Logo: to the web site of Uppsala University

uu.sePublications from Uppsala University
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Paradoxes in the cultural doula concept for migrant women: Implications for gender-inclusive care versus migrant-friendly maternity care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Reproductive Health and Migration.ORCID iD: 0000-0002-2900-2849
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Reproductive Health and Migration. Faculty of Social Sciences, Business and Economics, Åbo Akademi University, Turku, Finland.ORCID iD: 0000-0002-5385-5550
2023 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 126, article id 103805Article in journal (Refereed) Published
Abstract [en]

Objective

Swedish healthcare policies promote gender equality, shared parenting and cultural diversity. In response to the risk of adverse outcomes for migrant women, cultural doulas were introduced as support for migrant women during pregnancy and/or labour. The aim is to investigate potential tensions in the cultural doula concept in relation to policies of gender equality and diversity.

Design

An interview study was designed to analyse perceptions of the cultural doula concept among healthcare providers in Swedish sexual and reproductive healthcare. Through the framework of Bacchi's approach ‘What Is the Problem Represented to Be?’ and Hochschild's concept of ‘global care chains’, we analyzed whether the introduction of the cultural doula concept is in line with the policies of gender equality and culturally sensitive care by exploring paradoxes, unintended consequences and what was not reflected upon.

Setting and participants

Semi-structured interviews (n = 18) with midwives and obstetricians at hospitals in two Swedish counties during 2022.

Measurements and findings

The interviews were analyzed through thematic analysis. Cultural doulas were perceived as multi-tasking resources for facilitating integration and providing healthcare information and psychosocial support. Respondents did not identify doula support as a cultural practice in migrants’ origin countries. Despite awareness of cultural differences in gender norms, many respondents stated that doula support included male partners.

Key conclusions

The cultural doula concept includes paradoxes in relation to gender equality and diversity. Rather than empowering migrant women, the cultural doula concept is related to gendered patterns of low-educated, underpaid care work. Labour support interventions including migrant women's social network and intensified partner involvement would be more in line with Swedish policies of gender equality, shared parenting and cultural sensitivity when needed. However, doulas may be an imperfect solution for women lacking partners or social networks, for example, newly arrived migrant women, if no support is to be found within the perinatal care system.

Implications for practice

Midwives and obstetricians need reflexivity about what the problem is represented to be when it comes to gender equality and cultural sensitivity in their collaboration with cultural doulas, boundaries between roles, how they handle confidentiality, and why cultural doulas are needed in relation to migrant women's integration.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 126, article id 103805
Keywords [en]
Doula, Gender equality, Maternity care, Midwives, Migrant women, Sweden
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-517101DOI: 10.1016/j.midw.2023.103805ISI: 001097447100001PubMedID: 37714043OAI: oai:DiVA.org:uu-517101DiVA, id: diva2:1816594
Funder
Swedish Research Council, 2018-03365Swedish Research Council, 2018-03365Swedish Research Council, 2018-03365Swedish Research Council, 2018-03365Swedish Research Council, 2018-03365Swedish Research Council, 2018-03365Available from: 2023-12-04 Created: 2023-12-04 Last updated: 2024-01-10Bibliographically approved

Open Access in DiVA

fulltext(498 kB)69 downloads
File information
File name FULLTEXT01.pdfFile size 498 kBChecksum SHA-512
b907801c524960fef02d222fb6d99356b78361bd713f6c8a0e23cfdfd3a65f1ba3aee64d95c66eac0cb8c90743578de1722fadbccde2175ad0bc9f8bcaccfa81
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records

Essén, BirgittaEriksson, Lise

Search in DiVA

By author/editor
Essén, BirgittaEriksson, Lise
By organisation
International Maternal and Reproductive Health and Migration
In the same journal
Midwifery
NursingPublic Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 69 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 117 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf