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Driving Impact With Denver Health Doulas!

Driving Impact With Denver Health Doulas!

By: Bentley Porterfield-Finn

We wrapped up 2021 finalizing an exciting and strategic partnership with the Denver Health Doula Program (DHDP). Since launching our Corporate Social Responsibility (CSR) initiatives related to maternal health in June of 2021, establishing this first collaboration is an important step towards promoting maternal wellbeing in Denver. Our partnership with DHDP includes a generous grant to support an expansion of the program, as well as an in-kind contribution in the form of support with research, data analysis, and recruitment from goldbug’s Corporate Social Responsibility Coordinator, Bentley Porterfield-Finn.  We are excited to be part of a growing group of investors and community partners that are committed to improving maternal health in Colorado and we are just getting started!

More than 3,500 newborns are born at Denver Health annually, and this urban hospital serves the largest percentage of non-white, Medicaid, uninsured, homeless, refugee, immigrant, non-English speaking, and incarcerated individuals in Denver. This is important because it means they support some of the most vulnerable populations and those most susceptible to maternal mortality and morbidity. As covered in previous blog posts, maternal and neonatal morbidity in the United States is higher than in most developed countries, and these numbers are substantially higher for Black, Indigenous, and underinsured birthers. American Indian/Alaska Native and Black women are 2-4 times more likely than their White counterparts to die due to pregnancy-related complication [1]. Moreover, neonatal mortality rates are at least twice as high for babies of color than white babies [2]. By partnering with Denver Health we are focusing on a population of birthing persons with the statistically highest level of risk.

The DHDP was founded by Phoebe Montgomery, CNM in 2016. Doulas who participate in the program provide emotional, physical, and informational support to laboring parents, with no charge to the family. National research has linked doula support with decreased medical intervention, lower rates of cesarean birth, and decreased rates of postpartum depression. Doulas are also associated with increased vaginal deliveries, birth satisfaction, and breastfeeding rates. A 2017 Cochrane review of birth experiences of more than 15,000 women in the United States found that those with doula support experience:

  • Shorter labors by 41 minutes;
  • 15% increased likelihood of having a spontaneous vaginal birth;
  • 39% decreased likelihood of having a cesarean birth;
  • 10% decreased likelihood of needing pain medications;
  • 31% decreased likelihood of reporting a negative birth experience;
  • Increased rates of breastfeeding [3]
  • Babies with higher five-minute Apgar scores

The DHDP program works in shift model, so doulas sign up for 8 or 12-hour shifts on the labor and delivery floor of Denver Health. Then, when a person arrives in labor, the doula introduces themselves and inquires about whether the birthing person is interested in receiving support. Preliminary research from the program shows that about 94% of those who are offered doula support through DHDP accept it. Patients are not charged for the doula.  This is a critical part of the program and where goldbug’s dollars stand to have the highest impact. Private doula support can cost up to $1,800, making it inaccessible to low income and underserved communities.

There are many benefits to doula support, as referenced in our blogs on The Relationships Between Doula Support and Maternal Health. Improved birth experiences are correlated with parenting confidence, decreased depression, and improved quality of parent/child connection. Additionally, The Commonwealth Fund published a literature review of perinatal care models, which concluded that people of color and low-income families benefit the most from doula support [4].

Goldbug’s initial grant to DHDP is for one year, supporting the expansion of the program on multiple levels in order to provide equitable access to culturally and linguistically responsive doula care for any birthing or postpartum individual who desires these services. The program also hopes to develop a postpartum support dimension to this work, as approximately 50% of maternal deaths occur in the postpartum period. In collaboration with Denver Health we hope to learn what parts of the program are most effective so we can continue to modify and expand this to have greater reach and impact.

Finally, a unique facet of this program is the allocation of doula stipends. Doulas who participate in the program will receive a stipend for each shift, which covers the cost of transportation, childcare, and meals incurred to volunteers at Denver Health. This is unique because it allows for recruitment of doulas from diverse backgrounds, beyond those individuals who can provide these services voluntarily.

As we move into 2022, we are excited about the possibilities with this new partnership at Denver Health as we look to impact meaningful changes for mothers and their children.  Look for more about this project and our efforts to better understand the needs of our rural communities this Spring!

References:

[1] Petersen EE, Davis NL, Goodman D, et al. Racial/ethnic disparities in pregnancy-related deaths — United States, 2007–2016. MMWR Morb Mortal Wkly Rep. 2019;68:762–765.

[2] https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

[3] Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.CD003766.pub6

[4] https://www.commonwealthfund.org/publications/fund-reports/2021/nov/policies-reducing-maternal-morbidity-mortality-enhancing-equity