Community Health & Wellness

Volunteer doula program supports moms-to-be at this nearby hospital

Posted on January 29th, 2025 By: Conor Wilson

Leaders at St. Michael Medical Center’s Family Birth Center in Silverdale hope to improve outcomes for expecting mothers through a new volunteer birth doula program.

Birth doulas are trained non-medical personnel who support women who are pregnant, birthing or postpartum. Typically patients pay for a doula either out-of-pocket or through their insurance. But St. Michael plans to offer the service for free through a volunteer program. It is the first hospital in the Virginia Mason Fransican Hospital system, outside of Tacoma, to offer such a program.

What’s a doula?

Doulas do not offer medical care, but evidence indicates they improve birth outcomes and reduce risk of needing procedures like a c-sections. They are trained to support laboring patients physically, help them through the birth process and advocate on their behalf.

Jennifer Snider, director of the Family Birthing Center at St. Michael, said doulas provide comfort in a hospital setting. By nature, birth is intense and stressful. Doulas help patients navigate that.

“They also improve the overall satisfaction of the birthing mom’s experience,” she said, “so we love having them here.”

Kaylee Hope is one of three volunteer doulas at St. Michael Medical Center in Silverdale. Photo courtesy St. Michael Medical Center

Birth doulas go through an interview, background check and complete an approved training course before starting at the Silverdale hospital. They commit to at least two four-hour shifts per month. Three volunteers currently participate in the program, with a fourth expressing interest. Snider says they need more.

“We don’t have enough volunteers yet,” she said. “The quality of this program and its effectiveness really depends on the people who are willing to serve in this manner and volunteer their time.”

State efforts

St. Michael introduces its new program as Washington takes steps to standardize and expand access to doulas.

In 2023, the Legislature created the classification of “Birth Doula.” The bill established training and certification requirements for the position through a voluntary credential. Over 100 doulas have been certified since its launch.

In January, another law took effect allowing professional birth doulas to be reimbursed up to $3,500 per client for services they provide to Apple Health patients. Apple Health, the state’s Medicaid insurance, covers more than 40% of the state’s annual births, according to the Washington Health Care Authority.

“By implementing this benefit, we’re taking a step toward advancing health equity and improving pregnancy care across the state,” Dr. Judy Zerzan-Thul, the HCA’s medical director, said in a statement.

Bridging care, more OB-GYNs

State health officials say “strong evidence” shows doula care leads to better perinatal and infant outcomes, including reducing medical interventions, premature deliveries, length of labor and stress of delivery. Yet doulas are not a complete solution for all maternal health care needs in Kitsap.

Kitsap County has had a shortage of OB-GYNs for years. Because of this, many expecting mothers either did without pre-pregnancy care – which studies show leads to worse birth outcomes – or went out of the county for it, said Lynn Pittsinger, community health division manager for the Kitsap Public Health District.

Kitsap reported six OB-GYNs per 100,000 residents in 2023, according to most recent available numbers from The Washington Health Care Research Center. The state average is 14. Neighboring counties, including Pierce, Mason and Jefferson, also had rates below state averages.

That shortage contributed to just over half of mothers getting adequate prenatal care, according to data from the Kitsap Public Health District. That’s compared to about 70% of the state at large. The disparity has led to several new programs looking to bridge that gap.

Some of those who did not receive adequate prenatal care in Kitsap were military families, Snider said. They transfer into the community and can experience delays getting care.

Military moms-to-be

Challenges for military patients and their beneficiaries were exacerbated after Naval Hospital Bremerton stopped delivering babies over two years ago. The hospital maintains an OB-GYN department – which offers prenatal care up to the point of delivery – but staff now prioritize transferring patients to civilian providers.

The hospital launched its Obstetrics Navigator Program over a year ago in an effort to bridge the gap between its beneficiaries and the area’s civilian health care system. Most patients were able to get an appointment within 30 days, a process staff said previously took about six weeks.

The program has helped 638 pregnant women since its inception, hospital spokesperson Doug Stutz wrote in an email this week, “ensuring smooth pregnancies for women waiting on medical care from the civilian sector.”

The number of mothers not receiving adequate prenatal care was also part of the reason why the KPHD launched a Pregnancy and Parent Support line. The phone line, available at 360-728-BABY (2229) from 8 a.m. to 4 p.m. weekdays, gives the public and providers access to a public health nurse or community health employee. Staff members help connect patients with services for pregnancy, mental health, prenatal care and a range of other resources.

“We’re trying to make the actual connections to care so that folks aren’t just given a bunch of flyers,” Pittsinger said. but they can actually be connected to what they need.”

Pittsinger said the line helps mothers navigate the various and at times overwhelming number of programs the county has for expecting mothers.

In the beginning, she said most of the four to eight calls coming in each week were about how to access an OB-GYN appointment.

Help on the way

Today that challenge is beginning to wane. Although she did not have specific numbers, Pittsinger said providers around the county hired several OB-GYNs recently.

Snider also said that the situation has improved recently. Fewer of the county’s OB-GYN clinics were turning away patients like they had in the past. Still some patients seem to be electing to get care in Tacoma, she said, based on the idea that St. Michael and other providers are full.

“I think it’s important to get that out into the community that we’re not [full],” she said. “In fact we are accepting patients.”

To volunteer to be a doula at SMMC, visit: vmfh.org/smmc-doula-volunteer. Additional resources for Kitsap County residents are available at: kitsappublichealth.org/pch