Traditional Health Worker Doulas

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!

Oregon Weather & Childbirth

There are many jokes about the amazing Oregon weather.

“Oregon: where you get all four seasons in one day”

“You know you’re from Oregon when you don’t use an umbrella when it’s pouring rain”.

All though funny, it is absolutely true.

Just a few weeks ago, we had sunny days and it felt like spring was only coming faster, and then we get hit with a snowstorm, only to get sunny blue skies the next day!

So how is Oregon weather and childbirth the same and how can a doula support you through the seasons?

Well, if we substitute seasons for feelings, we are bound to get all the feelings in labor, and just like our weather doesn’t seem to come in a particular order, neither do these feelings.

Summer – The sun is shining, everyone is happy, and you’re looking forward to the many outdoor activities that our beautiful southern Oregon offers. You may want to go to Lake of the Woods, or Umpqua Falls, or go raft down the Rogue River. Your car may be loaded with bags with essential items for that awesome trip you’ve planned all year long. 

Early labor – You have lost your mucus plug, or perhaps your water broke. It could be that contractions have begun.  You’re excited and looking forward to all the adventures that are yet to come. You may decide to take a shower or a bath to refresh and relax, or you may start packing up your car with the bags you plan to bring with you to the hospital or birth center. Your long awaited birthing trip has begun and an overwhelming feeling of happiness begins to shine ever-so-brightly, like the sun on a hot summer day. Call your doula so she gets ready for the ride with you. 

Spring – What’s the forecast going to be like? Warm? Cold? Will it be sunny or rainy? Should you layer up?

Labor – You'll find that your body temperature fluctuates in labor. You may feel hot and sweating one moment and the next you're asking for a warm blanket. Your comfort is one of our priorities! We'll be ready to fan the air, apply cold washcloths, and give your ice-cold water to sip on or get blankets to keep you warm. 

Fall – The temperature is cooling down and the leaves are transitioning colors. This season often feels like a mix of summer and winter. You may be excited, because... Hello! Boots, leggings and pumpkin-spice-everything! Or you may feel gloomy as the days become a little darker.

Labor – There comes a point in your labor when you will also be transitioning as those leaves. This part of labor is often the shortest, yet hardest part to endure. Your doula can offer you information about what to expect, continue to offer you comfort and support, and ensure you’re well hydrated… most likely not with pumpkin-spice lattes though.

Winter – The days are gloomy and cold. You rather not be out and about. You prefer to stay warm in bed. You may actually enjoy winter because you can go skiing or snowboarding at Mt. Ashland. You are cautious as you walk on the icy pavement, holding on to cars or siding for support. You know that enduring this type of weather means you’re getting closer to those sunny days again.

Labor – As you’ve reached the transition phase, you may experience feelings of defeat. You are "done", and don’t want to continue laboring, but you know that this temporary feeling will get you closer to meeting your baby. Your doula will support you through this phase by encouraging you, reminding you that the end is almost near, and taking one contraction at a time. Provide you with physical support like massage and counter-pressure on your hips or sacrum as wanted.

Oregon weather – All four seasons in a day, but we wouldn’t have it any other way. We don’t mind having to layer up, walk in the rain, or drive in the snow, because, at the end of the day, we live in a beautiful place surrounded by tall trees, hills and mountains.

Labor – Just like the Oregon weather, going through the stages of labor has a beautiful advantage. A new journey begins with your baby to enjoy all the adventures that our state has to offer.

And as your doula… we will walk by you through the seasons enhancing your pregnancy and labor experience by providing you with compassionate and non-judgmental support.

 

A New Birth in the Rogue Valley!

It’s happening! I’m going to make it happen, I am making it happen! That’s right, I am opening the first Doula Agency in the Rogue Valley!

Earlier this year, I decided it was time to jump back into my life-long dream of being a doula. I had taken a couple years off after realizing that this type of career is a huge investment of not only time and money, but energy, physical, and emotional health, and at the time, I was investing more than what I could justify, especially since I was pregnant and planning my wedding. 

When I made the announcement of my return and the "birth" of Bella Vida Doula Services, I was welcomed back with warm arms. I've served a couple of clients which gave me the opportunity to advance my training with a new doula training organization.
In the short few months of Making the Switch, I have learned an immense amount of new skills to better support my clients and how to support myself in this career; how to make smart investments and build a sustainable business, so that I may continue my life-long dream without the easy burnout as I had experience earlier in my doula career. 

Rogue Valley Doulas: A premier doula agency supporting families during pregnancy, childbirth, and their parenting journey.

Due to the amount of support, encouragement, and education that my current training organization offers, I learned more about the different ways that doulas practice. I began looking at what was available in the Rogue Valley, and it was evident that a doula agency needed to be created. The role of doulas has evolved over time, and in most recent years, people are beginning to take this career serious and are dedicated to elevate the profession. 

In the Rogue Valley there are a variety of practicing doulas. Some give their valuable time at a local hospital or for local families. Others are paid staff at the hospital or work closely with midwives (their role may be more of a birth assistant than a doula, and the scope of practice is completely different than that of a doula). There’s private doulas who work independently or partner with another doula to offer back-up support.  Due to the nature of this work and the investments required, many doulas discontinue this career after a few years, because of the high demands and the lack of proper compensation.

Doula Agency Benefits: There are many benefits to not only the clients, but also the doulas, and medical providers/staff.

Clients: Easier to find and connect with doulas. Doulas work in teams, so the client can rest assure that one of the doula duos will be available to listen, support and encourage. Both will attend the prenatal visits to get acquainted, learn the birthing preferences, discuss comfort measures and any fears that may come with the journey at hand. During labor, one doula will be present (primary doula). In the event that the birth goes longer the primary doula can tag-team with the secondary doula so that the client is still receiving continuous support by a familiar doula.

Doulas: Many doulas in bigger cities love working for an agency, because they get to do what they love without worrying about the logistics and investments of owning a business (marketing, contracts, billing, lawyer fees, etc.), although some doulas still work independently aside from working for an agency. Doulas works in teams, have reliable back-up and more flexibility with their schedules.

Medical Providers/staff: Some concerns that medical providers and staff may have regarding doulas are that doulas work out of scope, or are there with an agenda (avoid all interventions, pain medication, etc.) Doulas working for an agency have greater accountability, if for any reason the doulas working for the agency are out of line, the medical provider or staff have a place to voice their concerns and or feedback. 

My goals are to build a sustainable business for myself and the doulas working for the agency, raise the standards of doula care in the community and pave the way for aspiring doulas.

Have you thought about becoming a doula? Want to know more? Let's chat! 

Martha Rivera, pre-CD Labor