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INTRODUCTION: Expanding access to doula care is a key strategy for improving the perinatal experiences and health outcomes of birthing people of color in the U.S. This study investigates the future of maternal healthcare in the U.S. from the perspective of doulas and highlights emerging technology and other opportunities related to strengthening the doula workforce. METHODS: The study recruited community doulas from 12 unique U.S. states, ensuring at least half of the doulas predominantly served communities of color. Doulas (N = 26) participated in semi-structured, futures-oriented interviews that explored their experiences providing care during the COVID-19 pandemic and utilization of technology. A subset of doulas (n = 8) were engaged in interactive workshops where they envisioned alternative futures for doula care and childbirth. Interviews and workshops were analyzed using the Framework Method. RESULTS: The COVID-19 pandemic heightened technology use among doulas and increased client accessibility. Social media serves as a unique space for critical community building and client outreach. Doulas reported opportunities to strengthen and mobilize the future workforce: recognizing doula care as a reimbursable service by health insurers, utilizing doula collectives for community practice to decrease burnout, increasing emotional support for doulas, and instilling a chain of learning through mentorship. DISCUSSION: Futures thinking served as a valuable approach for doulas to illuminate the implications of present-day challenges and empowered doulas to design roadmaps toward better futures for doulas and maternal health. Doulas should be engaged as partners to hold a meaningful decision-making role when discussing policies, employment structures, emerging technology, and other aspects of doulas positioning within the healthcare system.

PurposeThis commentary proposes a new direction to train the MCH workforce by leveraging today's rapidly changing innovation and technology to address persistent health inequities.DescriptionWe outline the creation of an MCH technology and innovation training pipeline developed by harnessing creative funding opportunities, diversifying training modalities, and expanding partnerships beyond traditional academic-practice partners, that be replicated and adapted by other academic programs.AssessmentTechnology and innovation will continue to be a growing intersection between health and equity, and we must create a robust pipeline of MCH leaders prepared to collaborate with entrepreneurial and innovation leaders.ConclusionTechnology offers an important opportunity to improve MCH outcomes and reduce disparities, but only if we train the MCH workforce to seize these opportunities.

Purpose This case study provides a high-level overview of the human-centered design (HCD) or 'design thinking' process and its relevance to public health. Description The Best Babies Zone (BBZ) initiative is a multi-year project aimed at reducing inequities in infant mortality rates. In 2012, BBZ launched pilot programs in three US cities: Cincinnati, Ohio; New Orleans, Louisiana; and Oakland, California. The Alameda County Public Health Department (ACPHD), the lead for the Oakland BBZ site, identified HCD as a promising approach for addressing the social and economic conditions that are important drivers of health inequities. HCD is a process for creating innovative products, services, and strategies that prioritizes the needs of the intended population. ACPHD partnered with the Gobee Group (a social innovation design consultancy) to develop the Design Sprint. The Design Sprint was a 12-week pilot in which 14 professionals from nine organizations used the HCD process to develop concepts for stimulating a vibrant local economy in the Oakland Best Babies Zone. Assessment Thirty- to sixty-minute semi-structured interviews were conducted with all 14 individuals involved in the Design Sprint. With the exception of one interview, the interviews were audio-recorded, transcribed, and inductively coded to identify themes. Conclusion Our experience suggests that HCD can: enhance community engagement; expedite the timeframe for challenge identification, program design, and implementation; and create innovative programs that address complex challenges., Author(s): Jessica Vechakul[sup.1] , Bina Patel Shrimali[sup.2] , Jaspal S. Sandhu[sup.3] Author Affiliations: (1) University of California, Berkeley, Berkeley, CA, USA (2) Alameda County Public Health Department, Oakland, CA, USA [...]