Traditional Health Worker Doulas
Martha Rivera
The Traditional Health Worker (THW) Doula path came into effect in 2013 after Oregon House Bill 3311 was passed.
The intent behind this bill: “Oregon Health Authority (OHA) shall explore options for providing or utilizing doulas in the state medical assistance program to improve birth outcomes for women [families] who face a disproportionately greater risk of poor birth outcomes.” THW Doulas are meant to reflect the priority communities that we are to serve such as:
Black, Indigenous, Latines, people of color
Families that English is not their primary language
LGBTQI+
Pregnant Teens
Families experiencing houselessness (homeless)
Families experiencing Substance Use Disorder
Of course, not all families fall into these priority communities and there are other social determinants that can impact pregnancy outcomes. The THW Doula workforce does reflect a wider range of communities, though the majority are higher- economic-cis-white doulas [2018 Oregon Doula Workforce; 2022 Listening to Doulas II]
This pathway enabled doulas to become THW Doulas as a first step into becoming eligible for Medicaid or Oregon Health Plan (OHP) reimbursement for services. Truthfully, there have been challenges throughout the years in becoming a Traditional Health Worker Doula, primarily, the process can be tedious and the reimbursements have been really low, $350.00 for 2 prenatal visits, labor support, and 2 postpartum visits (this rate is to be increased to $1500 sometime in 2023). Some Coordinated Care Organizations (CCOs) have really made THW Doulas a priority and been instrumental in providing better reimbursement rates for THW Doulas.
For Doulas and Company (Rogue Valley Doulas), the THW Doula model has been important to us because it has allowed us to integrate into various systems that provide care to our (mutual) clients. We’ve been able to sit in various committees and meetings locally, at the state level, and even nationally to advocate for better care for families.
As some of the first THW Doulas in the Rogue Valley that have paved the way, we've supported over a dozen doulas in our community to become eligible for the THW designation and continue to by welcoming them into our practice to meet the birth requirements and guiding them step-by-step on filling out the multiple applications and explaining the various processes to be fully set up as Medicaid Providers.
Our team understands the reasons why this program exists and makes continuous efforts to stay updated on Standards, Best Practices, and local hospital/birth center Protocols. We are committed to working collaboratively to serve our community. We share a common goal, respect each other’s expertise, and hold each other accountable to ensure we meet our ethical and professional standards.
Are you someone that would like to become a THW Doula? We highly recommend taking a training through Doula Training Center.
Are you a Doula already, but would like to take the next step into becoming a THW Doula? Let’s chat!
Already a THW Doula and would like to join our Collaborative Practice? Let’s Connect!
