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Assessing the Readiness of Massachusetts Hospitals for the Expansion of Medicaid to Cover Doula Services
Assessing the Readiness of Massachusetts Hospitals for the Expansion of Medicaid to Cover Doula Services
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20250211151137
- ISBN
- 9798382827551
- DDC
- 614
- 서명/저자
- Assessing the Readiness of Massachusetts Hospitals for the Expansion of Medicaid to Cover Doula Services
- 발행사항
- [Sl] : Harvard University, 2024
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2024
- 형태사항
- 158 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 85-12, Section: B.
- 주기사항
- Advisor: Siegrist, Richard.
- 학위논문주기
- Thesis (D.P.H.)--Harvard University, 2024.
- 초록/해제
- 요약In the United States, Black women are 3-4 times as likely to die from childbirth or experience poorer birth outcomes of labor and delivery compared to their white counterparts. Research has identified birth doulas as one way to close the racial disparity gap in birth outcomes. Birth doulas are non-clinical trained professionals who work with birthing individuals to provide emotional, physical, and information support during the perinatal period. Research has shown that doulas reduce unnecessary cesarean births, increase breastfeeding, and improve birthing experiences, among other clinical outcomes. However, given the high out-of-pocket cost or high-risk requirements to receive doula services, birth doulas are underutilized. Many state-level Medicaid payors have expanded to cover doula services, including Massachusetts, who expanded coverage in December 2023. This expansion could mean more doulas in the clinical space and more patients bringing their own doulas who are unfamiliar with hospital policy and culture, potentially creating problems within the clinical space. The objectives of this project were to: 1) identify barriers and facilitators within hospital infrastructure to the Medicaid policy expansion; 2) qualitatively assess infrastructure readiness of Massachusetts hospitals to welcome and support MassHealth doulas and their birthing clients; and 3) assess what Massachusetts hospitals can do to be more supportive and doula inclusive. Virtual qualitative interviews were conducted with doula program administrators and practicing doulas both internal and external to the hospital system in Massachusetts. Themes generated from the interviews included mixed doula experiences with the care team where participants experienced gatekeeping, being treated as a support person instead of a non-medical care team member, and a lack of doula access and inclusivity in the clinical setting. Participants perceived varied readiness of Massachusetts hospitals to support MassHealth doulas in the clinical space and identified ways hospitals can be more supportive such as creating and enforcing inclusive policies and eliminating logistical barriers to delivering care. Massachusetts hospitals who implement these suggestions would allow doulas to fully do their jobs, and given their effectiveness in improving birth outcomes and closing the racial disparity gap, is one potential solution in combatting the current maternal health crisis in the U.S.
- 일반주제명
- Public health
- 일반주제명
- Obstetrics
- 키워드
- Doulas
- 키워드
- Medicaid
- 키워드
- Birth outcomes
- 기타저자
- Harvard University Public Health
- 기본자료저록
- Dissertations Abstracts International. 85-12B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■00520250211151137
■006m o d
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■020 ▼a9798382827551
■035 ▼a(MiAaPQ)AAI31148625
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aOlden, Heather Alexis Benson.▼0(orcid)0009-0006-1234-2456
■24510▼aAssessing the Readiness of Massachusetts Hospitals for the Expansion of Medicaid to Cover Doula Services
■260 ▼a[Sl]▼bHarvard University▼c2024
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2024
■300 ▼a158 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-12, Section: B.
■500 ▼aAdvisor: Siegrist, Richard.
■5021 ▼aThesis (D.P.H.)--Harvard University, 2024.
■520 ▼aIn the United States, Black women are 3-4 times as likely to die from childbirth or experience poorer birth outcomes of labor and delivery compared to their white counterparts. Research has identified birth doulas as one way to close the racial disparity gap in birth outcomes. Birth doulas are non-clinical trained professionals who work with birthing individuals to provide emotional, physical, and information support during the perinatal period. Research has shown that doulas reduce unnecessary cesarean births, increase breastfeeding, and improve birthing experiences, among other clinical outcomes. However, given the high out-of-pocket cost or high-risk requirements to receive doula services, birth doulas are underutilized. Many state-level Medicaid payors have expanded to cover doula services, including Massachusetts, who expanded coverage in December 2023. This expansion could mean more doulas in the clinical space and more patients bringing their own doulas who are unfamiliar with hospital policy and culture, potentially creating problems within the clinical space. The objectives of this project were to: 1) identify barriers and facilitators within hospital infrastructure to the Medicaid policy expansion; 2) qualitatively assess infrastructure readiness of Massachusetts hospitals to welcome and support MassHealth doulas and their birthing clients; and 3) assess what Massachusetts hospitals can do to be more supportive and doula inclusive. Virtual qualitative interviews were conducted with doula program administrators and practicing doulas both internal and external to the hospital system in Massachusetts. Themes generated from the interviews included mixed doula experiences with the care team where participants experienced gatekeeping, being treated as a support person instead of a non-medical care team member, and a lack of doula access and inclusivity in the clinical setting. Participants perceived varied readiness of Massachusetts hospitals to support MassHealth doulas in the clinical space and identified ways hospitals can be more supportive such as creating and enforcing inclusive policies and eliminating logistical barriers to delivering care. Massachusetts hospitals who implement these suggestions would allow doulas to fully do their jobs, and given their effectiveness in improving birth outcomes and closing the racial disparity gap, is one potential solution in combatting the current maternal health crisis in the U.S.
■590 ▼aSchool code: 0084.
■650 4▼aPublic health
■650 4▼aObstetrics
■653 ▼aDoulas
■653 ▼aHospital readiness
■653 ▼aMedicaid
■653 ▼aMassachusetts hospitals
■653 ▼aBirth outcomes
■690 ▼a0573
■690 ▼a0769
■690 ▼a0380
■71020▼aHarvard University▼bPublic Health.
■7730 ▼tDissertations Abstracts International▼g85-12B.
■790 ▼a0084
■791 ▼aD.P.H.
■792 ▼a2024
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17160927▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
