The Milwaukee Health Department’s free doula program will now contract with individual doulas instead of employing them on staff, a change meant to allow for more flexible work hours for a job rarely carried out 9 to 5.
The Birth Outcomes Made Better Doula Program, known as BOMB, aims to connect more pregnant women in Milwaukee with doulas, who provide emotional support and education around the time of childbirth and have been shown to reduce the many health risks associated with birth. The program has enrolled 513 families since it began in late 2020.
But it was challenged with employees who were constrained by typical business hours and often had to work additional nights and weekends, creating overtime.
“It’s very difficult to fund and keep a program going when you have staff only hired those hours,” said Lori Plahmer, deputy commissioner of the health department’s Family and Community Health division.
The department is finalizing contracts with doulas and expects to work with between six and 12 of them, said BOMB Doula Program Manager Christina Drain. The program was previously allotted eight doulas directly employed by the health department, but there were often vacancies.
Doula work has been of growing interest in Milwaukee, which has among the highest infant mortality rates of any city in the country – especially among Black residents, who are also more likely than white residents to die from complications during or after pregnancy.
Studies show that women who work with a doula are less likely to require a cesarean section, have a preterm delivery or experience postpartum depression. Doulas can also reduce racial disparities by better understanding and advocating for their clients.
The BOMB Doula Program is open to any Milwaukee resident who is less than 30 weeks pregnant. Clients will meet with their doula between four and eight times before birth, including a meeting with the client’s medical team (doulas do not perform medical tasks). The doula will be present for labor and delivery, Drain said, as well as during the postpartum period.
Under the new employment model, clients will get to keep in touch with their doula for a year postpartum, an increase from three months postpartum under the old model. Postpartum visits are unlimited and can focus on anything from breastfeeding education and how to clean baby bottles to mental health support, Drain said. In the U.S., a majority of maternal deaths occur in the postpartum period.
The doula program will cost the city about $831,000 in 2026. Doulas will now be paid per client, Drain said, giving them more autonomy over how many to take on.
In selecting the doulas, Drain said, the health department is largely looking for experience – “knowing what you’re getting yourself into,” in other words, in a profession that can be mentally taxing.
She said she hopes that the contract model will both allow more residents to work with doulas and pay doulas better to do the job.
Madeline Heim covers health and the environment for the Milwaukee Journal Sentinel. Contact her at 920-996-7266 or mheim@usatodayco.com.
This article originally appeared on Milwaukee Journal Sentinel: Milwaukee doula program goes to contract model to improve availability
Reporting by Madeline Heim, Milwaukee Journal Sentinel / Milwaukee Journal Sentinel
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