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Doula Decisions: A Mental Models Approach to UnderstandingLack of Doula Use Despite the Benefits

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posted on 28.02.2019, 19:45 by Hannah McDonald
Research Question: Despite the proven benefits of utilizing a doula, only 6% of United States women choose to have a doula present at birth. What explains this lack of doula utilization?

Methods:This research employed the mental models approach, an in-depth interviewing and analysis method deriving from decision science, to examine the decision making process of expectant mothers with regard to the use of doulas. The process included 5 interviews with experts including OBGYNs, midwifes, and doulas,and 11 interviews with pregnant women.

Analysis:A gap analysis compares the mental models of experts versus pregnant women.

Results:Pregnant women have difficulty predicting what labor will be like, and thus how much continuous labor support they will need and want(a hot cold empathy gap). They also lack essential knowledge about what a doula is and does. They report not receiving information about doulas from their health care providers, which contributes to this gap in knowledge and is interpreted as a signal that the provider does not support the choice to use a doula. Lastly, pregnant women anticipate potentially negative relationship consequences when they imagine using a doula—both with their health care provider as well as with their partner.

Conclusions/Implications: Health care providers can provide preliminary information about doulas to their patients via methods such as a poster or pamphlet. This would not only give pregnant women basic information on the benefits of doulas but also signal that they support the decision. Doula communications can better address women’s knowledge needs and relationship fears by including information about their role in supporting both women and partners in the child birth experience.





Nichole Argo


Engineering and Public Policy

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