1. Volunteer Doula Programme: A Canadian Perspective Volunteer Doula Programme: A Canadian Perspective Shauna Powers NHS Lothian Health Promotion Service

2. Halifax, Nova Scotia Halifax, Nova Scotia

3. Halifax: Stats Population (2008): approximately 400,000 Population (2008): approximately 400,000 Industry: Shipping, defence, education Industry: Shipping, defence, education Located on the Atlantic Ocean Located on the Atlantic Ocean Largely White population (92.5%), Black (3.9%), Asian (2.4%) and Arab (1.4%) (2006) Largely White population (92.5%), Black (3.9%), Asian (2.4%) and Arab (1.4%) (2006)

4. Maternity Care in Nova Scotia Publicly funded healthcare Publicly funded healthcare Midwifery has been began legislation in NS November 2006. Midwifery Act passed in 2009. Midwifery has been began legislation in NS November 2006. Midwifery Act passed in 2009. Maternity care largely provided by Obstetricians, GPs and Maternity nurses Maternity care largely provided by Obstetricians, GPs and Maternity nurses

5. IWK Health Centre Approximately 5000 babies are delivered at the hospital each year. Approximately 5000 babies are delivered at the hospital each year. There are 2,976 employees at the IWK. There are 2,976 employees at the IWK. 147 air transports completed. 147 air transports completed. $10.9 million of funded research was underway at the IWK last year. $10.9 million of funded research was underway at the IWK last year. 3 midwives on staff as of July 2009 3 midwives on staff as of July 2009

6. Single Parents Centre Halifax Voluntary organization which helps mums and families in social and economically deprived areas of Halifax Voluntary organization which helps mums and families in social and economically deprived areas of Halifax Parenting skills, cooking classes, baby massage, prenatal education, counselling Parenting skills, cooking classes, baby massage, prenatal education, counselling 1996-Longest running volunteer doula programme in North America 1996-Longest running volunteer doula programme in North America

7. Steps to becoming a Volunteer Doula 30 hours of training 30 hours of training 12 hour shift at the IWK 12 hour shift at the IWK Program in partnership with the IWK and Capital Health – donate about 40% funding Program in partnership with the IWK and Capital Health – donate about 40% funding Approved by DONA International Approved by DONA International Currently about 50-60 volunteers Currently about 50-60 volunteers

8. Matching process Initial visit with programme manager Initial visit with programme manager First meeting between volunteer doula and mum. First meeting between volunteer doula and mum. Meetings to discuss birth plan, pain management, hopes, fears, breastfeeding baby issues etc Meetings to discuss birth plan, pain management, hopes, fears, breastfeeding baby issues etc Beeper/cell phone contact Beeper/cell phone contact Mom can contact manager if she is not satisfied with her doula Mom can contact manager if she is not satisfied with her doula

9. The Process Volunteer on-call to provide continuous 1:1 support when labour begins Volunteer on-call to provide continuous 1:1 support when labour begins Works with nurses, physicians and midwives to provide support Works with nurses, physicians and midwives to provide support Expenses are provided for doula (taxi, childcare) Expenses are provided for doula (taxi, childcare) Official hospital permission to accompany mother and partner in OR if needed Official hospital permission to accompany mother and partner in OR if needed Generally stays with family 2 hours after birth or until settled Generally stays with family 2 hours after birth or until settled

10. Post-partum care NS: Normal discharge 24 hours to 3 days NS: Normal discharge 24 hours to 3 days 1-2 visits first week to assess situation and provide referral if needed 1-2 visits first week to assess situation and provide referral if needed Support with general breastfeeding issues Support with general breastfeeding issues 1 visit week 2 and 3 1 visit week 2 and 3 Birth Story written and given to family Birth Story written and given to family

11. Current Statistics 122 referrals from April 2008 - March 2009 122 referrals from April 2008 - March 2009 (30 referrals in January 2010) Since 1996: 1060 referrals and approximately 400 doulas trained Referred Clients 18% newcomers 18% newcomers 48% little or no support 48% little or no support 55% with special needs 55% with special needs

12. Outcomes 41% no medication 41% no medication 48% had epidurals (IWK 85%+) 48% had epidurals (IWK 85%+) 14% C/S(IWK 30%+) 14% C/S(IWK 30%+) 94% breastfeeding @birth (IWK 73%) 94% breastfeeding @birth (IWK 73%) 84% breastfeeding @4weeks (NS 42%?) 84% breastfeeding @4weeks (NS 42%?)

13. Personal Experience with programme

14. Questions?