Promotora-Doulas: Community health workers providing support to women throughout pregnancy, during labor and delivery, and postpartum

This paper will discuss the use of community health workers as doulas, or nonmedical birth attendants. It will explore the program model used by Amor de Madre Community Doula Program, which is part of Migrant Health Promotion, a nonprofit agency in the Rio Grande Valley of Texas. This program model offers limited-resource communities access to the benefits of promotora education and support combined with the labor and delivery services of trained doulas. The paper will outline the innovative model of promotoras serving the role of doulas, and the challenges and successes they face in achieving program objectives such as: increasing the number of women accessing prenatal care, encouraging good nutrition during pregnancy, increasing breastfeeding rates, and increasing the women's use of local health care and social services. It will also examine satisfaction surveys with program participants to explore their experiences working with promotora-doulas. Conference participants will benefit from learning more about this program model because promotora-doulas offer unique services to women in communities that have limited knowledge of available health resources and/or be fearful to access those services. Research shows that doula support during labor is associated with positive outcomes such as shorter length of labor, fewer Cesarean sections, and higher Apgar scores for infants. Studies also show that women who deliver with doula support are more likely to initiate breastfeeding. Such outcomes may be particularly important to immigrant Latina populations in the United States, a group that has relatively high rate of Cesareans and low rate of breastfeeding.