Healthy Start Supplement: Community-Based Doulas

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This notice announces the opportunity to apply for supplemental funding under the Healthy Start Initiative: Eliminating Disparities in Perinatal Health, also known as the Healthy Start (HS) program. The purpose of the HS program is to improve health outcomes before, during, and after pregnancy, and reduce racial/ethnic differences in rates of infant death and adverse perinatal outcomes. The goal of this supplement is to increase the availability of doulas in Healthy Start service areas most affected by infant and maternal mortality and to increase the number of women with a higher risk of poor birth outcomes receiving doula services. Doulas will provide services to women during the periods of pregnancy, birth and at least three (3) months post-partum. Award funds will cover the training, certification, and compensation of doulas. HRSA understands the vital role doulas play in advancing health equity and reducing disparities in infant mortality (IM), maternal mortality (MM) and other adverse perinatal outcomes. One of our long-term goals is to ensure doulas have sustainable employment and career prospects that advance the MCH workforce at the community level. With this funding, recipients are expected to provide doula support to a minimum of 100 HS participants. Funding should also support the training necessary to expand the number of available doulas within the target community. Recipients should also develop a plan for sustainability after grant funding ends. To achieve these expectations, recipients may pursue a variety of options to expand doula support and customize a hiring approach to reflect community and program needs. This could include hiring full-time doulas, contracting out services on a per birth basis, or other models based on capacity and need. Recipients should demonstrate how doulas will provide effective and culturally responsive pregnancy and childbirth education, early linkage to health care and social services, labor coaching, and breastfeeding education and counseling while fostering parental attachment. Recipients should clearly outline methods to provide supportive services before, during, and after childbirth, including breastfeeding initiation promotion. Recipients should demonstrate how doula services will meet the needs of their HS communities and priority population in order to improve birth outcomes and reduce racial/ethnic disparities for participants who have the highest need. In order to achieve this purpose, applications should propose activities designed to meet the following program objectives by the dates indicated. Program Objectives: • By November 2022, each recipient will contract with one or more doula training organization(s) to provide training for doulas. • By February 2023, each recipient will recruit two or more candidates to become doulas. • By May 2023, each recipient will facilitate training for each hired doula. • By February 2024, doulas hired by each recipient will complete all requirements for a birth doula certification of the recipient’s choice (e.g., Doulas of North America [DONA], Childbirth and Postpartum Professional Association [CAPPA]). • By March 2024, each recipient will provide prenatal, birth, and short term- postpartum (within 3 months after birth) doula support to a minimum of 100 HS participants. The program objective timeline may fluctuate based on whether a recipient hires doulas as full-time employees versus contracting. For the purposes of retention, the recipient may consider requesting a formal agreement from each doula that is hired stating their intent to provide doula services to HS clients for a specific period of performance.

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