Addressing Gaps and Saving Lives: Doulas' Role in Addressing Substance Use and Mental Health Challenges Among Pregnant and Postpartum Clients-A Scoping Review.

OBJECTIVES: Doulas are a potential resource for addressing substance use and mental health challenges that pregnant and postpartum individuals experience. We sought to review peer-reviewed literature that examines Doulas' role in addressing these challenges to highlight the need for more research in this area. METHODS: We conducted a scoping review (2001-2021) to identify articles that examine the way in which Doulas address maternal substance use and mental health challenges in their clients. The articles were reviewed by two members of the research team. RESULTS: Nine articles describing Doulas' role in addressing substance use and mental health challenges were identified. Six described Doulas' role in addressing mental health, five of which saw positive mental health outcomes due to Doula involvement. One additional article recommended Doulas be considered in the future to address mental health challenges. While the minority of articles addressed substance use (n = 2), it was reported that Doulas were a positive addition to interdisciplinary teams addressing substance use challenges with pregnant individuals. CONCLUSIONS: While the literature showed that Doulas can improve substance use and mental health outcomes among pregnant or postpartum individuals, a significant gap remains in research, practice, and peer-reviewed literature addressing this issue.

The Effects of Race and Socioeconomics on the Relationship Between Gestational Diabetes Mellitus and Birth Outcomes: An Analysis of Southern US PRAMS data.

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications. Uncontrolled GDM increases the risk of negative pregnancy outcomes for both the pregnant individual and the infant. African Americans (AAs) have higher maternal morbidity and infant mortality rates than non-Hispanic whites (NHWs). The goal of the current study was to examine racial differences in the effect of GDM on birth outcomes. The data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was analyzed with a focus on four states in the southern U.S. (Alabama, Georgia, Louisiana, and Mississippi). The results presented suggest that AAs are at lower risk of GDM than NHW individuals. Even with the lower risk of GDM, AAs are at higher risk of pre-term births. In addition, socioeconomic factors and access to prenatal care play a role in birth outcomes including moderating the effect of GDM on outcomes. A discussion of potential policy interventions that may improve pregnancy outcomes is discussed including increased use of doulas to support pregnant people.

Racial Anxiety among Medical Residents: Institutional Implications of Social Accountability.

As the U.S. population becomes more racially diverse, physicians need to have cultural skills for optimal health outcomes; however, the literature is sparse for cultural skill application of medical trainees. This paper focuses on Family Medicine residents' perceptions of racial anxiety and their preparedness to manage cross-racial interactions. Of the 24 respondents, the majority were female. The ethnicities of respondents were 16 non-Hispanic White, five African American, and three Native American. Most participants demonstrated good general knowledge and/or self-efficacy on racial anxiety, but produced lower scores in workplace skills and actions related to racial anxiety. Thus, physician training programs should incorporate more skill development around racial anxiety. More research is needed to examine how medical schools approach multicultural education as a method of disrupting health disparities to reflect trends of social accountability and social justice.