Doulas for Health Reform

~ by Rachel Abramson, RN, MS, IBCLC, Executive Director, HealthConnect One


The Supreme Court decision on Health Reform comes down tomorrow. Yet, regardless of the outcome, the way people look at health care in this country has fundamentally changed since the Affordable Care Act (ACA) was introduced, debated, and signed into law.

Now people seem to understand the importance of prevention and health promotion.  Now people realize how unfair the health system can be. Now people are seeing the benefits of health reform in their coverage and their wallets. Now people are beginning to understand how huge the issue of health care is for our country. I am confident these lessons will stick, no matter what decision is handed down by the Supreme Court.

As the Executive Director of HealthConnect One, I have been committed to these issues for my entire career. Many of you have been, too.  Our work will continue, whether the Supreme Court agrees or disagrees with the constitutionality of the individual mandate.

But the debate will never be the same again:

  • How to invest in health and pay for health care
  • Whose responsibility this really is
  • The financial and human costs of chronic disease and obesity
  • The role of government

Are there other open questions you see from where you stand?

I’ve been encouraged to hear the leaders of our country asking the question our program partners, our donors, our community-based doulas and breastfeeding peer counselors have grappled with for over 25 years: How do we improve a community’s health?  How can we do things differently?

Time and again, I have been inspired by the impact of HC One’s community-based doula model in action.  I see this community health worker role as a template for innovative practices that change the future, and I have told the stories to my Senators and Representatives.  We see how one trusted mentor guides one pregnant mom through her prenatal care, delivery, and the early months of parenting.  We watch this happen over and over again.  We notice how this bond re-shapes both women’s lives.  This work absolutely improves health for mothers and babies.  It also strengthens and sustains communities.

When we stormed Capitol Hill during the last days before Health Reform was passed, proclaiming, “We are doulas for health reform,” we knew that if the vote was YES our country would refocus resources and start to level the playing field.

It’s been two and a half years since our victory. HC One’s doulas for health reform will continue advocating for community-centered health policies, with or without the Supreme Court’s support of the ACA. But we are all waiting – together – to see what tomorrow will bring.


Photo by Flint Chaney, 2011


Rachel Abramson is a master’s-prepared nurse and an International Board Certified Lactation Consultant.  She has provided leadership for HealthConnect One since 1986, for which she has received numerous awards – including APHA’s first Maternal and Child Health Outstanding Leadership and Advocacy Award (2009), the National Healthy Mothers, Healthy Babies State Impact Award (2003), and the Start Early: Learning Begins at Birth Award (2003) from Voices for Illinois Children.  She is co-author of The Community-based Doula: Reclaiming Birth, Empowering Families, published by Zero to Three Press in 2006.


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