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!

Becoming a Doula

Are you ready to start your career as a doula, but don't know where to start?
I'd love to support you on your path to becoming a professional doula! 

If you do a simple google search or ask in a doula forum, for doula trainings, you will come across a myriad of training organizations. Each holding different philosophies, certification processes, and fees.

Things to consider when looking for a training organization

Standardized Training:

Despite there being some highly recognized trainings, there are only a few that offer standardized training; meaning that all the trainers have gone through the same process to train other doulas ensuring that all the doulas trained through that organization have received the same materials and information. 

Training supports all types of births and parenting styles

Certain training organizations only speak and train in supporting the "natural" "unmedicated" "sacred" ways of birth and brush over other realistic births, such as providing support when the birthing person chooses an epidural or requires a cesarean. Likewise in a postpartum training, it may only be geared to supporting the "attachment parenting" style and only cover breastfeeding, and or "traditional parenting" styles. Your training should equip you to provide support to every family's unique dynamics and needs. 

Training covers infant feeding methods

Just like birth may look differently, so can a way a baby eats. While some families may begin breastfeeding, others may have opted to formula feed their baby since birth. It's important to know how to support families in their infant feeding choices, without bias. 

Business support

After your doula training, you should have an understanding of how to get started as a professional doula. The doula training should cover even briefly marketing, contracts, what to do in certain scenarios and how to go out and begin your doula journey. 

Certification Process

Are you required to read 3-5 books or more? Write papers on certain topics? Shadow other births? How many births are required to attend and do only certain births count? Is there a requirement as to by when you should arrive? What about reviews from clients? Do you need them from nurses and providers too? Most training organizations require three births for certification, and some have limits such as arriving at a certain dilation, or only counting vaginal deliveries and one cesarean even if the clients you're supporting have a cesarean. Some organizations require reviews from clients, nurses, and providers, although it is the client who you are providing services for. 

Fees

Attending a training is going to cost you anywhere from $400-$900, this includes books you may need for the training. On top of this some training organizations have a fee for purchasing the certification packet and a fee for processing it as well. There is a also a membership cost for some organizations. This is an investment in your doula career, but make sure your fees get you something in return such as: 

Office Support

Find a training that has office support. Seriously. You never know when you're going to need a little pep talk, or need clarification or have a situation come up that you need additional support in. Your training organization should be available, supportive, and value you as a member of their organization, especially if you are paying a membership fee and are working towards certification or are already certified. 

After your training, you should feel confident and ready to start your business and provide services to families. 

Who I recommend: 

Just like when a  birthing person asks  me for recommendations when it comes to providers, birthing facilities, comfort measures, etc. as their doula, I don't tell my clients who to go to or what to do, but present them with all their options and let them be the deciding factor in their journey. Similarly, as a professional doula, when aspiring doulas contact me, I present them with questions for them to think about and make that decision on who they want to train with. The only recommendation I make is that it's an in-person training, as I strongly believe there is a lot of value in learning the comfort measures hands-on. It makes a difference and you'll be more confident in applying them in the birth setting or in the family's home. 

Call or email me, I am always happy to chat and help you weigh out your options. Like us on Facebook to stay up-to-date on our events as we host a "Let's Talk Doulas!" talk every few months to discuss these points.  

If I were April, the giraffe's, Doula...

You have probably come across the live-feed of April, the giraffe from Animal Adventure Park in Harpursville, NY. There has been over 600K views on this video, some viewers watching for hours at a time, and others a few minutes or just scrolling right by it.

There's been some talk about April in some doula community boards about what and how this giraffe should be supported. You may even be able to spot some doulas by their comments on the video's posts'. Well, here is a glimpse of how I would support April, if I was here doula: 

I would have already known her birthing preferences through our prenatal visits.

I would know if she wanted physical support, like counter pressure or massage with the understanding that this preference may change throughout her labor.

I would know whether she wanted her family, friends, and strangers present during the entire time, just labor, or just the birth and what her vision of their role would be (yes, all 600K+ viewers).

I’d encourage her to rest.

We’d dim the lights and play some relaxing music, if that’s what she preferred.

I would make sure she had plenty of fluids to keep her hydrated.

I’d walk around with her in her stall as many times as she wanted.  

I’d ask her how she felt with everyone present at her birth, and if she needed some alone time.

I would encourage her to rest, yet again, if she’s able to.

We’d play a game of checkers, or tic-tac-toe to distract from early labor.

Or we’d watch a funny movie, like Bad Moms.

I would be a sounding board for her to express her thoughts, feelings, and concerns as she’s waiting for the birth of her calf.

We’d go over birth affirmations, if that helped her.

If I were April’s doula, I’d support her through her labor just the way she needed me to.  

Why? Because at Rogue Valley Doulas we offer this type of quality support.  

If this is the kind of support you're wanting for your upcoming or next birth, contact us! We'd love to chat with you.