Colorado county helping to fund and expand bilingual doula workforce

Arapahoe County Public Health has invested money to support Colorado moms and families through a bilingual doula program. Doulas are trained to give support before, during and after birth. With a diverse population, the county is expanding the doula workforce that's reflective of its residents.

Karee Augustus says they call themselves "birth besties."

"As a doula, I'm a friend. I'm a sister. I'm a therapist. I'm all of these things," said Augustus.

Doulas are not medical professionals, but they work alongside doctors, nurses and midwives. They're trained to give physical comfort, emotional support, and post-partum care.

About a year ago, Karee Augustus went through the doula training with Elephant Circle and was funded and sponsored by the county.

"I feel more confident in the hospital space. I can advocate for my clients, and it's being received. We also work as a team," said Augustus.

Communities of color and those with Medicaid have been historically excluded from doula care.

Mikayla Branz, who works in maternal child health for Arapahoe County Health, said 7,000 babies are born to Arapahoe County residents every year, and 35% of those births are covered by Medicaid.

A change in Medicaid benefits in 2024 now allows thousands more people to have access to doula care they didn't have before.  

Branz added with the change in Medicaid benefits, there are many people who don't know about doulas and their services at no cost.

"We're seeing an increase in the awareness that you could have a doula to support you throughout your birth," said Branz. "Doula care is shown to be effective. For the birthing person, it improves mental health. It supports the family in supporting the person. It's also important that people feel empowered and supported during their birthing experience, and doulas can do that.

Branz added, there are only about 200 Medicaid certified doulas in Colorado.

The county's public health department worked with local organizations to recruit and train 22 doulas. Nearly half of them also speak Spanish.

"We're trying to make sure that the workforce can actually meet that demand and is reflective of the community members who need doulas," said Branz.

"I want to speak up for my Hispanic community because the doula program is something that it's being missed, and people don't know about it," said Adriana Ruviano, a Spanish speaking doula who went through the training. "I think it's important to let people know this is available, that it exists, and that you can do it in your language."

Doulas can be especially important for Spanish speakers or women of color, who face inequities during pregnancy and childbirth.

"You are overcoming the language barriers to overcome what people know about hospitals and what to expect there. For me, it's overcoming those bridges, and overcoming those gaps," said Ruviano.

Ruviano said she also takes pride in making others feel empowered.

"It's beautiful to work with moms. We can all be that companionship. We can bring that support that you need at that moment," said Ruviano.

"We're there to empower, and we're there to support. Taking care of them, giving women the support that they deserve, it's so fulfilling," said Augustus.

As part of the training, the doulas participated in a four-day training course and attended three births. After the training, they could apply to become a Medicaid provider and get paid for their work through Medicaid.

Doulas continue to hone their skills by mentorship, meetups and conversations.