The NICU doula: family-centered support in the neonatal intensive care unit.

Background: Neonatal intensive care unit (NICU) admissions are steadily increasing in the United States. Doulas have been identified as a mitigating strategy to address maternal and infant health disparities. Yet, little is known about the experiences of doulas in NICU settings. Objectives: The purpose of this study was to understand how doulas support postpartum families in the NICU environment. Methods: A modified critical ethnographic qualitative study informed by the Life Course Perspective was conducted. Data were collected through a structured listening session and online demographic survey. Thematic analysis was used to code the data and identify key themes and subthemes. Results: A sample of nine individuals participated in the structured listening session. All of the enrolled participants self-identified as women, were currently practicing doulas, and had NICU experience. Many participants expressed personal and professional experiences that informed their decisions to support postpartum families in the NICU environment. Key themes included motivations; barriers and challenges; facilitators and successes; identified training needs; and opportunities for improvement. Doulas also discussed the importance and need of family-centered care in the NICU. Conclusion: Our findings suggest doulas are currently supporting postpartum families in NICU settings. However, there are several opportunities to improve the NICU environment to be more welcoming of doulas, while also building the capacity of doulas to support the unique needs of postpartum families during a NICU admission. Future research needs to further explore the barriers and facilitators of integrating doulas in NICU settings.