“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

Anu Manchikanti Gomez, Stephanie Arteaga, Jennet Arcara, Alli Cuentos, Marna Armstead, Renee Mehra, Rachel G. Logan, Andrea V. Jackson and Cassondra J. Marshall
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Anu Manchikanti Gomez: Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, 110 Haviland Hall, MC 7400, Berkeley, CA 94720, USA
Stephanie Arteaga: Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, 110 Haviland Hall, MC 7400, Berkeley, CA 94720, USA
Jennet Arcara: Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, 110 Haviland Hall, MC 7400, Berkeley, CA 94720, USA
Alli Cuentos: SisterWeb San Francisco Community Doula Network, 1912 Keith Street, San Francisco, CA 94124, USA
Marna Armstead: SisterWeb San Francisco Community Doula Network, 1912 Keith Street, San Francisco, CA 94124, USA
Renee Mehra: ACTIONS Program, School of Nursing, University of California, 2 Koret Way, San Francisco, CA 94143, USA
Rachel G. Logan: Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, 110 Haviland Hall, MC 7400, Berkeley, CA 94720, USA
Andrea V. Jackson: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 2356 Sutter Street, J-140, San Francisco, CA 94115, USA
Cassondra J. Marshall: School of Public Health, University of California, 2121 Berkeley Way #5302, Berkeley, CA 94720, USA

IJERPH, 2021, vol. 18, issue 20, 1-17

Abstract: 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. 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. We conducted qualitative interviews with SisterWeb doulas in 2020 and 2021 and organizational leaders in 2020. 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). Additionally, this approach did not provide doulas with healthcare benefits, which was especially concerning during the COVID-19 pandemic. 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. 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.

Keywords: doula; community doula; birth equity; compensation; health equity; labor conditions; maternal health; pregnancy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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