Research

Current Interests: 

My current research interests involve uncovering the hidden ways that the perinatal care system discourages patient empowerment and how that system affects how birth doulas operate, mostly in the United States. I’m also interested in the processes of labor support – what actually happens in human interaction that affects birth outcomes?  As a qualitative researcher, I utilize a variety of analytic methods, usually grounded theory or hermeneutic theme analysis when looking at micro level interactions.  From a macro perspective, I utilize system approaches. My research background is interdisciplinary but is heavily influenced by a human ecology model. In that model, people need to be studied in relationship to others or their environment to gain a critical understanding of a phenomena. In contrast, psychology examines the internal processes in an individual and sociology looks at the aggregate processes of groups of people. In my current analysis I’m adopting a systems approach to examine the growth and development of the birth doula as a profession as well as a social movement.  

The project I’m most known for, The Doula Effect: How and Why a Birth Doula Shortens Labor, Enriches Parenting, and Optimizes Mental Health Outcomes, has been ongoing for over ten years. I first presented this model at the DONA International Conference in 2008.  Marshall Klaus told me he thought I had the answer to the doula’s effectiveness.  We both agreed that we needed the science to be able to prove it.  Luckily the last four years has shown an explosion of fMRI images of the brain during various emotional states and neurological processes.  As the research into adult attachment relationships and the neurohormonal mechanisms of oxytocin influence on mood and the body has grown, so has my understanding in the role of labor and birth in shaping human relationships and attachment orientations.  

In October 2017, I began interviewing a new generation of doulas for my study sample.  The previous sample was the source material for my book, The Heart of the Doula: Essentials for Practice and Life.  Look for more on this topic as I define an Attachment-Informed Model of Childbirth.  It encompasses the Trauma-Informed model and goes beyond it to explore the potential for the healing of trauma during labor and birth.  

In addition, I’m working on an update to the 2006 project, “From Novice to Expert: The Five Stages of Doula Development”, which will include an examination of the five stages of how doula communities grow and change over time. 


Research Fellow:

As a research fellow, I am supported by the University of Wisconsin-Madison Center for Child and Family Well Being, an initiative of the School of Human Ecology. Because of their sponsorship I am up to date on research findings and enriching my continuing education offerings for perinatal professionals.  The fellowship also offers academic support for data analysis, model creation, and project planning.  The leaders believe strongly in supporting my doula research and encouraging dissemination of academic knowledge throughout the greater community.  Through the Center, I've become involved in several local initiatives to address racial disparities in perinatal care and increase access to sexual health information.  

University of Wisconsin-Madison School of Human Ecology Center for Child and Family Well-Being Research Fellowship  


Past Projects:

What Motivates People To Take Doula Trainings?, Journal of Perinatal Education, 2016
Eighteen identified motivations for attending a birth doula training workshop were ranked by 467 participants (466 females, 1 male) in 2010 and 2013. Participants selected a variety of reasons but only 30% chose to “become a professional doula” as their main reason. Another 20% wanted to “become a midwife.” Remaining participants selected 16 other professional and personal motivations, such as “increase birth knowledge,” “understand my own births,” “make future births better,” and “help women have better births (not as a professional).” One quarter had not attended a birth or had a child. Besides career training, these workshops are filling a cultural gap in childbirth education for people who are not expectant parents, and who intend to use this knowledge in unanticipated ways.  (pdf available in Member Area

Doulas As Facilitators of Transformation and Grief

Doulas and Intimate Labour: Boundaries, Bodies, and Birth
Angela N. Castaneda and Julie Johnson Searcy, 2015, Demeter Press)  
“It is important to recognize the role that doulas play during life changes and shifting relationships. Life changes always involve loss and grief over what has shifted. It is in this tender territory of loss where doulas in this study revealed their strength as facilitators of transformation. This chapter examines the processes of grief, transformation, and the function of the doula as a “wise witness” and “trusted guide.”...Doulas are engaged by mothers and their intimate family to be guides through the process of pregnancy and birth. While mothers are initiated into their maternal responsibilities by the health care system, fathers may feel that they have no place in the societal rituals of pregnancy. The doula fills that gap, treating clients as a pregnant couple if that is their desire.  She morphs her services to meet their presenting needs.  
 

Attending The Births of Friends – Round The Circle: Doulas Share Their Experiences 
Julie Brill, 2015  
“As doulas we are able to shift and change how we respond to our clients based on their needs.  We are still genuine but at prenatal visits we adjust how much information we give, how much emotional support we offer, and what our role is with her partner and other support people.  As doulas we may hold back at times from saying anything.  Our friends already know our opinions.  They know our birth preferences and what we think is best.  We can’t change who we are; they already know who we are!  If our friend has the same vision as us, that usually works out fine.  But if she doesn’t, there can be conflicts.” 


Sensitivity: The Critical Doula Skill We Can’t Teach 

Nurturing The Family: The Guide for Postpartum Doulas
Jacqueline Kelleher

“I’ve pondered what makes some birth and postpartum doulas successful and why others founder.  It isn’t a lack of commitment or desire to be effective.  It isn’t a lack of business savvy.  To me the most critical doula skill is sensitivity – the ability to read another person’s cues accurately and respond appropriately in a timely manner.  Sensitivity is a primary component of emotional intelligence and a key skill in successful parenting and creating secure attachment in infancy...So many research participants described their doula’s ability to understand what they were feeling without the need for words as “magical”.  But for doulas, it is the essential skill of reading people and interpreting their behavior accurately.  It’s using our brains, not magic.  The good news is that we have the innate ability to learn and improve this skill; our brains are pre-programmed for it.” 


Women’s Experiences of Female Ejaculation (2009) Sexuality and Culture. 

“Thirteen women responded to an open-ended questionnaire about their female ejaculation experiences.  Responses are described from a phenomenological perspective.  The major themes of responses include feelings of humiliation and shame or feelings of exploration and wonder, moving towards acceptance or acceptance tinged with resignation.  Women explain their relationships to their bodies as well as their relationship to the ejaculation fluids and how this affects their sexual identities.  The origins of their sexual fluids are mysterious.  The stimulation needed for ejaculation differed among respondents, and was also found to occur separately from orgasm for some women.  Ejaculation began at one of two distinct time points in the life course.  This study supports the existence of female ejaculation as a common experience for some women, and proposes new areas for further exploration.”  (pdf available in Member Area)


 

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