Royce Fellowship awarded to Online MPH student for study of birth doulas

What inspired your transition from urban policy to public health?

Right now, I work at the Rhode Island Department of Health in maternal and child health programming. A lot of what I learned in education policy at Brown—like building programs, workforce development, measuring outcomes and spotting trends—translates directly into my work in public health.

In my current role, I work on maternal health systems, which includes workforce development for doulas, midwives, certified lactation counselors, perinatal mental health professionals and community health workers. That overlap between education and public health got me thinking more broadly about how the social determinants of health shape people’s lives. It’s not just about education access—it’s about the larger systems that affect overall health and wellbeing. 

Tell us about the Royce Fellowship-winning project that you’re working on.

The project focuses on bilingual and culturally aligned doulas who support mixed immigration status families. Through interviews and focus groups, I’m exploring questions like: What challenges are families facing right now? Are they hesitant to access maternal health services, and if so, why? How are doulas helping them navigate the system in ways that feel safe and supportive through their birthing journey?

What motivated you to conduct this study?

It grew out of both my professional work and what I’ve observed in the broader political climate. Being in perinatal health and workforce development, and talking with practitioners, I realized that not many people are looking at how doulas specifically support immigrant and mixed-status families. It felt important to explore that intersection.

Another reason behind the project is that my family members are immigrants from Jamaica (my mom and dad, uncles, and aunts), so I definitely grew up in an immigrant household, which got me thinking about, from a young age, how the social determinants of health impact immigrant families and their ability to access resources and thrive.

Tell us about the partnerships you’ve built.

I’m collaborating with two local doula groups: Doulas Conectadas is a collective of bilingual doulas serving the multilingual Hispanic perinatal population in Rhode Island and greater New England. SacredPause Doula LLC. is a local bilingual doula practice serving families across Rhode Island, Massachusetts, and the greater New England region.

Sara Castañeda—a bilingual doula practicing in Rhode Island and Massachusetts, birth justice activist, and leader within both groups—is co-leading project planning, implementation and writing. Both organizations are true partners in the project, helping shape the research questions, staying involved through the process, co-analyzing the data and eventually co-publishing the findings.

What are some of the challenges you’re finding immigrant mothers face in accessing care?

One major challenge is discrimination and stereotyping from healthcare professionals, which has been documented in research and is also echoed anecdotally in our region. That can look like patients not being taken seriously when something is wrong, or not feeling welcomed or supported by maternal health staff.

For mixed-status families, fear is another barrier. In areas where ICE activity increases, families are often less likely to access social and medical services. Research has even linked immigration enforcement activity and raids to higher rates of preterm birth in impacted Latino communities, for both citizen and non-citizen birthing mothers. So, discrimination and fear are both major hurdles to overcome to support a person’s birthing journey.

How do doulas make a difference?

Doulas are already making a huge difference. They are non-clinical professionals that provide informational, emotional, and physical support during pregnancy. They’re strong advocates for their clients and can bridge gaps in trust between families and the healthcare system.

Research has shown that doulas help reduce maternal complications, increase breastfeeding rates and boost confidence in parenting. When doulas share the same cultural background as their clients, that trust deepens even more. They become a safe, reliable point of support. That’s part of what I hope to document in this project.

How do you hope this research will influence broader conversations around maternal health and health equity?

My hope is that it helps expand the conversation around how we support maternal health professionals like doulas, and how workforce development can strengthen access to care for underserved communities.

I also want it to add to the body of research showing the impact doulas make, and to highlight what mixed-status families are experiencing in this region. Ideally, it will push us to think more holistically about maternal health and equity.