AFRICAN AMERICAN INFANT AND MATERNAL MORTALITY (AAIMM) PREVENTION INITIATIVE DOULA PILOT PROJECT WEBINAR – FEBRUARY 4, 2020 NAKEISHA ROBINSON, MA, LMFT
Initiative and Project Overviews Doulas and Services Provided DPH Support TODAY’S PRESENTATION Training Opportunities Client Eligibility & How to Make Referrals Q&A Who to contact
WHY ARE WE HERE? INFANT MORTALITY
WHY ARE WE HERE? MATERNAL MORTALITY
WHY ARE WE HERE? PRETERM BIRTHS Figure & Table 15. Percent Preterm Births (17-36 weeks) by Mothers' Race, 3-Year Averages, Los Angeles County 2003-2017 % Preterm % Preterm % Preterm % Preterm % Preterm 2003 – 2005 2006 – 2008 2009 – 2011 2012 – 2014 2015-2017 (95% CI) (95% CI) (95% CI) (95% CI) (95% CI) 9.8 9.9 8.6 7.9 7.9 White (9.6 – 10.0) (9.7 – 10.1) (8.4 – 8.8) (7.7 – 8.1) (7.7 – 8.0) 10.8 10.5 8.4 8.6 9.2 Hispanic (10.7 – 10.9) (10.4 – 10.7) (8.3 – 8.5) (8.5 – 8.7) (9.0 – 9.3) 15.0 15.1 12.6 12.1 12.2 African American (14.6 – 15.4) (14.7 – 15.4) (12.2 – 12.9) (11.7 – 12.5) (11.8 – 12.6) 9.7 9.4 8.1 7.2 7.6 Asian (9.4 – 9.9) (9.1 – 9.6) (7.9 – 8.3) (7.0 – 7.4) (7.3 – 7.8) 10.8 10.7 8.8 8.6 8.9 Los Angeles County (10.7 – 10.9) (10.6 – 10.8) (8.7 – 8.8) (8.5 – 8.6) (8.8 – 9.0) Notes: Preterm births are defined as births occurring from 17-36 weeks gestation. Gestational age calculated based on first date of last menstrual period for 2002-2007 and based on obstetrical estimation for 2008-2016. Data not shown for Native American, Pacific Islander, Other and Unknown races. Three-year averages used to account for random annual rate fluctuations. Data Source: 2003-2017 California Department of Public Health, Birth Statistical Master File
PILOT PROJECT OVERVIEW Whole Person Doula Pilot Project Project timeline Care funding goals/outcomes
WHAT IS A DOULA A birth doula is a companion who supports a birthing person during labor and birth. Birth doulas are trained to provide continuous, one-on-one care, as well as information, physical support, and emotional support to birthing persons and their partners. Doulas are not medical professionals. They do not: Change shifts (although Pressure the birthing Perform clinical tasks such Make decisions for the Take over the role of the some doulas may call in Give medical advice or person into certain as vaginal exams or fetal client (medical or partner, support person, Catch the baby their back-up after several, diagnose conditions choices just because that’s heart monitoring otherwise) or family member several hours of what they prefer continuous labor)
WHY DOULAS Evidence shows that continuous support Access to continuous labor support can decrease the risk of Cesarean, the from a doula is especially vital for use of medications for pain relief. Labor birthing people of color. Black women support also increases breastfeeding experience higher rates of poor birth initiation/retention rates; satisfaction outcomes, including higher rates of with the birth experience; and the Cesarean, preterm birth, low birth chance of a spontaneous vaginal birth. weight, and infant death (Thomas et al., Continuous support may also shorten 2017). labor and decrease the use of Pitocin.
AAIMM DOULAS Currently have a cohort of 12 Doulas reside all over Experienced = 6+ experienced the county (SPAs 1, 2, births Black/African 3, 6, 8) American doulas
OUR AAIMM DOULAS Jordan Smith Bethany Benson Keisha Smith-Spears Felicia Francis-Edwards Carla Clark Maryam Abdul Karim Monique Cowan Mercedez Johnson Latrice Matthews T onya Michelle Syreeta Staples Tamara Robertson
DOULA SUPPORT PROVIDED Available to clients Continuous labor and Prenatal visits (3) Postpartum visits (3) througout pregnancy delivery support Preparing for birth Questions; Information On-Call 24/7 Infant feeding/breastfeeding Signs of labor Provide support outside of Golden hour Infant daily care & safety scheduled visits Navigating the medical Bonding activities system/staff Connecting to local Infant feeding resources/peer support Maternal mental health (screening, referral
DPH SUPPORT TO DOULAS Stipends Doula kits Print materials Client incentives Media campaign Peer-mentor Training support and opportunities technical assistance
TRAINING Lactation Educator Trauma-informed CPR/AED/First Aid Other/Additional New Doula (2020) Specialist (45 hours) Care (9 hours) (newborn care, full spectrum doula, business T echnical Assistance) Spring and Fall 2020 (60 Spring and Fall 2020 (80 Spring and Fall/Winter (80 participants) participants) participants)
CLIENT ELIGIBILITY ➢ Clients must self-identify as Black/African American and be pregnant. ➢ We are accepting clients from: ➢ SPAs 1, 3, 6, & 8. Medi-Cal eligible clients are priority, but clients with other insurance is accepted. ➢ SPAs 2 and 4, Medi-Cal eligible only. ➢ There is no gestational requirement. *There will be incentives for participating clients*
HOW TO REFER CLIENTS Self-referrals are accepted Doula, agency, clinic, hospital, and T o make a referral please contact organization referrals accepted program staff: Michelle Sanders at: msanders@ph.lacounty.gov or Ariana White at: awhite@ph.lacounty.gov or by phone at: (213) 639-6448 Client name, phone number, zip code, and estimated due date (EDD)
➢ EVIDENCEBASEDBIRTH.COM ➢ A PATHWAY TO EQUITY: THE 5-YEAR PLAN TO CLOSE THE BLACK-WHITE GAP IN INFANT MORTALITY, CENTER FOR HEALTH EQUITY, LA QUESTIONS/FEEDBACK COUNTY DEPARTMENT OF PUBLIC HEALTH: HTTP://PUBLICHEALTH.LACOUNTY.GOV/CENTER FORHEALTHEQUITY/PDF/AAIM-ACTIONPLAN.PDF
GET INVOLVED! Contact us to join the AAIMM Doula Advisory Committee Nakeisha Robinson, MA, LMFT Michelle L. Sanders Doula Clinical Consultant Program Coordinator (213) 639-6468 (213) 637-8466 Nperkins-robinson@ph.lacounty.gov msanders@ph.lacounty.gov Helen O'Connor, MSPH, MA, LES (213) 639-6442 Hoconnor@ph.lacounty.gov www.blackinfantsandfamilies.org
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