Building a Community-Based Doula Program in Your Area

Occasionally, people visit our blog who have read about the effectiveness of community-based doula models and are researching how to create a program in their area.

If this describes you, please contact us for information or just to talk about what you're considering. Open Arms has had a community-based doula program for years now and have learned a few things along the way, especially as we've built our Outreach Doula program with the White Center Early Learning Initiative, and we are happy to share that expertise with you to help your program get off the ground.

The Open Arms program is based on the Chicago HealthConnect One community-based doula model. To follow that model, there are several key steps that a program must adhere to:

• Employ women who are trusted members of the target community
• Extend and intensify the role of doula with families from early pregnancy through the first months postpartum.
• Collaborate with community stakeholders/institutions and use a diverse team approach
• Facilitate experiential learning using popular education techniques and the HealthConnect One training curriculum
• Value the doulas' work with salary, supervision and support

Although there are other web pages and programs out there that describe how to start a community-based doula program, we strongly feel that this model provides an excellent foundation for this kind of program. There are reasons for each of these steps, and they have been proven to increase the effectiveness of the program. They also help a community-based program to be truly community-based ... if you skip any of these steps, it's easy to veer off course and provide a program that isn't actually from the community it serves and therefore will have reduced effectiveness and simply won't be as valuable to your clients.

Contact us by email or phone at 206-723-6868 and we'd be happy to talk with you.

Open Arms wins Seattle Human Services Coalition Award

We at Open Arms are thrilled to have received the Seattle Human Services Coalition award for Innovative Program!

The winners were announced today:

18th Annual Human Services Awards

The award recognizes Open Arms for its "response to an existing need in a new way, its ability to build upon an outstanding program model, its creativity in leveraging resources, and its positive program results."

I'm thrilled about this award. Today I had a wonderfully stimulating and energizing conversation with one of our current board members and a potential board member and left that conversation feeling so excited about the work we do at Open Arms, as I often do when I have a chance to step back and really look at Open Arms with fresh eyes. Our programs are innovative - and I'm pleased to see that recognized through this award.

Open Arms is a community-based organization, and all of our programs are deeply committed to working within the cultures and communities we serve - not imposing structure from the outside. Open Arms Programs - our regional birth doula services program and our White Center Early Learning Initiative (WCELI) birth doula and outreach doula programs - show results and are cost-effective.

Our clients - low-income women, refugees, immigrants and others - struggle in many ways, but one of the ways that is most apparent is in the area of health disparities. Issues such as postpartum depression, preterm birth and infant mortality disproportionally affect our clients. By removing barriers to service, increasing awareness and personal advocacy, providing education about pregnancy, birth options, breastfeeding and positive early parenting, and reducing medical interventions and the costs of perinatal care, Open Arms programs are able to fill in the gaps that are left in perinatal care and give families a healthier start - which has a great impact in terms of health care costs, early learning and future success of families.... and that affects us all.

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.