lactation study
Phase 1 of this study concluded on 2/1/23
Upon receiving the Racial Equity in Postpartum Care prize funds, the Diversifying Doulas Initiative created the Breastfeeding Support Initiative (BSI), which was designed to create an addendum to DDIs postpartum care program. This program applies a non-clinical culturally resonant co-care intervention to a designated group proven to benefit from specialized breastfeeding and postnatal social support and education.
In addition to any qualitative data the respondents provided regarding barriers and perspectives on chestfeeding, a secondary objective of this study was to determine prenatal medical narratives as well as perinatal social barriers and comorbidity factors as related to mental disorder diagnosis, illicit drug, tobacco, and alcohol use, as well as perinatal morbidities of preeclampsia and gestational diabetes. Bedside interviews were conducted by doulas for three consecutive months using a 25-question survey pre- and post-discharge. As this study included both ethnographic assessments through the learning group as well as through limited and anecdotal open response, this study was determined as a mixed methods ethnographic and action research plan. Ethnographic data was obtained by DDI’s resident researcher, Ms. Chatman who attended lactation learning circles as a participant observer, speaking casually with both practitioners and patients who met criteria and other attendants. Bedside interviewers were strategically chosen among DDI certified Doulas to interview admitted patients, as current research shows that patients are more likely to be satisfied with their care if supported by a doula8. The inclusion criteria for participation in the bedside questionnaire were 1) identifying as Black or African American, 2) expressing a desire to breastfeed, 3) hospitalized in the immediate postpartum state, and never having a doula during the current pregnancy. Responses were captured in real time via electronic forms on a tablet to a secured cloud based application. The questionnaire was utilized at every point of contact during the inpatient and outpatient status. In addition, postpartum patients and doulas were encouraged to participate in a weekly Lactation Learning Loop session as part of the Breastfeeding Support Initiative. During the Lactation Learning Loop, clients receive guided support from an IBCLC, learn best practices from other breastfeeding people, engage in baby weight checks, and obtain no cost Breastfeeding products. Sessions regularly featured an inservice learning opportunity provided by a board-certified Ob/Gyn physician on postpartum topics including gestational diabetes, pre-eclampsia, substance use disorder, and postpartum depression. Findings will be published here upon completion of study analysis.
Dr. Livingston , co-founder of Patients R Waiting is a Board Certified OB/GYN and Obstetrics Chair at UPMC in Lititz, PA. Dr. Livingston takes post natal health outcome disparities seriously, through her personal and professional dedication in delivering talks at our lactation circle which was an integral aspect for the investigation of this study. She believes that the ability to have support for an additional time post-delvery can mean a tremendous diffrence in the lives of marginalized patients, and is working diligently to advocate for ways in which to faciitate the organic extension of existing doula servies to ensure that support is accessible for those most in need.
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In this study, members of Cohorts 1 and 2 of trained douls from The Diversifying Doulas Initiative served as qualitative researchers of recently-delivered pre-discharged moms. A report outlining our findings will be made available 4/12/23 via this site.
For more on Dr. Livingston and her work at UPMC, you can click here:
