By Joan Tupponce: VCU Health

Between 2018 and 2020, nearly three times more parents died during or after childbirth than in 1982. And yet, nearly two-thirds of maternal deaths are preventable, according to the Centers for Disease Control and Prevention.

A new doula partnership at VCU Health aims to reverse these trends.

Doulas can reduce risk of adverse maternal health outcomes

Working with a doula, a certified professional trained to provide non-medical pregnancy-related support, can curb complications from birth.

Evidence shows that doula support contributes to lower rates of preterm and cesarean birth, and postpartum complications. In addition, doulas promote the overall health of the patient and baby through their work.

For many years, doula services were out of reach for many families because of the cost, which is usually not covered by insurance.

But in October 2021 the Department of Medical Assistance Services (DMAS) announced that Virginia would offer state-certified community doula services as a benefit for Medicaid members. Until this point, pregnancy-related Medicaid coverage usually expired 8 weeks after delivery, but now coverage has been expanded to a full year postpartum.

Virginia is the fourth state in the nation to offer these services, which cover four prenatal visits, birth and four postnatal visits. For eligible Medicaid members, these services are now free.

VCU Health increases access to doulas

In an effort to increase access to doulas, VCU Health has partnered with Urban Baby Beginnings, a non-profit providing community-based support services for pregnant and parenting families, to bring community doulas to the VCU Medical campus in downtown Richmond.

“Doulas are currently on-site as a resource for providers and patients and are truly meeting patients where they are by discussing unique patient challenges and necessities,” said Jordan Hylton, DO, interim medical director of Women’s Health Outpatient Clinics.

Representatives from Urban Baby Beginnings are in the clinical setting to meet with potential clients and work with them to decrease any barriers of care as well as provide education and support.

“Partnering community-based systems with clinical care services allows both systems to focus on areas that are really critical to healthy outcomes for moms and babies,” said Stephanie Spencer, founder and executive director of Urban Baby Beginnings. “For us, it’s providing the home-based social support and care that is often not available in clinical systems. Now, both systems, in collaboration, can continue to excel in the areas in which they specialize.”

And patients benefit. “They have helped me a lot during my pregnancy journey. Really, I am very happy because they are always there to help,” one mom told VCU Health.

VCU Health has worked with multiple doula programs in the past 20 years. The current collaboration with Urban Baby Beginnings is not only making the process easier for patients to get established with the resources that they desire, but also makes them aware of what exists outside of the medical care our providers are giving.

Doulas are valued members of the VCU Health care team

VCU Health has always valued certified doulas as part of a patient’s care team. “We recognize the important role doulas play in a successful pregnancy, birth and after birth experience for patients,” said Hylton. “As such, we were one of the few area hospitals that allowed doulas in the birthing room throughout COVID-19 visitor restrictions.”

At VCU Health, a doula generally accompanies the patient through labor and delivery. After being cleared and designated as a doula, they can “begin to provide the amazing, continuous birth support that they offer,” added Holly DeBernard, Nurse Manager of Labor and Delivery at VCU Health.

Doulas at VCU Health also have access to a new respite room located on the Labor and Delivery Unit floor. This is the only doula respite room in a Richmond hospital. 

“The doula respite room is an area for the doula to take a moment to rest and recharge, so they can provide the very best care to each of our patients,” DeBernard said.

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