The number of clients served has shifted in response to staffing levels, referral volume, and client engagement patterns. Periods of higher service delivery are often aligned with stronger referral flow from clinical partners and a full roster of active doulas. At times when doula staffing was lower, or referrals slowed, the number of clients served declined. External factors—like seasonal changes, holidays, or changes in eligibility screening—also played a role in these fluctuations. Increases tend to follow intentional outreach and consistent follow-up with newly referred clients.

Clinics, hospitals, and community-based organizations have been essential in referring clients to SisterWeb doulas. Partners who provide prenatal services, case management, or WIC support are often the first connection families have to our program. Expanding collaborations with schools, early childhood centers, and public health departments could help identify more birthing people needing doula support.

Personalized outreach, warm handoffs from partners, and early contact from doulas have been effective in helping clients follow through with appointments. Providing options for both in-person and virtual care also improves access. Research from other community-based doula programs highlights the value of embedding doulas into clinic workflows or co-locating services, which reduces client drop-off between referral and appointment.

To consistently serve more clients, SisterWeb can prioritize strengthening referral systems, ensuring prompt doula contact, and maintaining staffing levels aligned with client demand. Improving internal tracking systems and building capacity for follow-up calls and reminders will support retention. Continued relationship-building with trusted community and clinical partners will also be key to expanding reach and supporting more families.