In the postpartum period, doulas provide advice and support around holistic recovery after birth, as well as the transition to parenthood, including newborn care, infant feeding, and parent–infant bonding. For example, doulas help birthing people become informed about their care and birthing options and provide emotional reassurance throughout labor. Doulas provide critical support for birthing people, working to ensure that their nonmedical needs are met by providing advocacy, advice, assistance, nonjudgmental support, and comfort. A doula is a nonclinical birth worker who provides physical, emotional, and informational support to a pregnant person during pregnancy, childbirth, and the postpartum period. Our study suggests that efforts to promote community doula care must integrate structural solutions to provide appropriate compensation and benefits to doulas, simultaneously advancing birth equity and equitable labor conditions for community doulas.Īs health policy advocates and policymakers look toward doula care as an intervention to mitigate adverse maternal and infant health outcomes in the United States, examining the sustainability of providing this type of care has become crucial. As hourly, benefited employees, doulas experienced a greater sense of financial security and wellbeing from receiving consistent pay, compensation for all time worked, and benefits such as health insurance and sick leave, allowing some to dedicate themselves to birth work. Additionally, this approach did not provide doulas with healthcare benefits, which was especially concerning during the COVID-19 pandemic. Overall, leaders and doulas reported that the contractor approach, in which doulas were paid a flat fee per client, did not adequately compensate doulas, who regularly attend trainings and provide additional support for their clients (e.g., referrals to promote housing and food security). We conducted qualitative interviews with SisterWeb doulas in 20 and organizational leaders in 2020. This case study explores two different approaches for compensating doulas (contractor versus hourly employment with benefits) utilized by SisterWeb San Francisco Community Doula Network in San Francisco, California. Site visitors also can review the chronology and history of fiscal sponsorship and check out resources related to the field.With the increased policy emphasis on promoting doula care to advance birth equity in the United States, there is a vital need to identify sustainable and equitable approaches for compensation of community doulas, who serve clients experiencing the greatest barriers to optimal pregnancy-related outcomes. Each organizational snapshot includes a short description, contact information, eligibility criteria and fees, and services rendered and offered to community partners. Visitors to the directory can search for a fiscal sponsor by state, category, or keyword. The center is a member of the National Network of Fiscal Sponsors, which works to professionalize the field, provide assistance to sponsors and projects designed to improve financial management, and spark organizational development throughout the nonprofit sector. The Fiscal Sponsor Directory is produced and maintained by the San Francisco Study Center, a multiservice nonprofit organization that disseminates information about public interest issues. To help connect community projects with fiscal sponsors and foster understanding of these relationships and how they influence the nonprofit sector.
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