May 13, 2022
NYC Health + Hospitals/Elmhurst, NYC Health + Hospitals/Queens and the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai today launched the HoPE Doula Program for pregnant people. The HoPE Program, or Helping Promote Birth Equity through Community-Based Doula Care, provides community-based doula support, free-of-charge, to any pregnant person seeking care at either Elmhurst or Queens Hospitals. Doula care has been associated with better birth outcomes for parents and babies. Patients at the two hospitals will be matched with a doula for the duration of their pregnancy and post-partum care. The program is an integral part of the public health care system’s response to addressing the disparities in maternal mortality among people of color. The HoPE Doula Program is a collaborative effort led by NYC Health + Hospitals/Elmhurst and Queens, the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Ancient Song Doula Services, Caribbean Women’s Health Association, and the NYC Department of Health and Mental Hygiene. The work is being funded in part through a $455,000 grant from Robin Hood, New York City’s largest poverty-fighting philanthropy.
“As New York City finally fights to end the disparate rates of maternal mortality among women of color, we know that doulas can play a key role between birthing people, doctors, and nurses,” said New York City Mayor Eric Adams. “Through their training, doulas listen, educate, and guide their clients through the entire amazing experience of childbirth. Doulas do make a difference and can help save lives!”
“I’m so pleased that the HoPE Doula Program will allow both Elmhurst and Queens Hospitals to lead the way in introducing the concept of doulas to the birthing process in our public hospitals,” said NYC Health + Hospitals/Elmhurst CEO Helen Arteaga Landaverde, MPH. “The fact is, there are stark racial and ethnic disparities in healthcare outcomes for pregnant women and their infants in the United States, and these differences are even more pronounced in New York City. Doula care, or trained lay support during childbirth, is an evidence-based strategy designed to improve birth outcomes and result in an overall positive childbirth experience.”
“I am excited to be involved in launching the HoPE Doula Program at both Elmhurst and Queens Hospitals, as it will enable us to transform the birthing experience to one that is more personalized, respectful, and memorable for our parents” said NYC Health + Hospitals/Queens CEO Neil J. Moore, MBA, MPA, FACHE. “A doula will typically meet with a birthing person, their partners and families during pregnancy to help them prepare for childbirth, build rapport, manage expectations, and provide evidence-based resources. We will also prioritize pairing a pregnant person with a doula from the same ethnic, linguistic, or religious background, which can be essential to improving equity and providing culturally responsive care.”
“No one should have to give birth alone,” said Arnhold Institute for Global Health Director and Chair of the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai Rachel C. Vreeman, MD, MS. “We know that doula care results in better birthing outcomes—a decreased need for C-section, a decreased risk of premature babies, low birth weight and being sent to the NICU. We are very hopeful that this model will be able to significantly decrease health disparities.”
The doulas affiliated with Elmhurst and Queens Hospitals’ HoPE Program are from two well-established community-based doula organizations: Ancient Song Doula Services and Caribbean Women’s Health Association. There will be 20 Queens-based doulas in the program. These doulas will be matched with patients based on neighborhood, language, and ethnicity. Once matched, that doula will remain engaged with their client through prenatal, birthing, and postpartum care. Patients will be referred for doula services by their clinical providers, including social work providers and the maternal medical home coordinator. Doulas are compensated based on the time they spend with each client.
The HoPE Program was developed to mitigate maternal and infant health disparities, particularly in parents and babies of color. In New York City between 2011 and 2018, the rates of pregnancy-related death were eight times higher for black women than white women; and the rates of pregnancy-related death were two times higher for Hispanic and Asian women than white women. Additionally, in New York City in 2018, the infant mortality rate in high-poverty areas was 1.5 times the infant mortality rate in low-poverty areas. The pandemic worsened the situation, with minority pregnant people in New York City infected at a higher rate than white pregnant people. Nationally, both black and Hispanic pregnant people had higher rates of COVID-19 infection and death.
“In launching the HoPE Program, Elmhurst and Queens Hospitals share the goal of not only improving childbirth outcomes for our patient population, but also increasing engagement in care and providing respectful care across the prenatal-birth-postpartum care continuum, particularly in the context of the COVID-19 pandemic,” said NYC Health + Hospitals/Elmhurst Attending Physician and HoPE Faculty Lead Sheela Maru, MD, MPH, Assistant Professor of Global Health and Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai. “We envision the HoPE Program will ultimately benefit a population of women that has suffered a high burden of maternal and infant disparities – and now additionally faces a high burden of COVID-19 infection and its social, economic, and healthcare repercussions.”
“Living through the past two years, we’ve learned that the coronavirus pandemic has shed a laser-like focus on childbirth inequities leading to disproportionately negative outcomes among women of color,” said NYC Health + Hospitals/Queens Director of Obstetrics and Gynecology Aleksandr Fuks, MD. “This ongoing situation has created an environment where communities of color may hesitate to see their doctor for fear of getting sick, or because of language barriers, or because they may lack health insurance. These women will more often than not find themselves in a precarious position and would benefit from the comfort and reassurance of a consolidated support system that extends beyond their immediate family, and this is where the participation of a doula can be most valuable.”
The HoPE Program is part of a larger partnership known as the COVID-19 Unit for Research (CURE-19) at Elmhurst and Queens hospitals, a collaboration between Mount Sinai’s Arnhold Institute for Global Health and NYC Health + Hospitals/Elmhurst Global Health Institute that formed in 2020 during the initial peak of the pandemic. CURE-19 translates data, experiences, and lessons from clinicians at the Mount Sinai Health System, NYC Health + Hospitals/Elmhurst, and NYC Health + Hospitals/Queens into research to address both the global pandemic and root causes of health disparities in New York City.
NYC Health + Hospitals/Elmhurst worked closely with a specially-convened Community Advisory Board comprised of postpartum women, local community-based organizations, stakeholders from Elmhurst and Queens Hospitals, and from the NYC Department of Health and Mental Hygiene, to shape the development, implementation, and evaluation of the HoPE Doula Program. Discussions included taking into consideration the community’s needs, design and evaluation of the HoPE Program, publicizing the program to the community, and accountability systems for the program. The Community Advisory Board will conduct monthly two-hour workshops through the remainder of 2022.
Doula care has been associated with better birth outcomes for parents and babies, such as shorter labor, fewer Cesarean sections, the promotion of breastfeeding, and an overall positive birth experience. Specifically, community-based doula care is even better suited to reduce maternal and infant health disparities by connecting birthing parents with local resources and providing ongoing social and emotional support. Doulas are trained to provide non-clinical emotional, physical and informational support for people before, during, and after labor and birth.
Derived from the Greek word meaning ‘woman servant or caregiver,’ a doula is employed by the parent(s)-to-be as their continuous caregiver during the pregnancy and birth. The role of the doula is to be there the whole time to provide emotional support as well as to inform and empower the parent. Benefits include hands-on comfort measures, the sharing of resources and information, and facilitating communication between expectant parents and their clinicians by helping people articulate their questions, preferences, and values.
For more information about NYC Health + Hospitals/Elmhurst, visit their website www.nychealthandhospitals.org/elmhurst. For more information about NYC Health + Hospitals/Queens, visit our website www.nychealthandhospitals.org/queens, or call for an appointment.