Maternity Care

• Midwives are health care practitioners who provide the person giving birth with the necessary medical support, care and advice during pregnancy, labor and the postpartum period. Doulas are trained to provide evidence-based information, emotional and physical non-medical support before, during, and after labor.
• Both a midwife and a doula can be used on your birth team.

• A community-based doula is a trained labor support person who comes from the same culture and background as the person giving birth. As trusted community members, community-based doulas can perform home visits, help connect persons giving birth to local social services, and provide a holistic approach focusing on prenatal and postnatal health.
• Community-based doulas of color can help a person giving birth navigate structural racism in healthcare.

• Improved maternal and infant health
  • In studies, Doulas have been associated with: more spontaneous vaginal births, higher satisfaction with the birth experience, increased breastfeeding initiation, and shorter labor.
  • Doulas have also been shown to lessen the chance of low birth weight and infant/maternal mortality.
  • On average, people who use doula services have fewer c-sections and require less use of pain medication during delivery.
• Increased satisfaction and engagement with maternity care
• Decrease in health disparities and lesser effect of stressors (from racial discrimination, food insecurity, poverty, etc.) on the birth process
• Decreased healthcare spending (because Doulas can reduce the number of c-sections, repeat c-sections, epidurals, birth complications, and chronic conditions, they can decrease the cost of maternity care for both private insurance and Medicaid)

• Clients in this program will receive services free of charge.
• Doulas will be paid by a grant received by the Richmond and Henrico Health Departments.

• The US has one of the highest rates of maternal death compared to other developed countries.
• Black persons giving birth in the US have maternal death rates more than double that of white persons giving birth, regardless of socioeconomic status.
• Black, immigrant, low-income, under-insured/uninsured, and Medicaid-recipient people giving birth are at the highest risk for poor birth outcomes and face the most barriers to getting doula care.

• People who identify as black/African American/Afro-Latinx, live in Henrico County,  plan to give birth in the Greater Richmond Area, and are low-income (qualify for WIC).

• Doulas can provide physical and emotional support to all different types of births, and are there to help the person giving birth and support their birth plan.

• Doulas do not take the place of a supportive partner. Rather, they are there during the delivery to support both the person giving birth and their partner/family, as well as before and after birth.

• This program allows for virtual doula visits if necessary due to Covid-19 precautions.

• Doulas will have up to 8 prenatal/postpartum visits with each client.

• Home visiting programs provide education and guidance to families and their children to help promote healthy parent-child attachment starting from pregnancy throughout a child’s early years. Community-based doulas are focused on providing information, advocacy, and support for the birthing person before, during, and just shortly after birth. Both home-visiting and doulas can work together to help the person giving birth have the best possible outcome.

Greater Richmond Regional Maternal Child Health Collective Impact Taskforce

Mission

Improve maternal and infant health outcomes and eliminate disparities through collaborative action as members of the Greater Richmond Regional Maternal Child Health Taskforce.

History

In summer 2019, the Richmond City Health Department, with mayoral support, convened a group of community members, nonprofit organizations, legislative representatives, and health and social service providers in the City of Richmond to address racial disparities in maternal health outcomes. In response to this request, these individuals and entities organized to form a collective impact group, the Greater Richmond Regional Maternal Child Health Taskforce, which has been meeting since June 2019.

What is Collective Impact?

Collective impact is a way for many collaborators and stakeholders to work together efficiently and effectively to address complex problems, bring people together, and achieve social change.

A collective impact task force is made of participants who have shared goals and a commitment to achieving positive change. Participants track progress with shared measures, build trust with continuous communication, and engage in mutually reinforcing activities to support and learn from each other, while also maximizing their end result. Finally, a collect impact taskforce benefits from “backbone support” which can be a single organization or many actors that provide administrative and financial support to ensure the initiative stays focused and moves forward.

Steering Committee Members

Amy Popovich, RN MSN
Nurse Manager
Virginia Department of Health
Richmond and Henrico Health Districts

Emily Schreer
Public Health Associate, Maternal Child Health
Virginia Department of Health
Richmond City Health District

Kenda Sutton-EL, CLC, Student Midwife, Certified Full Spectrum Doula
Executive Director & Co-Founder
Birth in Color RVA

LaWanda Dunn BSN, RN/PHN
Supervisor
Virginia Department of Health
Richmond City Health District

Leslie Lytle
Founder & Executive Director
Nurture RVA

Nikiya Ellis
Cofounder, Co-Director & Certified Full Spectrum Doula
Birth in Color RVA

Osita Iroegbu
Senior Policy Advisor
Community Engagement, Inclusion and Equity
Office of Mayor Levar M. Stoney

Phyllis Bradley, MSW, MA, ECD, EDS, QMHP-A, QMRP-C
Director, Early Childhood Development
Urban Baby Beginnings

Whitney E. Tidwell, MPH, BSN, RN
Public Health Nurse, Maternal Child Health
Virginia Department of Health
Richmond City Health District

Work Group Goals and Leads

Doula Workgroup

• Goal: To establish training and certification guidelines for doulas; determine the minimum qualifications/core competencies; set doula fund eligibility requirements.
• Leads: Phyllis Bradley and Nikiya Ellis

Family Planning Workgroup

• Goal: To increase access to family planning services; Increase the number of women enrolled in Medicaid; Promote whole woman wellness models and cultural humility training for providers.

Integrated Care Workgroup:

• Goal: Create an integrated care model considering potential costs, positions needed, and resources needed (funding sources, policy changes); create an online platform for resources and information to support access to care and information about family planning options.
• Leads: Leslie Lytle and Kenda Sutton-EL