Daisy C.H.A.I.N. Mothering: Empowering ALL families through home visiting services from qualified community professionals

What if professional postpartum services were equitable to ALL families, providing empowerment and lifelong health benefits to all children?

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Founding Story: Share a story about a key experience or spark that helps the network understand why this project got started or a story about how you became inspired about the potential for this project to succeed.

DC’s co-founders shared 20 years of friendship, the joys and challenges of pregnancy and motherhood, as well as a passion for community activism before establishing the nonprofit in 2012. During the course of their university experience, Jennie Hawthorn Mayes and Jaclyn Ann Mahoney each began their journey as mothers, giving birth to five children between the two of them. Inspired by personal experiences with the lack of professional postpartum support, each founder began their path to shift that paradigm by sharing their Doula and IBCLC education/training with families. They founded DC in honor of Daisy, one of their daughters, who died during birth as the result of a lack of research and evidence-based care.

Jennie and Jaclyn began researching the services and community resources available to Lane County families and found a gap in postpartum services that their professional training could fill. The two used a combination of their professional, educational, and personal experiences to develop the programs and services of Daisy C.H.A.I.N. Mothering. “Homevisiting Program,” and “Nursing Nook: walk-in support,” to offer equitable access to certified and trained professionals who are qualified to improve breastfeeding outcomes and screen for mood disorders. Daisy C.H.A.I.N. Mothering sustained two years as an all volunteer organization, before receiving its first grant funding in September 2014.

Which categories describe you? (the answer will not be public)

  • Hispanic, Latinx, or Spanish origin (for example: Mexican, Puerto Rican, Cuba, Salvadoran, Dominican, Colombian)

Website

www.daisychainmothering.org

Location: Where is your organization headquartered? [State]

  • Oregon

Location: Where is your organization headquartered? [City]

Eugene

Location: Where is your project primarily creating impact? [State]

  • Oregon

Location: Where is your project primarily creating impact? [City]

Lane County, Oregon: Cheshire, Coburg, Cottage Grove, Creswell, Dallas, Deadwood, Dexter, Dorena, Eugene, Florence, Horton, Junction City, Leaburg, Oakridge, Springfield, Thurston, Veneta, Vida

Problem: What problem is this project trying to address?

The latest Breastfeeding Report by the Center for Disease Control reports 90.2% of Oregon mothers initiate breastfeeding, yet by three months the percentage of Oregon babies that exclusively breastfeed is 53.2%, and by six months only 23.9%. According to first year data, 80% of DC clients that accessed the full DC model of care, achieved six months of exclusively breastfeeding, in comparison with the state average of 23.9%. The first 2 weeks after birth are crucial for breastfeeding, family adjustment, and screening for postpartum mood disorders, yet during this time, most families do not have contact with postpartum professionals. By a mother’s first check-up, usually between 2-6 weeks, many challenges have already affected the family’s mental and physical health. DC programs address poverty, education, and inequality by providing vital postpartum services at no-cost to families.


Shifting the Paradigm

DC removes institutional barriers to success by shifting the cultural paradigm of postpartum care and creating equitable access to professional services, in order to improve immediate and lifelong health outcomes for new-mothers and their families. By receiving free support from a Professional Postpartum Doula and International Board Certified Lactation Consultant (IBCLC) families experience 1) decreased incidence of mental illness 2) reduced stress 3) increased rates of breastfeeding duration 4) greater access to referrals and community resources for necessary interventions 5) more positive parent-child interactions, and 6) reduction in isolation. 

DC offers FREE professional postpartum support services for ALL families following the birth or adoption of a child, regardless of income, demographic, or risk, because ALL families deserve equitable access from qualified professionals in their community.  Recipients of DC services include parents that range from ages 16-45, income levels of zero to six figure, and ethnic backgrounds that are reflective of the Lane County Community.  The organization is pleased to serve single parent, same sex, joint custody, refugee, relinquishing parent, and grieving parents with nonjudgmental support, that empowers parents regardless of social background and history.  DC's direct services include HomeVisiting Program, Nursing Nook, and Breastfeeding Education.


Service Delivery

HomeVisiting Program sends Professional Postpartum Doulas and IBCLCs into families' homes for the first two weeks following the birth or adoption of a child.  Parents who participate in the DC HomeVisiting Program have children who benefit from a stable, healthy caregiver and home environment. These factors transform health outcomes, empower families, and reduce stress.  Doula appointments are two hours for a total of 10 hours and IBCLC appointments range from one and a half to three hours and are offered as needed. Doulas and IBCLCs offer evidence-based information on infant feeding, soothing, and breastfeeding.

DC's postpartum doulas are professionally trained by international doula associations to teach families about postpartum adjustment; newborn characteristics, care, feeding and development; and the promotion of parent-infant bonding. The education and professional support provided by doulas improves attachment/bonding, social/emotional and cognitive development, and lowers risk of developing infectious and chronic diseases. Postpartum doulas are specifically trained to support the whole family, which research indicates positively impacts parents' emotional adjustment and parenting experience, reducing the risk of postpartum depression and mood disorders.  In addition to emotional support and newborn care, doulas are also able to provide practical assistance for household duties and tasks such as laundry, meal prep, and older sibling respite care.  These tasks are often left to outside family members but not all new-mothers have access to such a support network, nor are they able to ask their case workers to relieve them of such things.  All DC staff and volunteers receive in-house training in promoting protective factors and resilience through a nonjudgmental and culturally appropriate approach to support. Separate visits for breastfeeding support allow IBCLCs to screen for, prevent, and treat breastfeeding difficulties as they arise with individually tailored plans of care.  The IBCLC credential is the highest certification in breastfeeding support and the only internationally recognized credential in the field of lactation.

Nursing Nook is weekly walk-in breastfeeding support from an IBCLC in a group setting and serves families who have transitioned out of HomeVisiting Program and families who are referred by other means. Nursing Nook is available to families with children of any age for the entirety of their breastfeeding relationship and offers a relaxed atmosphere where parents can engage with other families while receiving quality care in the comfort of a non-clinical setting. Providing care in our safe, nonjudgmental community center, encourages families to engage with their community and reduces isolation that is often experienced in new-motherhood.

Private, in-office appointment times with an IBCLC are offered to families with newborns up to 6 weeks.  Once new-mothers have transitioned out of the homevisiting program or if they are new to the organization, they can continue to access individualized care from a qualified professional outside of the clinical setting, in order to continue fostering the sense of empowerment.

Breastfeeding Education classes are taught at local high school parenting programs, on field visits to breastfeeding mothers at Willamette Family Treatment Center, and at Daisy's Place community center for clients and health professionals alike, in order to create continuity of care between community resources.


The Larger Scope

Access to professional homevisiting services can start at $160 per hour for IBCLC support locally but unlicensed professionals also have been found to charge upwards of $100/hr.  Professional postpartum doulas often charge $30 or more per hour and due to independent training programs, can often lack the cultural sensitivity, informed trauma care, and perinatal mental health training that DC requires of its homevisiting staff.  Every family deserves equitable access to these health transforming services.

Under the Affordable Care Act, both IBCLC and Postpartum Doula services are billable, yet the current infrastructure of insurance companies is not compliant.  

These services can be available to every family in America, with satellite programs in different cities and states, serving ALL families, regardless of risk, income, and background.  In order to achieve nationwide success, ACA compliance needs to be achieved and streamlined provider/community referrals need to be established.  But the research and evidence-based programs that Daisy C.H.A.I.N. Mothering offers already speak volumes to reducing isolation, increasing confidence and knowledge base, and increasing protective factors in both parents and children.  Equitable access to immediate and long term health success is achievable in the immediate future through community health improvement plans, health coalitions, and a concerted effort between healthcare professionals and community workers.  By providing parents and families with the education and professional support they deserve, we create a stronger foundation for our children to achieve emotional and physical health and equitable opportunities in their community.

Is your model focused on any of the following traditionally underserved communities?

  • Communities of color
  • Children who are differently abled
  • LGBTQ or non-binary individuals
  • Religious minorities (non-Christian)
  • Low-income communities

Does your model work within any of the following sectors?

  • Childcare
  • Child and Family Services
  • Community Development and Empowerment
  • Criminal Justice
  • Education
  • Mental Health

Year Founded

2012

Project Stage

  • Established (the solution has passed the previous stages, and has demonstrated success)

Example: Walk the network through a specific example of what happens when a person or group engages with your solution.

*Sarah is a teen mom who was pregnant with her second child and became associated with DC through the Teen Breastfeeding Education class. The 2hr class offered at local schools educates parents about feeding amounts, common problems, feeding cues, hospital expectations, and asks students to call on their own knowledge base. By providing Sarah with nonjudgmental research and evidence-based information, she was empowered to take charge of her health and came into the community center to sign up for homevisiting services after the birth of her second child. By engaging in classes, homevisiting, 24hr text support, & community center support, Sarah gained the knowledge and confidence to lead her family towards the healthiest future possible.

Impact: What was the impact of your work last year? Please also describe the projected future impact for the coming years.

Quality care was provided to each client and is reflected in end of service program evaluations that were administered to families served. Last year’s accomplishments were: 82.7% of clients indicated they could not afford IBCLC and/or professional postpartum doula services, 96.8% enjoyed enhanced confidence and broadened knowledge base, 100% who accessed in-home services reported stress reduced, 96.% reported their personal breastfeeding goals supported and met, and 92.7% who accessed full DC model met the 6 month World Health Organization and American Academy of Pediatrics recommendations. DC's 92.7% 6 month exclusive breastfeeding rate is a look into how the state rate of 23.9% will be improved with coordination of care between community resources, strengthening networks of support for families, and a paradigm shift where families come to expect equitable access to quality care.

Organization Type

  • nonprofit/NGO/citizen sector

Annual Budget

  • $100k - $250k

Financial Sustainability Plan: What is your solution’s plan to ensure financial sustainability?

DC services are billable under the Affordable Care Act although current insurance infrastructure cannot support billing. DC will continue its pursuit of insurance reimbursement in coordination with state representatives, as well as contracted services with local school districts & community health organizations. Monthly fundraisers, business sponsorships, individual donations, &100% board giving will continue to supplement grant funding.

Unique Value Proposition: How else is this problem being addressed? Are there other organizations working in the same field, and how does your project differ from these other approaches?

No other organization provides free in-home services from IBCLCs & Postpartum Doulas, DC programs are unduplicated. Three walk-in breastfeeding programs exist in the area but are only available to clients who meet their qualifications and often without an IBCLC. Federal/hospital-based programs target high risk and low income families, often neglecting families that do not give birth in hospital or are not 'in the system'. IBCLC services can start at $160, are often only available after referral from a healthcare provider, and are typically restricted to clinical settings and availability.

Reflect on the Field and its Future: Stepping outside of your project, what do you see as the most important or promising shifts that can advance children’s wellbeing?

Prevention, education, and equitable access are much needed changes to transform health outcomes. Focus has traditionally been given to 'at risk' families for homevisiting services offered through state and county services. Families that do not meet the standard model of 'at risk' criteria are often left without equitable access to professional services, despite the fact that they may still need support networks and community referrals. It is time for quality care to be accessible to ALL families, regardless of income or risk, it is time for a paradigm shift.

Source: How did you hear about the Children’s Wellbeing Challenge? (the answer will not be public)

  • Email

Referral: If you discovered the Challenge thanks to an organization or person other than Ashoka, who was it? (the answer will not be public)

Robert Wood Johnson Foundation

Program Design Clarity

a) New-mothers and their families directly benefit from DC services yet services are not limited to females, as adoptive parents, and single fathers/guardians are also served.
b) Breastfeeding support, promoting the mother-infant dyad, educating regarding newborn/infant care, and providing practical support for stress relief are primary activities of DC services.
c) Clients can be served every day, up to 20hrs in the first 2 wks, and once weekly for the duration of their breastfeeding relationship.
d) IBCLCs and Professional Postpartum Doulas deliver homevisiting and in house services

Community Leadership

In 2014, Key Stakeholder Meetings and a Community Needs Assessment confirmed DC fills a critical gap in Lane County. DC is actively involved in Live Healthy Lane County's Community Health Improvement Plan and serves as a member of the Early Childhood Development Strategy Team. By continually communicating with insurance providers, local hospitals, and community health boards, DC is able to address the changing needs of the community.

Age of Children Impacted

  • Pregnancy - 0
  • 0-1.5
  • 1.5 -3
  • 3 - 5
  • 6 - 12
  • 12+

Spread Strategies

DC is in talks with state representatives and local Health Insurance Commissioner to ensure the coverage of IBCLC and Postpartum Doula services under the ACA. By looking at other state legislation that support these services, DC has been able to build infrastructure that would support the future expansion of these programs to different cities and states. Achieving state and nationwide recognition for these award winning services is paramount.

Reflect on how your work helps children to thrive. How are you cultivating children’s sense of self, belonging, and purpose through your model?

DC services increase attachment and bonding between new-parents and their newborn. Research shows that by soothing a crying baby, addressing hunger cues and signs of discomfort, newborns build confidence in their environment and their caregiver that lasts a lifetime. Most parents have the tools to provide healthy outcomes for their children, they just need to be empowered to do so and a child's emotional needs will consequently be met.

What awards or honors has the project received? (Optional)

2013 & 2015 IBCLC Community Care Award, 2013-2016 World Breastfeeding Week Proclamations: City of Eugene & City of Springfield, OPHI Genius Award Nominee, 1 of 6 contracts to partner with the local CCO Trillium, 2016 Lane County Excellence in Public Health Award, Pioneer in the Children’s Wellbeing

Organization's Twitter Handle

@DC_Mothering

Organization’s Facebook Page (URL)

https://www.facebook.com/DaisyCHAINMothering

Evaluation results

4 evaluations so far

1. Relevance: Does this project seem to help children (ages 0 to 12 years) develop a strong sense of self, belonging, and purpose?

5 - Yes, this is great! The project lays out a strong, compelling case for how its model nurtures children’s wellbeing. - 25%

4 - It seems like a good fit, and the model talks explicitly about children’s wellbeing. - 50%

3 - I think so. The project seems related to children’s wellbeing, but the logic is vague. - 25%

2 - Not sure. The project doesn’t have much to do with wellbeing, or it doesn’t give enough information. - 0%

1 - Nope, this project definitely doesn’t fit the challenge brief (e.g., It doesn’t help kids younger than 12, isn’t in the U.S., etc.) - 0%

2. Innovation: Does this project tackle children’s wellbeing from a new angle?

5 - I loved this! The project describes a novel model that addresses important cultural or systemic barriers. - 0%

4 - This is pretty cool. The project is addressing an important problem in a new or compelling way. - 25%

3 - I feel like there’s something there, but I want more details about what makes it distinctive. - 75%

2 - It’s a good project, but I’ve seen others like it before. - 0%

1 - It was confusing or hard to tell what it made it different. - 0%

3. Social Impact: What is this project’s potential for creating positive social impact?

5 - Lots of potential. This project is achieving impressive results, and it’s growing quickly. It could absolutely inspire changes in the ways we approach caring for kids nationally, across sectors (e.g. childcare, healthcare, education). - 0%

4 - Pretty good potential. This project demonstrates significant positive impact so far, and it could scale regionally or nationally one day and fundamentally change how a system operates (e.g. childcare, healthcare, education). - 50%

3 - Budding potential. This project is creating local impact, but it would take a few adjustments before it could scale. - 50%

2 - Some potential. This project demonstrates some initial positive impact, but it would require major changes before it could scale. - 0%

1 - Limited potential. This project has great intentions, but it looks like it does not include key drivers of a shift towards children’s wellbeing. - 0%

4. Overall, how do you feel about this idea?

5 - This idea rocked my world. It’s awesome! - 0%

4 - This idea seems really exciting. With a little more polishing, it’d be among my favorites. - 50%

3 - I think the idea is great, but it needs some work before it moves onto the next round. - 25%

2 - I liked it fine but preferred others. - 25%

1 - It didn’t make my heart beat faster. Needs significant revisions. - 0%

5. Offer some feedback. Where should this participant spend some time revising?

DEFINING THE PROBLEM. Make sure to articulate the root causes or main barriers of the social issue your project addresses. (Founding Story, Problem, Solution). - 0%

CLARITY OF MODEL. Make sure to mention (a.) the beneficiary, b) the main activities, and c) how those activities drive social impact. Keep it streamlined! - 50%

MARKETPLACE. Make sure to research other players in this space and articulate how this project is different. I didn’t get a complete sense of how this project compares to others. - 100%

IMPACT POTENTIAL. Make sure to use specific numbers to describe what your project has achieved so far! And consider how you might scale the model or its insights, through partnerships, trainings, or franchising. - 50%

WRITING STYLE. Try to stay concise and make it vivid. Avoid jargon. - 0%

Nothing stands out! I thought it was great. - 50%

2 comments

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Photo of Tambra Raye Stevenson
Team

I love the focus on providing prevention, education and support to mothers. Given the stressors and lack of support for many parents, having this model can be the difference in saving a life. Thank you for your invaluable work!

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