Community-Based Doulas Achieve Dramatic Breastfeeding Outcomes in Underserved Communities

The HealthConnect One Community-Based Doula (CBD) Program is a nationally recognized model that provides support to families throughout pregnancy, labor and birth, and in the early months of parenting. To date, more than 6,000 low-income families have benefitted from services provided by HC One-trained doulas, through community-based doula replication programs nationwide. To further understand the potential integration of this model into current healthcare practices and identify the impact this CBD has on breastfeeding duration, HealthConnect One was asked to convene a panel of unbiased expert (Expert Panel) to provide recommendations to federal partners regarding the evaluation, implementation and integration of this CBD program. An independent evaluation of the CBD program outcomes was evaluated using data collected from eight nationally distributed CBD programs for the years 2008-2012. An unadjusted comparison between participants tracked through an online program evaluation tool (n=542) and a sample of participants in PRAMS (Pregnancy Risk Assessment Monitoring System) from 2008-2010 was conducted. Significantly higher breastfeeding duration and exclusivity rates at 6 weeks, 3 months and 6 months was found for CBD program participants.  Breastfeeding duration and exclusivity rates among both Black and Hispanic mothers in CBD programs were significantly higher than PRAMS benchmarks. Both the number and the timing of prenatal and postpartum visits (early and frequent) and the doulas’ attendance at birth were associated with increased breastfeeding rates. This analysis provides empirical evidence of the impact of CBD program on breastfeeding duration and exclusivity. Final recommendations from the Panel are expected in Fall 2014.