Improving Maternal & Child Health Outcomes through Great Rivers HUB & Community Health Worker/Doula Workforce Expansion
At a Glance
The Great Rivers United Way’s project Improving Maternal and Child Health Outcomes through Great Rivers HUB and Community Health Worker/Doula Workforce Expansion (La Crosse County) will expand a community health worker/doula program to reduce the low birthweight and other poor health outcomes by addressing social determinants of health and supporting prenatal care.
The Challenge
Great Rivers United Way’s Pathways Community HUB model leverages community health workers (CHWs) to provide holistic care in place of prenatal care coordination and support to high-risk families postpartum in the La Crosse County area.
The births supported through this program were all supported by a CHW but, Great Rivers HUB recognized the potential impact of having a dually trained CHW/doula position to serve at-risk pregnant individuals in the region.
Similar to CHWs, doulas have demonstrated success in improving maternal and infant outcomes as they receive training specific to birth and offer a specialized understanding of prenatal and postpartum needs. The presence of a doula has been shown to decrease the likelihood of a low birthweight baby, decrease the likelihood of needing birthing intervention and increase the likelihood of initiating breastfeeding. While doulas offer an evidence-supported way to improve health outcomes, many individuals who are most at-risk lack financial accessibility to them.
Project Goals
To improve birth outcomes in the La Crosse County area, this project aims to establish a broader network of support for pregnant individuals and their families by expanding the diversity of trained community health worker/doula positions in the area. Great Rivers HUB has four goals in this expansion plan:
- Hire and train two CHW/doula positions representing a diverse range of populations
- Develop a model for sustainability of the CHW/doula positions that can be shared broadly around the state
- Enroll 60 mothers/families throughout the course of the grant to meet both clinical and social determinants of health needs
- Decrease the number of low birthweight births for enrollees in the program when compared to similar demographic populations in the general community
Progress Update
In the first year of this project, Great Rivers HUB partnered with the Family and Children’s Center to hire and train two community health worker/doula positions. With these positions filled, 31 mothers/families have been enrolled in the program and it is expected that the goal of 60 enrollments will be met or exceeded by the end of 2024.
The program supported 15 births over the past year. Of those births, 87 percent resulted in “normal” birthweight babies. The two infants with low birthweight were enrolled in the program in the second and third trimesters of pregnancy but were both born at full term and did not require a stay in the NICU. In addition, through the support of the CHW/doulas, 10 of the 15 births had mothers who were breastfeeding.
Great Rivers HUB continues to sustain a referral network of partners including health systems, health plans, and community-based organizations to refer pregnant populations to the program. A new partnership with Gundersen Health System, made possible by a grant requirement of partnership with a community-based organization, was formed to recruit two additional CHW/doula positions over two years. The partnership will support rural expansion of Gundersen’s Pregnancy Addiction and Social Support (PASS) clinic.