MultiCare, Spokane Professional Doula Association Q&A

By Jean-Paul Arnaud-Marquez

The role doulas play in a mother’s birth experience is one that can be misunderstood. To help bring a bit of clarity, we took it upon ourselves to interview some of MultiCare’s Family Birth Center staff at MultiCare Deaconess Hospital and MultiCare Valley Hospital to better understand their role and uncover more about the relationship between MultiCare and the Spokane Professional Doula Association (SPDA).

Zibby Merritt, MSN, Perinatal Nurse Educator:

What is the relationship between MultiCare and SPDA?

MultiCare partnered with SPDA very early on in their organization’s foundation. In the beginning, MultiCare was “known” for welcoming doulas. We value the SPDA doulas so much because they collaborate with our care processes and we work together as a team. They help facilitate the hands-on care we all aim to provide each patient. SPDA has also hosted classes for our staff on how to facilitate natural birth methods, positioning and pain relief. We really appreciate what they do.

What makes their services special and why do you think they’re valuable?

“Mothering the mother” is an essential doula concept. It means that the doula’s sole purpose is to care for the mom. She advocates for her birth wishes and sees to the mother’s comfort, whether it be through natural means or medication. Our nurses are responsible for the care of both the mom and fetus, while doulas can make the mom their sole focus. Although we often fulfill the role of a doula by providing labor support, our nurses may have other patients, might be needed to help in other emergency situations, or may have legal charting obligations. That’s what makes doulas valuable; they collaborate with our team to offer more holistic care.

Jackie Bartosh, RN, Labor & Delivery Manager:

From a leadership perspective, what makes MultiCare’s partnership with SPDA a valuable tool to be able to offer our birthing mothers/families? ​

A doula is way more than a tool – they are a partner in the birthing process. They have such a unique perspective because they have developed a much deeper relationship with the patient and their support person during the pregnancy. They know what fears the patient has, how they cope in times of stress and what’s the most important aspect of the patient’s birth experience. They use this knowledge to collaborate with the hospital staff while the patient is in our care. Their support is critical to the patient’s emotional response to labor and helps the nursing staff to connect with the patient on a deeper level. Having a doula present also helps the nursing staff to focus on the medical aspect of care with the confidence that the patient has an emotional support person solely focused on them.

What can you say is the biggest impact they have on our families? ​

The doula acts as an advocate for the family. They have a keen perspective on the family environment that the newborn will be going home to and the support system the mom has postpartum. This is an incredible resource for these new moms!

Nicole Hamblet, RN, Labor & Delivery Nurse:

As an RN, do you appreciate having a doula around? If so, why?

I love having doulas around! I see them as an integral component of any birth team. For first time parents, they’re great at helping guide what questions to ask and what to expect. Since they’re familiar to the expectant family they already have a great rapport with them in the event labor deviates from their birth plan. I also love learning new support methods, massage/counter pressure or verbal encouragement statements from doulas.

Angie Tollefson, RN, Lactation Nurse:

Are doulas helpful in other ways?

From a lactation perspective they are very helpful with getting baby skin-to-skin with momma, getting baby latched for those very first feeds, encouraging her and getting breastfeeding started off on the right foot. Plus, having the new mom already familiar and comfortable with the person who will be touching her adds another level of confidence. Additionally, once the mom and baby are discharged from the hospital, doulas provide additional follow-up to make sure feedings are going well and they offer them continued support and encouragement.

Melanie Floerchinger, SPDA Founder:

How do you feel about the relationship between MultiCare and Spokane Doulas?

SPDA has a wonderful working relationship with MultiCare. MultiCare nurses and providers have always acknowledged the beneficial role that doulas provide to laboring women and their families and have worked collaboratively with doulas in providing exceptional care to patients and families.

How much do doulas cost patients on a regular basis? Can it be covered by insurance?

Birth doulas’ fees range depending on certification status and experience from $600-$1,200. Postpartum doulas’ fees also vary from an hourly rate of $15-$25 per hour, overnight rates to package rates. Bereavement doulas’ fees vary from hourly to package rates.

Currently, most insurances do not cover doula services, but some are beginning to. Many HSA’s will cover doula services.

Is having a doula worth it?

Having a doula on your birth/postpartum team is added support for families. Doulas provide non-medical care to families during their childbearing years focusing on the physical, mental, and emotional needs of a family. Doulas are essential helping fill the gaps of care in these areas for birthing people and their families while helping to ensure a safer and better birth experience.

• 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
• 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
• 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
• Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
• 38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
• 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff

Why are your doulas, specifically here, special?

Spokane Professional Doula Association is unique to Spokane in that all our doula members are:

• Certified or currently pursuing certification
• Provided oversight through a mentorship program
• Adhere to DONA’s Scope of Practice and Code of Ethics
• Accountability with our Grievance Policy
• Work collaboratively with medical professionals to provide the highest level of care
• Our member include birth, postpartum and bereavement doulas

What’re you offering during COVID-19? (Virtual support, etc.) And how much does that cost?

All SPDA doulas are providing their services virtually and in-person when appropriate. Even though doula support might look a bit different due to COVID-19, having that extra support is even more important than before. Families will have personalized support before, during and after birth ensuring they feel supported during these unprecedented times. Doulas fees range from $500 – $1,050.

Due to social distancing, many families and individuals may not have all the support they need. Support is an essential part of the childbearing years whether it’s through a miscarriage or loss, birth and the challenges that come during the postpartum period. Our doula members want to offer support to families in need or at risk due to COVID-19 at no charge or by donation. SPDA has set up a hotline for families in need or at-risk during COVID-19. SPDA birth, postpartum and bereavement doulas will provide virtual support at no charge or by donation. Email [email protected] and by phone at 208-352-3251.