{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T07:15:11Z","timestamp":1783235711068,"version":"3.54.6"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000886","name":"Duke Endowment","doi-asserted-by":"crossref","award":["7045-SP"],"award-info":[{"award-number":["7045-SP"]}],"id":[{"id":"10.13039\/100000886","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UNC Health Foundation"},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"crossref","award":["AD-2020C3-21142"],"award-info":[{"award-number":["AD-2020C3-21142"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Equity"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Continuous doula support during labor and delivery in the hospital setting is associated with improved maternal and newborn outcomes, such as reduced labor duration and higher infant Apgar scores. ACURE4Moms, a 4-arm cluster randomized controlled trial of 39 prenatal clinic groups across North Carolina, is evaluating whether community-based doula support can reduce low birthweight. This short report outlines hospital doula policy insights gleaned from implementation of the doula support intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Identify the most common models for doula support in the hospital setting and discuss their potential impact on patient access to doula support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We worked with study clinics and their health systems to obtain their hospital doula policies so that we could prepare study doulas to support patients at the participating hospitals. We conducted thematic analysis to categorize the policies by their various approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key observations:<\/jats:title>\n                    <jats:p>Four commonly observed approaches to hospital access policies for doulas were identified among study sites: (1) the Visitor Model, (2) the Credentialing Model, (3) the Vendor Compliance Model, and (4) the Hospital Workforce Model. We noted that the wide variability in policies and their enforcement and restrictiveness could create confusion and unnecessary barriers for doulas who support patients in labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is a need for equitable, standardized, and clearly communicated hospital doula policies to ensure that more patients, especially those from underserved populations, can access the benefits of continuous doula support in hospital-based births.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24731242261455178","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:28:20Z","timestamp":1783081700000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Models of Birth Doula Access in Hospital Settings: Insights from the ACURE4Moms Study in North Carolina"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0410-1448","authenticated-orcid":false,"given":"Stephanie S.","family":"Sperry","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella H.","family":"Boynton","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela A.","family":"Tatum","sequence":"additional","affiliation":[{"name":"Momma\u2019s Village-Fayetteville, Fayetteville, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Jackson","sequence":"additional","affiliation":[{"name":"MAAME, Inc, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"McMillan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Miller","sequence":"additional","affiliation":[{"name":"School of Medicine, Wake Forest University, Winston Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda K.","family":"Lanning","sequence":"additional","affiliation":[{"name":"School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Lipscomb","sequence":"additional","affiliation":[{"name":"Novant Health, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Peragallo","family":"Urrutia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2537-7"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005937"},{"issue":"5","key":"e_1_3_3_4_1","first-page":"e39451","article-title":"The effect of doulas on maternal and birth outcomes: A scoping review","volume":"15","author":"Sobczak A","year":"2023","unstructured":"3.Sobczak A, , Taylor L, , Solomon S, et al. The effect of doulas on maternal and birth outcomes: A scoping review. Cureus 2023;15(5):e39451.","journal-title":"Cureus"},{"issue":"7","key":"e_1_3_3_5_1","first-page":"CD003766","article-title":"Continuous support for women during childbirth","volume":"7","author":"Bohren MA","year":"2017","unstructured":"4.Bohren MA, , Hofmeyr GJ, , Sakala C, et al. Continuous support for women during childbirth. Cochrane Database Syst Rev 2017;7(7):CD003766.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_6_1","volume-title":"Doulas in North Carolina: a landscape analysis and summit report","author":"North Carolina Department of Health and Human Services","year":"2023","unstructured":"5.North Carolina Department of Health and Human Services. Doulas in North Carolina: a landscape analysis and summit report. Division of Public Health: Raleigh, NC; 2023."},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1363\/psrh.12203"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1891\/JPE-2021-0013"},{"key":"e_1_3_3_9_1","unstructured":"8.An Act concerning doulas and supplementing Title 26 of the Revised Statutes. Stat S-4119\/A-5739 (NJ 2024)."},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JPN.0000000000000639"},{"key":"e_1_3_3_11_1","volume-title":"Guide for hospital doula policy creation","author":"New Jersey Health Care Quality Institute, HealthConnect One, New Jersey Doula Learning Collaborative","year":"2024","unstructured":"10.New Jersey Health Care Quality Institute, HealthConnect One, New Jersey Doula Learning Collaborative. Guide for hospital doula policy creation. New Jersey Health Care Quality Institute: Trenton, NJ; 2024."}],"container-title":["Health Equity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24731242261455178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24731242261455178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24731242261455178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T06:46:11Z","timestamp":1783233971000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24731242261455178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"alternative-id":["10.1177\/24731242261455178"],"URL":"https:\/\/doi.org\/10.1177\/24731242261455178","relation":{},"ISSN":["2473-1242","2473-1242"],"issn-type":[{"value":"2473-1242","type":"print"},{"value":"2473-1242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"24731242261455178"}}