Midwives & Doulas Mapping Project
Project Overview
This research project maps the geographic distribution of certified midwives and doulas to better understand healthcare access patterns, particularly for maternal health support services. By analyzing where these professionals practice, we can identify healthcare deserts and understand barriers to accessing birthing care.
Research Objectives
Geographic Mapping
- Create comprehensive maps showing locations of certified midwives and doulas
- Identify regions with high concentrations vs. underserved areas
- Analyze urban vs. rural distribution patterns
Access Analysis
- Examine socioeconomic factors affecting maternal health support availability
- Identify correlations between doula/midwife density and birth outcomes
- Understand transportation and distance barriers for pregnant individuals
Healthcare Equity
- Investigate disparities in access across different communities
- Examine how race, income, and geography intersect to affect care access
- Document the maternal healthcare gap
Methodology
Data Collection
- Compiling public registries of certified midwives and doulas
- Surveying practitioners about their practice locations and client base
- Gathering demographic and health outcome data from public health databases
Geographic Information Systems (GIS)
- Using GIS software to create detailed maps
- Analyzing spatial patterns and clustering
- Calculating accessibility metrics (distance to nearest provider, etc.)
Statistical Analysis
- Examining correlations between provider density and maternal health outcomes
- Analyzing socioeconomic variables related to access
- Comparing access patterns across different regions
Preliminary Findings
Geographic Disparities
Our initial analysis reveals significant geographic disparities in midwife and doula availability:
- Urban Concentration: Certified midwives and doulas are heavily concentrated in urban and suburban areas
- Rural Gaps: Many rural communities lack any certified midwives or doulas within a 50-mile radius
- Regional Variations: Coastal regions tend to have higher provider density than inland areas
Socioeconomic Patterns
- Communities with higher median incomes have greater access to doula services
- Areas with larger populations of color often have fewer midwifery options
- Insurance coverage significantly impacts access to these services
Healthcare System Integration
- Hospital-based midwifery services are more accessible than independent midwives in some regions
- Doula services remain largely out-of-pocket, creating financial barriers
- Few Medicaid programs cover doula care, limiting access for low-income families
Significance
Public Health Impact
Understanding the distribution of maternal health support professionals helps:
- Policy Development: Informing policies to expand access to midwifery and doula care
- Resource Allocation: Guiding where to invest in training and recruiting new providers
- Health Equity: Addressing disparities in maternal health outcomes
Birth Outcomes Connection
Research shows that continuous support during labor (such as doula care) can:
- Reduce cesarean section rates
- Decrease the use of pain medication
- Shorten labor duration
- Improve satisfaction with the birth experience
- Reduce postpartum depression rates
Access to midwifery care is associated with:
- Lower intervention rates
- Higher rates of breastfeeding initiation
- Better continuity of care
- More culturally responsive care options
Community Impact
Maternal Health Crisis
The United States has one of the highest maternal mortality rates among developed nations, with significant racial disparities. Black women are 3-4 times more likely to die from pregnancy-related complications than white women.
Increasing access to midwives and doulas—particularly in underserved communities—is one strategy to address this crisis.
Barriers to Care
Our research is documenting barriers including:
- Geographic Distance: Lack of providers in rural and some urban areas
- Financial Access: High out-of-pocket costs for doula services
- Insurance Coverage: Limited Medicaid coverage for midwifery and doula care
- Cultural Competency: Need for providers who understand diverse communities
Connections to My Work
This research informs my understanding of:
Healthcare Equity
- How social structures create unequal access to essential services
- The intersection of race, class, and geography in health outcomes
- The importance of community-based support systems
Research Methods
- Data collection and analysis techniques
- Working with GIS and spatial data
- Collaborating with community organizations and health departments
Sociology of Health
- Understanding healthcare as a social issue, not just a medical one
- Recognizing how systemic factors shape individual health experiences
- Seeing the role of non-physician providers in improving health outcomes
Future Directions
- Expand Geographic Scope: Include additional states and regions in the mapping
- Longitudinal Analysis: Track changes in provider distribution over time
- Community Engagement: Partner with community organizations to understand barriers from community perspectives
- Policy Recommendations: Develop evidence-based recommendations for increasing access
Collaborations
This project involves collaboration with:
- California State University, Fresno Sociology Department
- Local public health departments
- Midwifery and doula professional organizations
- Community health centers
Presentations
- Student Research Symposium, CSU Fresno (2024)
- California Sociology Conference (Upcoming)
This research contributes to understanding maternal health access as a social justice issue and informs efforts to improve birth outcomes for all families, regardless of geography or socioeconomic status.