Tuesday, March 30, 2010

Community-based doula model

I wanted to share this from our luncheon.

Our speaker was Rachel Abramson, Executive Director of HealthConnect One in Chicago. She spoke about the kinds of results they have seen from community doula programs. The Open Arms Outreach Doula program is modeled after the program in Chicago.

Rachel said:

Let me tell you a bit about the community-based doula model, the foundation for Open Arms’ Outreach Doula program. This evidence-based model has been cited by the Center for American Progress as one of five important national evidence-based home visiting models. It began with a four-year pilot serving low-income African-American and Latina pregnant and parenting teens in Chicago from 1996 – 2000. With 254 mothers in the evaluation, we saw:

* 80% breastfeeding initiation rates, including 65% initiation rates at an agency with practically no breastfeeding in their home visiting program before the doula piece was integrated

* 8.1% c-section rates

* 11.3% epidural rates

* Increased pregnancy spacing for young teens

* Significantly enhanced maternal scores on the NCAST scale to rate videotapes of maternal-infant interaction

* Decrease in preterm births

* Cost savings including $750 per person in c-sections and epidurals not performed, approximately $500 per breastfed baby in savings on formula, and broader savings from shorter hospital stays and less illness among breastfeeding babies.

These outcomes have held up over time and with replication in a variety of underserved communities across the country. We have seen consistent high breastfeeding rates, consistently lower c-section and epidural rates, increased use of birth control, increased practice of skin-to-skin contact after birth, and lower preterm and low birth weight babies. There are now 40 community-based doula replication sites in 14 states, 6 of which are funded through the new HRSA Maternal and Child Health Bureau funding stream. We have rolled out this year a robust and user-friendly data collection system designed to continue the process of evaluating these programs and researching the outcomes and processes of community-based doula program.


These outcomes are so important. The birth outcomes that come from having a doula are outstanding - resulting in healthier moms and babies, lower health care costs and shorter hospital stays.

But the one that really caught my eye is the better parent-child interactions. That is the key - the lasting effect that will go on to improve lives for years to come. When a parent increases the quality of interaction with the child, all sorts of brain development happens, attachment happens, and the entire family is strengthened.


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