Collaborative Education as a Conduit to Build Trust and Skills in Black Birth Workers

Abstract

Background: Black mothers have worse birth outcomes than White mothers. Historic medical abuses and systemic racism render a sense of mistrust between Black birthing individuals towards their obstetric healthcare providers and may result in Black birthing people seeking medical advice from doulas outside their traditional practice scope. Objective: The objective of this study was to create a structured collaborative curriculum between community doulas and academic obstetric providers to address common prenatal and postpartum pregnancy complications that disproportionately affect Black birthing people. Study Design: The collaborative training session was a two-hour session jointly developed by the founding director of Homeland Heart Nashville Birth and Wellness Collective, a Vanderbilt Maternal-Fetal Medicine Specialist, and a Vanderbilt Certified Nurse midwife. On the day of the collaborative training, the doulas (n=12) took a pretest to assess their knowledge of postpartum warning signs, preeclampsia, breastfeeding, and GDM. After the didactic session, the doulas were given a post-test. The scores were averaged across the four pre and post-assessment topics. We calculated students' t-tests between the pre-and post-assessment. A p-value of < 0 .05 was considered significant. Results: All twelve participants identified as Black female birth workers. The mean score correct of the pretest results was 55.25±13.36%. The initial percent correct for post-birth warning signs, hypertension in pregnancy, and gestational diabetes mellitus/ breastfeeding sections were 37.5±19.55 %, 72.9±16.72 %, and 75±18.46%, respectively. The post-test mean score of correct answers rose to 91.92 ± 4.66% (p< 0.01). The percent correct per section increased to 92.7±9.91 %, 81.3±11.31 %, and 100±0 %, respectively. The student T-test calculated P-value from the pre-and post-test mean was < 0.01. Conclusion: An educational framework that leverages community and academic partnerships between doulas and obstetric providers can bridge the gap to improve doulas’ knowledge and holds promise to improve Black birthing outcomes.