The Wallace Center is collaborating with communities, patients, providers, and health systems to improve health equity in perinatal care. Through a variety of research projects, we are studying the implementation, effectiveness, barriers, and facilitators of new models of perinatal care – from community doulas to racially-concordant group care to new models for postpartum care.
Quality Improvement for Health Equity in Reproduction (QI4HER+) (PI: Kim Harley)
We have joined forces with Alameda Health Systems to create a community-based research initiative focused on improving perinatal health at Oakland's Highland Hospital, the safety-net hospital for Alameda County. QI4HER+ is a long-term research collaboration that is guided by community needs and interests, and powered by the Wallace Center's faculty and graduate researchers. Current projects include an evaluation of Highland Hospital's of BEloved Birth Black Centering program.
Policy on Postpartum Care (PIs: Sylvia Guendelman and Lindsay Parham)
The postpartum period (roughly the first year after giving birth) is a critical time to recover from birth, transition to parenthood, and develop bonds with a new baby. However, the current maternity care system in the US is fragmented and neglects women's and families’ medical and socio-emotional needs during the postpartum period. Wallace Center faculty and researchers are addressing this understudied time period using a mixed methods approach to map the landscape of current clinical practice and norms, the views of clinical providers on innovating current practices with new policy and technology, and the perspectives of health insurance carriers about ways to improve postpartum services.
Community-based Doula Care (PI: Cassie Marshall)
Researchers at the Wallace Center, led by Dr. Cassie Marshall, continue to work on a variety of projects focused on community-based doula care as a person-centered intervention to improve maternal and infant health equity. Dr. Marshall’s current work focuses on Medicaid coverage of doula services and an interprofessional collaboration between a community-based doula organization and clinical partners in San Francisco.These research efforts evolved from Dr. Marshall’s recently completed projects that were conducted in collaboration with Dr. Anu Manchikanti Gómez, associate professor and director of the Sexual Health and Reproductive Equity Program (SHARE) at the UC Berkeley School of Social Welfare.Most recently, they explored California payer perspectives on Medicaid and commercial coverage of doula care with support from the California Health Care Foundation. Another recent project aimed to build capacity for partnered research on community doula care. Funded by the Patient-Centered Outcomes Research Institute (PCORI), this effort resulted in a shared research agenda on community doula care.Additionally, from 2018 to 2022, Drs. Gómez and Marshall conducted a partnered evaluation of SisterWeb San Francisco Community Doula Network’s community doula programs for Black and Pacific Islander birthing people. This work was conducted alongside Dr. Andrea Jackson, an OB-GYN and professor in the UCSF Department of Obstetrics, Gynecology & Reproductive Sciences. Topics explored through the process and outcome evaluations include barriers and facilitators to program implementation, client experiences of community doula care, compensation models for community doulas, health care provider perspectives and experiences working with doulas, and more.
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