Doctoral Dissertations
Date of Award
12-2025
Degree Type
Dissertation
Degree Name
Doctor of Philosophy
Major
Nutritional Sciences
Major Professor
Katherine F. Kavanagh
Committee Members
Cristina S. Barroso, Sarah E. Colby, Marsha L. Spence
Abstract
Background: Receiving community doula care during the perinatal period may have significant benefits such as higher incidence of spontaneous vaginal delivery, shorter labor, improved knowledge of childbirth and postpartum care, improved breastfeeding outcomes and overall positive birthing experiences. This may be particularly crucial for Black or African American (AA) mothers and birthing people, as they experience adverse pregnancy-related outcomes disproportionately in the United States. These disparities are prevalent in Tennessee where use of doula services is limited, and maternal mortality is also high. Objectives: The objectives of this exploratory research were to describe the lived practice experience of AA doulas practicing in Tennessee and to develop a survey instrument for assessing the birthing experiences and perceptions of community doulas among AA mothers and birthing people in Tennessee.
Methods: These objectives were achieved through a two-part protocol. In-depth interviews were conducted with AA doulas (part 1) and a survey development process began (part 2).
Results: Results of thematic analysis of 12 audio-recorded interviews suggest that critical benefits of doula care included providing education, advocacy, and the centering of mothers’ and birthing people’s voices. Cost of doula services emerged as a major barrier to doula use. Unpleasant experiences reported were inadequacy of patient approval or violation of consent during birthing procedures and discourtesy and derogatory behavior from providers to mothers and birthing people. The survey instrument was developed under seven phases, culminating in an initial survey testing phase with AA mothers and birthing people (n=20). Phase 7 survey results indicated that 80% (n=16) of the sample had heard of the word ‘doula’, reflecting findings of previous nationally representative surveys.
Conclusion: AA doulas serving AA mothers and birthing people in Tennessee are aware of the benefits they offer their clients, especially education and advocacy. They are proponents of informed consent during birthing procedures. The final four phases in the survey development- cognitive interviews, online survey data for factor analysis, factor analysis and concurrent criterion were discussed and proposed as next steps in the creation of this validated doula survey tool. Future research should continue to build the literature base in this area.
Recommended Citation
Abayomi, Temitayo L., "Knowledge and Awareness of, and Receptivity to Community Doula Services among African American Mothers and Birthing People in Tennessee.. " PhD diss., University of Tennessee, 2025.
https://trace.tennessee.edu/utk_graddiss/13558
Included in
Maternal and Child Health Commons, Nutrition Commons, Public Health Education and Promotion Commons, Social and Behavioral Sciences Commons, Women's Health Commons