The Birth Outcomes Made Better (BOMB) Doula Program aimed to address and improve the poor birth outcomes experienced by Black mothers and infants in Milwaukee. Between 2016 and 2020, nearly 50 percent of Milwaukee births were to Black mothers, yet 70 percent of infant deaths were among Black infants. Because culturally appropriate support from doulas has been shown to significantly improve birth outcomes and maternal health, this approach was critical to address the disparities Black women and infants face in Milwaukee.
The BOMB Doula Program successfully advanced its mission to improve birth outcomes for Black families in Milwaukee by providing crucial resources, health education and employment opportunities. By offering free doula services, the program ensured broad accessibility and met high demand by expanding its team from four to eight full-time employees. Additionally, the program trained doulas as Certified Lactation Counselors, increased appointment attendance and created sustainable employment opportunities.
The Challenge
In Milwaukee, predominantly Black neighborhoods experience high rates of infant mortality and adverse socioeconomic conditions that have been exacerbated by long standing issues like redlining and segregation. Between 2016 and 2020, nearly 50 percent of Milwaukee births were to Black mothers, yet 70 percent of infant deaths were among Black infants. Community-based doula programs have been implemented in other communities to help address similar disparities in birth outcomes and provide culturally appropriate support from doulas who share similar backgrounds with the families they assist. These care models help pregnant patients and their mothers navigate institutional racism in health care, leading to better birth outcomes, reduced use of pain medications, fewer Cesarean births and more positive childbirth experiences. Evidence from other doula programs have demonstrated that doula support significantly improves birth outcomes and maternal health, making this approach especially critical for Black women and infants in Milwaukee.
Project Goals
The goal of the Birth Outcomes Made Better (BOMB) Doula Program was to address and improve the poor birth outcomes experienced by Black mothers and infants in Milwaukee. The program aimed to expand community-based models of care in order to make doula services more accessible and free of cost, provide consistent health education and support, increase breastfeeding rates, connect families to prenatal and postpartum care and offer employment opportunities for doulas. Additionally, the program sought to transition from a pilot program to a sustainable, long-term service to provide a broader community impact and influence policy reform in maternal and child health.
Results
The BOMB Doula Program successfully advanced its mission to improve birth outcomes for Black families in Milwaukee by providing crucial resources, health education and employment opportunities. Doula services were provided for free, with no restrictions other than residency, which ensured broad accessibility to the program and led to high demand. To meet the growing need, the doula team was expanded from four to eight full-time employees. The doulas provided regular, client-centered health education that was tailored to the cultural and literacy needs of families. They utilized a point-in-time curriculum, along with flexible in-home and telehealth options, to help clients better understand the prenatal and postpartum stages and accommodate families’ preferences of care.
To achieve its goals in breastfeeding support, the program trained doulas as Certified Lactation Counselors and offered comprehensive education and assistance which resulted in consistent breastfeeding initiation rates. By connecting clients to routine care, accompanying them to visits, and providing transportation support, the program increased appointment attendance and comprehension of medical guidance. Additionally, the BOMB Doula Program created sustainable employment opportunities for doulas by offering livable wages, benefits and professional development, which has attracted significant interest in these positions.
