This performance measure reflects doulas’ perception of respect from clinical providers in hospital settings. After starting at 7.6 in October 2024, reported respect rose to a high of 10.0 in November and January, indicating positive interactions and improved integration. However, a slight decline began in February and March (9.7, 9.8), followed by a more significant drop to 8.7 in April 2025. This downward shift may reflect challenges such as rotating clinical staff, reduced familiarity with doulas’ roles among new hospital providers, or persistent systemic issues in provider-doula dynamics. Anecdotal feedback suggests travel nurses or unfamiliar providers may bring biases or operate with less collaboration, which can impact how welcomed doulas feel at the bedside.

Key partners in this outcome include OBs, midwives, anesthesiologists, and nurses working in hospitals where SisterWeb doulas are active. Internally, CDI champions and program leads play a vital role in preparing doulas and facilitating relationship-building with clinical teams. SisterWeb doulas themselves are the reporters and primary actors in these experiences. Hospital administrators and staff educators are also partners in addressing systemic dynamics and improving doula integration into labor and delivery units.

Respectful interactions tend to increase when doulas are introduced early in the care process, when there are established expectations around their role, and when medical staff have had previous positive experiences working with SisterWeb. Some hospitals have begun including SisterWeb in staff trainings, tours, or interdisciplinary meetings, which helps foster mutual understanding. Tools such as CDI feedback forms and real-time reporting channels have also helped capture and address issues more proactively.

To address the recent dip and strengthen provider-doula relationships, SisterWeb can reinforce regular CDI Champion Dyad meetings, encourage doulas to proactively introduce themselves to care teams, and build stronger communication pathways with hospital staff. Gathering specific examples of both respectful and challenging interactions can inform targeted training and advocacy. Additionally, SisterWeb may consider providing short orientation materials for hospital staff on the doula model and its evidence-based benefits, reinforcing the value of collaborative, respectful care across disciplines.