DOULAS ENHANCE THE BIRTHING EXPERIENCE Brookings Health System | Brookings, SD MATERNAL HEALTH CASE STUDY Overview Doulas who are not already licensed must attend training workshops, hosted by Brookings Health, that Brookings Health System serves nearly two dozen cover fundamentals such as background screening, communities in eastern South Dakota. The rural health immunization records and HIPAA requirements. New system includes the 49-bed Brookings Hospital; a 79-bed doulas also are mentored by more experienced doulas. skilled nursing home, congregate living apartments for seniors, and several specialized clinics. Impact Brookings Health System is a non-profit, city-owned The doula program received high levels of patient health system that offers the community a full range of satisfaction according to a survey by South Dakota State inpatient, outpatient, surgery, home health, and extended University. Expectant mothers stated they received added care services. emotional support and closeness from their partners, who were often much more engaged when they had a clearer In 2011, in response to community interest, Brookings understanding of how they could assist in the birthing Health System established South Dakota's first free process. doula program, staffed by volunteers. Doulas are women who provide continuous labor support during childbirth, Doulas also gave the program high marks for providing working with mothers and their partners to provide professional benefits, such as improved clinical skills, as emotional and physical assistance and using relaxation well as the opportunity to build their own practices with techniques to help with positioning and massage. One private clients. year later, Brookings added a free, volunteer postpartum doula program, becoming the first health system in the In addition, full-time staff at Brookings Health also were nation to do so. highly supportive of the doula program. They consider the birthing assistants to be team players, who are respectful of hospital policies and norms. In short, the doulas have truly become a part of the Brookings Health team. Doula program administrators note it has had little impact on Brooking Health's already low C-section rate, which continues to hover in the 12% range. According to the Centers for Disease Control and Prevention, the national C-section rate is close to 32%. Lessons Learned The first nine years of experience with the doula program has imparted several lessons for Brookings Health System: • Some form of data collection should accompany the launch of any new program. It helps to measure ©2020 American Hospital Association | November 2020 Page 1 | www.aha.org Future Goals Because many of its patients cannot afford a doula, Brookings Health System's main goal is to find innovative ways to keep the service available to patients cost-free. This requires continued focus on supporting doulas and keeping them involved with their desire to help women. "We created testimonial videos with moms who have used doulas to educate the community about the service as well as to reaffirm to the doulas that we value them," said Julia Yoder, director of marketing and public relations how the program is working and where it can be at Brookings Health System. improved. While Brookings will not waver from its commitment • Retaining doulas has been a challenge; the health to provide volunteer doulas for mothers and their system often recruited nursing students from partners who want the service, it also intends to offer the local university. However, by focusing on recommendations from its pool of volunteers to women "motivators," such as the desire to help other who can afford to hire private doula services. This women and providing opportunities for personal and approach also allows doulas to build their clientele beyond professional development, administrators found that their volunteer efforts. older doula volunteers were often more committed and consistent in carrying out their duties. Contact • Introducing doula services during prenatal classes helped to get the word out, build the program, and Mary Schwaegerl, RN helped doulas feel that they were meeting their goal Obstetrics Director of serving the community. (605) 696-8053 mschwaegerl@brookingshealth.org • By charging for doula training workshops (which were initially offered for free), Brookings Health Julia Yoder, MBA found that the personal financial investment Marketing & Public Relations Director prompted volunteers to take their commitment more (605) 696-8028 seriously, and that it raised the overall quality of the jyoder@brookingshealth.org doulas that were recruited and retained. ©2020 American Hospital Association | November 2020 Page 2 | www.aha.org