jurisdictions (LHJs) selected a Community-Based Doula program as an intervention for their community.
Some LHJs are using evidence-based models with adaptations such as HealthConnect One2, while others have developed innovative approaches.
In collaboration with their communities, all LHJs implementing Community-Based Doulas outlined the intended benefits (“Is Anyone Better Off?” measures) for women and birthing people participating in the intervention as listed below. These benefits might be in addition to what was originally described as outcomes for evidence-based interventions.
- Percent of women who felt the doula contributed positively to their birth experience.
- Percent of women who reported having a C-section.
- Percent of women who reported initiating breastfeeding (were able to do some breastfeeding).
- Percent of women who reported completing one or more postpartum visits with their healthcare provider.
Successes
Combined enrollment in the programs increased over the years, from 10 participants and 26 sessions provided in fiscal year (FY) 2020-2021 to 387 participants and 1,729 sessions in FY 2023-2024 (sessions occurred before, during, and/or after delivery). Most participants felt supported by the doula and received breastfeeding support. The percentage of participants who reported benefits associated to doula care has remained high (“Is Anyone Better Off?” measures, 85% or higher across intervention years) since FY 2021-2022.
Perinatal Health Outcomes
Doula care can lower the odds of cesarian deliveries.3 The percent of women surveyed across LHJs who reported a C-section was considered an important outcome. This percentage fluctuated from 36.7% in FY 2021-2022, to 22.8% in 2022-2023, and 31.3% in 2023-2024. While some of these results are encouraging, it is not advisable to directly compare these data to California population-level data. Fluctuations in program data can be due to multiple factors including but not limited to the number of survey responses, the demographic and health profile of respondents, and survey selection bias.
Dashboard
Use the dropdown in the dashboard below to explore Community-Based Doulas performance measures by fiscal year. Please see the footnotes to learn how many LHJs reported data (for at least one measure) for a given FY. Refer to dashboard instructions to learn more about how to use the dashboard.