Client responses to this measure have been consistently strong, with 100% of surveyed clients reporting that their SisterWeb doulas helped them feel confident using their voice, asserting their wishes, or asking for time to make a decision. This level of consistency over multiple quarters indicates that empowerment is not only a core value but also an embedded outcome of SisterWeb’s care model. Clients are consistently leaving their birth experiences with a stronger sense of agency and self-advocacy, which is especially significant for communities historically marginalized or dismissed in healthcare settings.

Doulas are the primary facilitators of this empowerment, guided by mentors, supervisors, and training teams who prepare them to center client autonomy throughout the care relationship. Clients themselves are key partners in this outcome, offering insight into how support was received and where they needed help finding their voice. Clinical partners—such as hospital staff and midwives—also influence how safe and respected clients feel when asserting their preferences. SisterWeb’s evaluation team ensures this feedback is captured accurately and reviewed regularly to sustain accountability.

SisterWeb’s culturally congruent model prepares doulas to engage in respectful, strengths-based communication that honors clients’ values and lived experience. Doulas regularly coach clients during prenatal visits on how to speak up in healthcare settings, practice scripting or role-playing, and validate a client’s right to pause or question care. During labor and birth, doulas often model this advocacy in real time, giving clients a framework they can use themselves. Empowerment is also reinforced through birth planning sessions, where clients reflect on their goals, boundaries, and decision-making styles.

To maintain these high levels of reported empowerment, SisterWeb should continue integrating client voice and autonomy into every phase of care. Trainings can include updated scenarios that reflect real client-provider dynamics, including how to navigate moments when clients feel rushed or dismissed. Qualitative data—such as quotes from satisfaction surveys—can provide deeper insight into how clients define empowerment and what made them feel supported. Additionally, ongoing collaboration with hospitals to encourage shared decision-making can further reinforce the client's voice beyond the doula relationship.