Volunteer Doula Volunteer Doula Programme: Programme:

A Canadian PerspectiveA Canadian Perspective

Shauna PowersShauna PowersNHS Lothian Health Promotion ServiceNHS Lothian Health Promotion Service

Halifax, Nova ScotiaHalifax, Nova Scotia

Halifax: StatsHalifax: Stats Population (2008): approximately Population (2008): approximately

400,000400,000 Industry: Shipping, defence, educationIndustry: Shipping, defence, education Located on the Atlantic OceanLocated on the Atlantic Ocean Largely White population (92.5%), Largely White population (92.5%),

Black (3.9%), Asian (2.4%) and Arab Black (3.9%), Asian (2.4%) and Arab (1.4%) (2006)(1.4%) (2006)

Maternity Care in Nova Maternity Care in Nova ScotiaScotia

Publicly funded healthcarePublicly funded healthcare Midwifery has been began legislation Midwifery has been began legislation

in NS November 2006. Midwifery Act in NS November 2006. Midwifery Act passed in 2009.passed in 2009.

Maternity care largely provided by Maternity care largely provided by Obstetricians, GPs and Maternity Obstetricians, GPs and Maternity nursesnurses

IWK Health Centre IWK Health Centre

Approximately 5000 babies are delivered at the hospital Approximately 5000 babies are delivered at the hospital each year. each year.

There are 2,976 employees at the IWK. There are 2,976 employees at the IWK. 147 air transports completed. 147 air transports completed. $10.9 million of funded research was underway at the IWK $10.9 million of funded research was underway at the IWK

last year. last year. 3 midwives on staff as of July 20093 midwives on staff as of July 2009

Single Parents CentreSingle Parents CentreHalifaxHalifax

Voluntary organization which helps mums and Voluntary organization which helps mums and families in social and economically deprived areas families in social and economically deprived areas of Halifaxof Halifax

Parenting skills, cooking classes, baby massage, Parenting skills, cooking classes, baby massage, prenatal education, counsellingprenatal education, counselling

1996-Longest running volunteer doula 1996-Longest running volunteer doula programme in North America programme in North America

Steps to becoming a Volunteer Steps to becoming a Volunteer DoulaDoula

30 hours of training30 hours of training 12 hour shift at the IWK12 hour shift at the IWK Program in partnership with the IWK Program in partnership with the IWK

and Capital Health – donate about and Capital Health – donate about 40% funding40% funding

Approved by DONA InternationalApproved by DONA International Currently about 50-60 volunteersCurrently about 50-60 volunteers

Matching processMatching process

Initial visit with programme managerInitial visit with programme manager First meeting between volunteer doula and First meeting between volunteer doula and

mum. mum. Meetings to discuss birth plan, pain Meetings to discuss birth plan, pain

management, hopes, fears, breastfeeding management, hopes, fears, breastfeeding baby issues etcbaby issues etc

Beeper/cell phone contactBeeper/cell phone contact Mom can contact manager if she is not Mom can contact manager if she is not

satisfied with her doulasatisfied with her doula

The ProcessThe Process Volunteer on-call to provide continuous 1:1 Volunteer on-call to provide continuous 1:1

support when labour beginssupport when labour begins Works with nurses, physicians and Works with nurses, physicians and

midwives to provide support midwives to provide support Expenses are provided for doula (taxi, Expenses are provided for doula (taxi,

childcare) childcare) Official hospital permission to accompany Official hospital permission to accompany

mother and partner in OR if neededmother and partner in OR if needed Generally stays with family 2 hours after Generally stays with family 2 hours after

birth or until settledbirth or until settled

Post-partum carePost-partum care

NS: Normal discharge 24 hours to 3 daysNS: Normal discharge 24 hours to 3 days 1-2 visits first week to assess situation and 1-2 visits first week to assess situation and

provide referral if neededprovide referral if needed Support with general breastfeeding issuesSupport with general breastfeeding issues 1 visit week 2 and 31 visit week 2 and 3 ““Birth Story” written and given to familyBirth Story” written and given to family

Current StatisticsCurrent Statistics

122 referrals from April 2008 - March 2009122 referrals from April 2008 - March 2009(30 referrals in January 2010)(30 referrals in January 2010)

Since 1996: 1060 referrals and approximately 400 Since 1996: 1060 referrals and approximately 400 doulas traineddoulas trained

Referred ClientsReferred Clients 18% newcomers18% newcomers

48% little or no support48% little or no support

55% with special needs55% with special needs

OutcomesOutcomes

41% no medication41% no medication 48% had epidurals 48% had epidurals (IWK 85%+)(IWK 85%+) 14% C/S14% C/S (IWK 30%+)(IWK 30%+)

94% breastfeeding @birth (IWK 73%)94% breastfeeding @birth (IWK 73%) 84% breastfeeding @4weeks (NS 84% breastfeeding @4weeks (NS

42%?)42%?)

Personal Experience with Personal Experience with programmeprogramme

Questions?Questions?