During its first decade of work, 2002-2012, hundreds of young women in Atlanta who would otherwise feel and be alone throughout their pregnancy had meaningful and loving support from four community-based Doulas: Hanifah Rios, Erika Ortiz, Ponchitta “Perez” Ridley and Maria Ordaz. Trained by HealthConnect One, Families First’s Doula Project helped hundreds of teens to access prenatal care, deliver full-term and healthy weight babies with no unnecessary medical interventions, and breastfeed their babies.
After DHHS ended funding for the community-based Doula program last year, we thought that we would have to totally close the program. Although we had secured a few small grants, we had not secured sufficient funds to run a full-fledged program. Also, Atlanta has not had a community-based Doula training since G-CAPP’s 2002 initiative.
Families First is committed to the model of community-based Doulas because it so closely aligns with our mission to “ensure the success of children in jeopardy by empowering families.” Because our work is based in the communities where women live, we are able to reach women early in their pregnancy and ensure healthy outcomes.
Fortunately, in September 2012, United Way of Greater Atlanta invited Families First to implement a full-fledged Doula program and training as part of United Way’s Babies Born Healthy Initiative. United Way is working to reduce the number of low birth weight and pre-term births, as well as reduce the disparity among African-American women by supporting evidence-based interventions. In November 2012, we organized to train and graduate a new class of twenty-four women as community-based Doulas, as well as to hire three full-time Doulas, Camisha Muhammad, Robyn Carson and KyJuana Perry.
One of Families First’s key strategic planning goals is to galvanize community in support of children. Thus, the opportunity to train women as doulas was especially exciting and fortuitous and enabled us to further leverage United Way’s investment by increasing the overall number of women whom we would be able to reach with doula services.
Of course when we learned of the grant, we first reached out to Jere McKinley, National Program Director for HealthConnect One. Jere helped us to stay true to the core values and strategies of the community-based Doula model, including training for trainers. We held planning meetings to confirm that each of our guest speakers understood the unique needs of our target population (i.e., low income African-American adult women); the women being trained (i.e., under and unemployed women of color); and the value of training and employing community health workers. Our trainers included leading maternal and child health stakeholders in metro Atlanta, including Emory University’s Urban Health Initiative, the Georgia OBGyn Society, Lumina Birth, Mother Nature’s Belly, Reaching Our Sisters Everywhere, Save 100 Babies, and the Center for Black Women’s Wellness.
As a result of United Way’s investment, as of May 2013 we now have a cadre of twenty-seven women prepared to affect community awareness about breastfeeding, prenatal care, birth, and avoiding unnecessary medical interventions during childbirth. Our three full-time Doulas will serve sixty women this year. Our twenty-four Doula training graduates have committed to serving three women each, for an additional seventy-two women this year.
Perhaps, most importantly, the training armed graduates with critical information about chronic conditions and social determinants of health that impact themselves, their families and their communities. Our graduates can speak informatively about nutrition to manage diabetes, reducing stress through relaxation techniques, improving interpersonal relationships by using listening skills, and how to encourage self-advocacy during healthcare visits. Thus, in addition to healthy babies and pregnancies, Families First is supporting healthy women and communities.
Families First holds three lenses through which we view success. From our administrative lens, our success is dependent upon our ability to secure funding to sustain program services including staff salaries and program materials. From our managerial lens our success is dependent on our ability to train, supervise and retain qualified staff. From our direct service lens, our success is dependent upon achieving our target outcomes, specifically healthy pregnancies, births, babies and families.
With regards to sustainability, we have a number of pending grants and are also hopeful that the Affordable Care Act (ObamaCare) will support community health workers and home visitation. We have a partnership with one of our state’s Care Management Organizations (CMOs) and hope to do the same with all of them.
Community-Based Doulas often support women whose conditions and situations are dire. They may be without family or friend support, survivors of abuse and/or violence, physically ill, developmentally challenged, homeless, etc. This emotional load, especially when healthcare and social service availability is limited, is overwhelming for the most seasoned social worker with decades of clinical training. With regards to staff development, we have committed to coordinating monthly meetings with our graduates and, of course, consistent, frequent and intense supervision with our Doulas so that they can talk through their feelings, brainstorm strategies and be reaffirmed in their work.
With regards to outcomes, Georgia’s rate of low birth-weight and pre-term births exceeds the United States average, which is in itself too high. Breastfeeding rates for some populations hover around 50% in spite of data that resoundingly supports the importance of mother’s milk. Our Doula program has had impressive success at exceeding national benchmarks on these health outcomes.
We at Families First are thrilled to be able to continue to do so.
Submitted by Dr. MiShawna Moore, Program Manager, Healthy Babies, Healthy Moms; and Teri L. Lewis, Former Director, Healthy Families and Relationships, Families First, Inc.
Teri L. Lewis is a longtime youth and family advocate whose health education career began as a Peace Corps Volunteer in West Africa. Since then, she has served as the Executive Director for the AIDS and Adolescents Network of New York, launched a community center in Fort Greene, Brooklyn, and trained hundreds of youth and community health workers.