Accompany doula care was founded...

By six birth and postpartum doulas who are public health professionals, community organizers, doula trainers, mothers, and passionate believers in the value that doula care brings to the birth experience for every birthing person who wants support.

Beginning in 2017, six doulas met in earnest to see if the dream of integrating doula care into the healthcare system could become a reality. With their knowledge of the tremendous value of doula care, the beginning of shifts in the Massachusetts healthcare system towards the Accountable Care Organization (ACO) model, and the growing recognition of the value of Community Health Workers, the time seemed right to explore this possibility.

The founders wanted to create a new model of doula care. At the time, doula care was paid for on the private market by families who could afford the fees. For families for whom payment was a barrier to receiving doula care, doula care was delivered via a volunteer or supported through grant funding. The founders believed all of these options were not the ideal way to honor and serve doulas, families, and the healthcare system.

The founders set out to build something that was sustainable and benefited all stakeholders: the doula workforce, families who desired access to doula care, and the healthcare system who needed to contain costs while increasing quality, satisfaction, and positive outcomes. To do so, the founders placed the following values at the center of their creation and implementation:

1. Growing and employing a doula workforce who were diverse in race, ethnicity, age, culture, language, and religious and professional background. Special emphasis was given to recruiting and employing community doulas, who come from the same community as their clients and best understand the needs of the families they serve.

2. Addressing health inequities in perinatal outcomes and reducing the amount of non-medically indicated interventions in birth as well as the amount of birth trauma in communities of color.

3. Paying the doulas a living wage for their services, so women from the community could maintain gainful employment and provide for their families.

4. Training and providing a career ladder for doulas across MA, particularly in areas of the state where health inequities persist. This also included reducing barriers to becoming a doula, such as securing funding to subsidize training fees for new doulas.

5. Partnering with the healthcare system in a way that doulas are an integrated part of the client’s healthcare team. This included developing trust and seamless communication between Accompany and the healthcare provider or payer so that all stakeholders were striving toward the best care for the client or member.

6. Achieving Berwick’s Triple Aim so that the healthcare and public health systems could work together to provide optimal quality care, while containing costs.

In order to achieve this ambitious vision, for two years, Accompany relied upon countless volunteer hours given by the founders and many others who gave of their time, talent, and expertise, often pro bono or at largely reduced rates.

In April 2019, Accompany Doula Care was proud to sign its first agreement with a MassHealth ACO. The pilot, which ran from May until December 2019, included a group of over 20 doulas with a 10 language capacity, and served 79 members resulting in 30 births.

Currently, Accompany Doula Care continues its role of serving ACO members as well as patients at hospitals and federally qualified healthcare centers; employs over 20 doulas and several staff members; and is continually recruiting and fundraising in order to remain sustainable and grow well into the future.

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