A program that pairs expectant mothers with an advocate and support person called a doula has dramatically cut the rate of caesarean births among participating mothers and increased other positive outcomes, according to Indian River Healthy Start Coalition CEO Andrea Berry.
“When I joined Indian River Healthy Start Coalition six years ago as chief executive officer, I visited a 15-year-old mother who was sharing living room space with her newborn, her sister and her sister’s infant,” said Berry. “She had given birth at the hospital the night before, by herself, with no support person to help her.
“Fortunately, one of our health educators was called in for emotional support,” Berry added. “I couldn’t imagine being all alone during childbirth, and I wondered how often this happened. I contacted Megan McFall, director of Women’s Healthcare at Cleveland Clinic Indian River Hospital, and found out that in about 100 births a year, the mother had no support person. This was unacceptable.
“Megan and I collected data on these unsupported births and collaborated on how we could help these women and improve outcomes by addressing factors that contribute to fetal death, infant and maternal mortality and morbidity,” said Berry.
“We developed the G.R.O.W. (Guidance, Resource, Openhearted Wisdom) doula program, a partnership between Healthy Start Coalition and Cleveland Clinic Indian River Hospital. The program pairs a doula – a non-medical support person, different from a midwife – with an expectant mother for physical, emotional and educational support before, during and after the birth.”
The G.R.O.W. doula program supports, educates and empowers pregnant women to take control of their health. Nationally, doula care has been shown to reduce caesarean section rates, improve breastfeeding initiation rates and childbirth satisfaction rates. Studies have shown a decrease in babies born preterm and with low-birthweight, and a decrease in babies transferred to Neonatal Intensive Care Units (NICU).
“During the first three years of the program our participants had less than a 10 percent rate for caesarean births compared to the community rate of less than 30 percent,” Andrea said proudly.
“We believe that every woman should do with her birth whatever she wants and that every woman would benefit from having a doula to act as her advocate.”
Dr. Dana Teagarden, director of the Obstetrics Hospitalist program at Cleveland Clinic Indian River Hospital, agrees. She, too, would like to see every woman have their own doula, even if they have the support of family and friends.
“A doula gives the patient an impartial third party that has the full responsibility of being their voice and support, eliminating family politics or dynamics,” Dr. Teagarden said. “The expectant mother has someone outside their usual support group who gets to know them and understand their desires. That doula can guide all of us when there may be situation that the patient feels inhibited to say what she wants or is in so much pain she can’t communicate.
“Our experience with doulas in the delivery room has been invaluable,” Dr. Teagarden continued.
“Doulas come from the mother’s own community, they are highly trained and they are there before, during and after the delivery. I have seen friendships evolve between the doula and the mother that go well beyond the birth of the child.”
Indian River County Healthy Start Coalition has trained about 80 doulas in the course of the past six years and assisted about 550 mothers in the birthing process.
“We recruit doulas based on community needs, interview, vet and train them,” explained Berry.
“We pay for the training, fingerprinting, insurance and set them up in business so that they can work for our program or anywhere else. Our doulas are a diverse group and anyone who wants to help with the journey into motherhood is welcome to apply.
“Doula programs have failed in other hospitals because the providers didn’t understand what they do. The providers at Cleveland Clinic Indian River Hospital love our program because we do the work, we show them the outcome and now the doctors, nurses and doulas work together as a team.”
Cleveland Clinic Indian River Hospital has a unique OB/GYN hospitalist program where all of the babies delivered in Indian River County are delivered by one of the OB/GYN hospitalists on staff.
“We take of anything relating to OB/GYN that walks through the door,” explained Dr. Teagarden.
“It could be a vaginal delivery, a scheduled or unscheduled C-section, someone who needs consultation or surgery, or someone who had been admitted to the hospital floor that has a gynecological issue come up.
“It provides an extra layer of safety for the patient and the hospital. Gone are the days when the OB/GYN who saw the patient during her prenatal care is called in for the delivery but is not there for the many hours of labor preceding it. Now they care for the patient in their office but once the patient is admitted to the hospital our staff of three full-time OB/GYN physicians and four midwifes will be with them all the way through the labor and delivery. There is a physician and midwife here every day, 24/7.”
The hospital holds meet-and-greet events on the fourth Saturday of every month for expectant mothers to become familiar with the hospitalist program and meet the doctors and midwives.
“This gives us the opportunity to explain the concept and what the benefits are to having us here at all times. We will also ask if they are interested in having their own doula,” said Dr. Teagarden.
The partnership between Cleveland Clinic Indian River Hospital and Indian River County Healthy Start Coalition provides a benchmark for expanding the G.R.O.W. doula program into other parts of the state. The hospital put together a video explaining how important the doula program is to its whole culture of childbirth. This helps to document how effective the program is and educates other hospitals on how to integrate it into their curriculum. Since its inception, Indian River County Healthy Start Coalition has implemented 13 doula programs throughout the state of Florida.
For more information on how to become a doula or how to obtain a doula, contact Andrea Berry at Indian River County Healthy Start Coalition at 772-563-9118. For information about Cleveland Clinic Indian River Hospital’s Obstetrics tours, call 772-567-4311 ext. 6759.