May 9, 2025 • 18 mins
Birth is influenced by three major stakeholders with different objectives: the birthing people, the birth place, and the policies governing care. Understanding the "Three P's" helps expectant parents navigate their birth journey and identify where their interests align with the larger healthcare system.
• Birthing people want safety, support, a voice in their care, and a positive, meaningful experience
• Hospitals focus on clinical safety while balancing risk management, efficiency, standardization, and resource allocation
• Insurance companies prioritize cost management but share interests with families in reducing unnecessary interventions
• Birth centers often have more alignment with birthing people's objectives than hospitals do
• Doulas create value by improving outcomes in ways that benefit both families and insurance companies
• Even within large healthcare systems, families can make requests that personalize their care
• Human connection and compassionate care significantly impact the birth experience
Please reach out today and make a human connection. Do something kind for someone nearby – whether a stranger or someone you know – and you won't regret it.
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Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello and welcome to the Ordinary Doula podcast.
My name is Angie Rozier, I'myour host and I appreciate you
being here with us today.
As always, I like to cover someinteresting or important points
about all things surroundinglabor, birth, pregnancy,
postpartum, lactation.
That's kind of a big packagebut lots of different pieces and
(01:11):
parts to it.
So today I want to talk about Icall it the three Ps the three
Ps of this whole experience.
So the experience being gettinga tiny human here.
However, you, you know thatjourney looks different for
everyone.
So I want you to envision alittle baby just sitting there,
right like it's.
It's arrived, it's earth side,it's maybe it's being held by
(01:33):
its parents, it's hanging out inthe warmer.
It's cute, it's tiny, it'slittle and um, think of all the
moving parts that had a hand ingetting that little baby here
and all the interested parties.
So what matters most aboutbirth and to whom does it matter
?
So the three P's I like toconsider in this are the people,
(01:56):
the place and the policiesPeople, place and policy.
So the people, of course, arethose that are giving birth,
those that are having babies,those that are expanding their
families, the people generallyit's a woman and a partner.
Those are the main people,those are the main players here.
But their experience has a lotto do with the other two Ps,
(02:18):
which is place and policy.
So the objectives about these,the same experience from these
different groups, is a littlebit different.
Um, so the people, especiallyif they've chosen right, they've
sought after this pregnancy,they've chosen to deliver a baby
at this time, hopefully theyhad some choice in where to do
it and with whom to do it.
(02:39):
But sometimes they don't right,sometimes that's all driven by
insurance, right, and whatchoices you do or you do not
have when it's based oninsurance.
But the heart is at the matter.
Like they want a healthy, happybaby.
They want a healthy, happy momat the end of that experience.
That's their whole goal is thatthey have.
(03:01):
You know, they bring this babyinto the world and it should be
a happy, joyful time.
Not always the case, of course.
The objectives of the other twoPs the place and the policy are
a little bit different.
They're driven by differentfactors of just.
We want a great experience, wewant a healthy, happy baby.
They do want those things,especially the health of the
baby and the mom.
(03:22):
That's hugely important to them.
But what are their drivers forthat right?
There's a lot of timesfinancially driven that they're.
That's what's driving theirobjectives.
So let's go over these three Ps,the main objective from the
people right, the people havingthe baby.
They want to feel safe andsupported and they'll hopefully
(03:42):
choose a place that they feelsafe and hopefully feel
supported by the team theysurround themselves with.
That's not always the case.
That's another rabbit hole wecould dive into a little bit
later.
They also want to be heard.
They want to have a voice.
They want to make sure that inthat place and with the people
whom they choose to besurrounded with, that they have
a voice, that their concerns areheard, their fears are heard.
The people want to be heard.
(04:09):
They also want a sense ofempowerment so that they're
taking part in their birthexperience.
It's not just being done tothem, they're not just, you know
, an object going through themotions there, but they want a
sense of empowerment andautonomy around that.
They also want continuity ofcare and compassion to be given
to them.
They think they honestly thinkand hope that those caring for
them are going to look out forthem, have their best interests
(04:31):
in mind, really, genuinely,truly care for them and provide
compassion for them.
That may or may not be the case, depending on the places and
the policy that surround that,but they want continuity of care
and compassion, so being withpeople they know they trust,
even if they just get to knowthem over a period of hours and
they want to believe thatthey're being taken care of.
They also want a positive andmeaningful memory, so they want
(04:54):
to be able to look back on thisbirth experience and say you
know what?
That was awesome, we were wellcared for, I liked that
experience.
That's not always the case.
I work with people all the timewho look back on their birth
experience and it was anythingbut positive.
Meaningful maybe, yes, but itmight not be meaningful in a
very great way.
They also want, of course, ahealthy baby and a healthy
(05:15):
parent.
So those things feel safe andsupported, be heard and have a
voice, have a sense ofempowerment and autonomy.
Continuity of care withcompassion, positive, meaningful
memory, healthy baby, healthyparent that's the main goal of
the people.
Let's move to the next P theplace.
So the place is oftentimes ahospital.
In the United States, we'remost often delivering in a
hospital setting, so prettyclinical setting.
(05:37):
Our hospitals range from verysmall to very large, that they
both have benefits being small,being large, being rural, being
urban, being a research hospital, being a teaching hospital,
being a small community hospitalthere's lots of different
hospital settings.
This is in, but here's the mainobjectives from the place,
(05:57):
right?
So all the drivers that go intothis, from hospital
administration to the hospitalmarketing team, to your medical
director, to your teams of OBs,midwives, to your nurse manager,
to all the teams of nurses, tothe housekeepers, to the you
know we've got kitchen and foodservices, nutrition services All
of that is the place.
There's so much tied up intoplace.
(06:19):
So here's what they want out ofthis Getting a little human here
.
Here's what they're looking forSafety of parent and baby Great
overlap.
That's what the patient wantedas well, the people being the
patient.
So that would be clinicaloutcomes.
The clinical outcomes are good.
That means we're having healthymoms, healthy babies.
Everyone's safe medically atthe end of the day.
(06:39):
They also are looking at riskmanagement and liability
avoidance, right.
So they're going to setpolicies into place that are
going to keep their personal,well, financial, corporate,
bureaucratic risk low.
They want to manage their riskand they want to avoid liability
so that if any mistakes aremade, anything's done.
(07:01):
That shouldn't, that that isnot going to cost them a whole
lot of money in a lawsuit or incourt, right?
So risk management, liabilityavoidance, efficiency they want
efficiency.
This is a machine, thesehospitals, and regardless of
their size, they want efficiencyand throughput.
That means like systems goingthrough as we're putting
(07:22):
patients on the conveyor belt,getting them through, and we've
kind of standardized care to dothat right.
Another objective is protocoladherence and standardization.
When we are cranking a bunch ofmoms and babies through a
system to be efficient we haveto have some systems in place.
So standardization of care andprotocol adherence.
So that's protocol for everypiece of the team and that
(07:47):
includes all the people wetalked about labs, pharmacists,
nutrition and food services,nurses, providers.
There's protocol adherence.
So your staff is being reallywell trained on what to do, how
to do it, why to do it, when todo it and, of course, how to
document it right.
So we crank people through onthis pretty standard system.
That doesn't always overlap wellwith what people may want.
(08:09):
They may want something alittle different outside of that
standardization, and a curiousthing is how are they treated?
How are they, you know, doesthat compassion remain in place?
If somebody wants something alittle bit different, it depends
on the place in the hospital.
So another objective for thehospital is data collection and
reporting.
So they are collecting data.
You know that every singlething is being documented.
(08:29):
Charting is going on, almostmore than patient care charting
is going on, so that they'recollecting data.
They can learn a lot from thedata that they collect, because
a lot of places they're workingin higher volumes, right, and
they're gonna report that datato different entities, to
themselves, to their corporation, to the NIH, to the CDC.
(08:50):
Like there's data collectiongoing on.
We're kind of being data minedas being a patient, any patient
is being data mined.
And then also resourceallocation and staffing.
So they have a certain numberof people that they have to do a
certain amount of work with.
So a lot of human hours go intoresource allocation and
staffing and that's resourcesall the way down to your linens,
(09:10):
to the foods, to themedications, things available
from the pharmacy to the manhours available, woman hours in
many cases.
So staffing with a certainamount of nurses, other staff,
that's if we have techs, if wehave providers on call, all that
resource allocation andstaffing.
That is because of the size ofthe system.
(09:34):
That is a whole lot of humanhours going into getting a baby
here, right, they make acorporation out of it.
They make a whole big to-doabout it and it's a billions and
billions of dollar corporationdoing that.
Okay, we're going to move to thethird P and that's policy.
So policy can come from acouple of different places.
(09:54):
I'm going to speak specificallyto policies generally from
healthcare providers.
So this would be like yourinsurance companies, your
healthcare plans.
These are pretty big players aswell who are definitely
interested.
They have, you know, a lot ofskin in the game when a patient
(10:16):
is delivering a baby.
Another piece of policy we'renot going to talk a whole lot
about is legislative policy.
So every state and on a federallevel there's also legislation,
of course, that affects policy.
But for now, for the purposesof today, we're going to talk
about policy as coming fromhealth plans and insurance
companies who provide medicalinsurance.
(10:37):
So your private employers aregoing to be involved with this
Also.
We might have definitelyMedicaid involved with this, and
here are some things, theobjectives that they're
interested in Cost managementand risk reduction, all right.
So whatever happens at the place, at the hospital.
This is who's paying for it byand large, right.
So cost management theinsurance policy is going to be
(11:01):
very alarmed with a c-sectionrate that's extremely high or
NICU stays that are extremelyhigh.
They want to reduce costs andreduce risks, right?
So the more interventions wehave and the more risks,
sometimes, the more the cost.
Of course, they also want topromote preventative and
value-based care.
(11:21):
So this is awesome.
This is kind of goes to whatthe people want in a lot of
cases and, because this is adoula podcast want in a lot of
cases, and because this is adoula podcast, this aligns
really well with what doulasobjectives are as well to
promote preventative andvalue-based care.
So a doula is a cost item.
It takes, you know, a doularequires some money from someone
(11:42):
that that doula is getting paid, but the value of that can
really prevent a lot of othercost management, extremely high
cost management things by havinga value-based care system in
place.
So the insurance companies arepretty interested in that and
that can include, like it says,preventative things childbirth
education, lactation support,doula support.
(12:06):
Hopefully those go into thepostpartum period as well.
Another objective from thepolicy the health plans the
insurance companies is networkmanagement and utilization
control.
So they may have a certainnumber of members or lives, they
call them, maybe it's 30,000,100,000, we can get up into the
millions.
They need to manage thatnetwork.
Also, systems are requiredthere because of the size of
(12:28):
things and then utilizationcontrol.
So, depending on what theirmembers and those who have that
health plan are doing, um, theirpopulation, whatever their
population is doing, they haveto you know what are they're
going to assess data all thetime too, like what are we
utilizing?
Are we ever utilizing, um, youknow, coverage for uh, urology
(12:50):
or for ortho?
Like there's all differentkinds of things we could look at
.
They're also very interested indata collection and quality
control for a little bitdifferent reasons, but they want
to know where's our money going, where's our pain points,
where's our value-based points,when can we kind of reallocate
that?
Another objective of theirswhich I absolutely love and
where they align really wellwith doulas is reducing cesarean
(13:11):
rates and unnecessaryinterventions.
Their purpose might bedifferent than the patient's
purpose, but that's great.
We're on the same page thereabout reducing cesarean rates,
which in turn reduces costs,right, can reduce NICU stays and
unnecessary interventions.
That can be anything from, youknow, internal monitors to
(13:34):
forceps, vacuum delivery, anyinstrument, assisted deliveries
but they want to reduce thosekinds of things.
For them it's about money, butwe love that it aligns with what
the patient wants.
They also want to encouragealternative care models when
it's cost effective, right.
So alternative care modelsmight be kind of thinking
outside the box.
I work for an insurance companyright now who happens to provide
(13:55):
doula services on their healthplans Awesome, they're thinking
outside the box and that's avalue-based preventative
promotion where they can providedoula services to encourage
more cost-effective care, tokeep down those costs and other
risks that can be involved withchildbirth with higher
(14:16):
interventions.
And then member satisfactionand retention that kind of comes
last on the list, but they wantpeople to be satisfied with
their care.
They want to provide qualityproducts at quality places so
that their population remainshealthy right, so that they are
taking care of their people atthe lowest possible to them.
(14:38):
So kind of interesting as welook at that simple act of
getting a baby to Earthside andall the different players
involved in that, it's kind ofmore complicated and there's a
lot more fingers in the pie, ifyou will, than we sometimes
realize, but it's interesting tonote that, again from a doula
standpoint, doulas and insurancecompanies have a whole lot of
(15:01):
overlap when it comes to theobjectives they're trying to
achieve.
So, going back to and this isto impact and affect all people,
right, people of all differentbackgrounds, around different
parts of the country when we canadd a value-based care item,
which a doula is and that canhave good impacts on birth
(15:24):
outcomes, which has good impactson costs, that's going to be
very helpful.
It helps everyone out.
So keep in mind the people, theplace and the policy.
Wherever you're having a baby,kind of dig into those things,
do a little research, ask somequestions.
(15:46):
What people are going to beinvolved, of course you know you
yourself having a baby and orthe people you choose to
surround you with from yourimmediate circle, the place
you're in.
Now, this is all different fora birth center, right.
This is kind of looks a lotdifferent for a birth center,
where there's a whole lot moreoverlap in objectives between
birth centers and people thanthere is from hospitals and
people, for a variety of reasons.
(16:07):
And then policy, whether that'slegislative policy based on this
particular place you live orthe healthcare that is available
to you and not everybody hasamazing healthcare available to
them.
That also is going to affectthe experience as we look at
getting a little human earthside.
So take a look at those things.
They're very important.
(16:28):
People play some policy.
Hopefully you can have goodoptions available to you.
You can tweak a few things,make a few requests Even in
these big systems we can makesome requests that might go
against quote unquote policy sothat you have a more
compassionate experience, usesome continuity of care and have
(16:49):
high quality care given to you.
That's my desire and goal foreveryone that I work with is
that they have stellar healthcare given to them, not just
clinically, but human to human.
That human to human contact andconnection is going to be
important in their experience.
So we'll wrap this up today.
Again.
I want to end with as I do withall episodes please reach out
(17:12):
today, make a human connection,whether that's with a stranger
or someone you know.
Reach out and touch the life ofsomeone around you, do
something kind for someonenearby and you won't regret it.
Thanks for being with me heretoday.
Again, this is Angie Rozierwith the Ordinary Doula Podcast
Looking forward to seeing younext time.
Speaker 1 (17:44):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving Birth.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello and welcome to the Ordinary Doula podcast.
My name is Angie Rozier, I'myour host and I appreciate you
being here with us today.
As always, I like to cover someinteresting or important points
about all things surroundinglabor, birth, pregnancy,
postpartum, lactation.
That's kind of a big packagebut lots of different pieces and
(01:11):
parts to it.
So today I want to talk about Icall it the three Ps the three
Ps of this whole experience.
So the experience being gettinga tiny human here.
However, you, you know thatjourney looks different for
everyone.
So I want you to envision alittle baby just sitting there,
right like it's.
It's arrived, it's earth side,it's maybe it's being held by
(01:33):
its parents, it's hanging out inthe warmer.
It's cute, it's tiny, it'slittle and um, think of all the
moving parts that had a hand ingetting that little baby here
and all the interested parties.
So what matters most aboutbirth and to whom does it matter
?
So the three P's I like toconsider in this are the people,
(01:56):
the place and the policiesPeople, place and policy.
So the people, of course, arethose that are giving birth,
those that are having babies,those that are expanding their
families, the people generallyit's a woman and a partner.
Those are the main people,those are the main players here.
But their experience has a lotto do with the other two Ps,
(02:18):
which is place and policy.
So the objectives about these,the same experience from these
different groups, is a littlebit different.
Um, so the people, especiallyif they've chosen right, they've
sought after this pregnancy,they've chosen to deliver a baby
at this time, hopefully theyhad some choice in where to do
it and with whom to do it.
(02:39):
But sometimes they don't right,sometimes that's all driven by
insurance, right, and whatchoices you do or you do not
have when it's based oninsurance.
But the heart is at the matter.
Like they want a healthy, happybaby.
They want a healthy, happy momat the end of that experience.
That's their whole goal is thatthey have.
(03:01):
You know, they bring this babyinto the world and it should be
a happy, joyful time.
Not always the case, of course.
The objectives of the other twoPs the place and the policy are
a little bit different.
They're driven by differentfactors of just.
We want a great experience, wewant a healthy, happy baby.
They do want those things,especially the health of the
baby and the mom.
(03:22):
That's hugely important to them.
But what are their drivers forthat right?
There's a lot of timesfinancially driven that they're.
That's what's driving theirobjectives.
So let's go over these three Ps,the main objective from the
people right, the people havingthe baby.
They want to feel safe andsupported and they'll hopefully
(03:42):
choose a place that they feelsafe and hopefully feel
supported by the team theysurround themselves with.
That's not always the case.
That's another rabbit hole wecould dive into a little bit
later.
They also want to be heard.
They want to have a voice.
They want to make sure that inthat place and with the people
whom they choose to besurrounded with, that they have
a voice, that their concerns areheard, their fears are heard.
The people want to be heard.
(04:09):
They also want a sense ofempowerment so that they're
taking part in their birthexperience.
It's not just being done tothem, they're not just, you know
, an object going through themotions there, but they want a
sense of empowerment andautonomy around that.
They also want continuity ofcare and compassion to be given
to them.
They think they honestly thinkand hope that those caring for
them are going to look out forthem, have their best interests
(04:31):
in mind, really, genuinely,truly care for them and provide
compassion for them.
That may or may not be the case, depending on the places and
the policy that surround that,but they want continuity of care
and compassion, so being withpeople they know they trust,
even if they just get to knowthem over a period of hours and
they want to believe thatthey're being taken care of.
They also want a positive andmeaningful memory, so they want
(04:54):
to be able to look back on thisbirth experience and say you
know what?
That was awesome, we were wellcared for, I liked that
experience.
That's not always the case.
I work with people all the timewho look back on their birth
experience and it was anythingbut positive.
Meaningful maybe, yes, but itmight not be meaningful in a
very great way.
They also want, of course, ahealthy baby and a healthy
(05:15):
parent.
So those things feel safe andsupported, be heard and have a
voice, have a sense ofempowerment and autonomy.
Continuity of care withcompassion, positive, meaningful
memory, healthy baby, healthyparent that's the main goal of
the people.
Let's move to the next P theplace.
So the place is oftentimes ahospital.
In the United States, we'remost often delivering in a
hospital setting, so prettyclinical setting.
(05:37):
Our hospitals range from verysmall to very large, that they
both have benefits being small,being large, being rural, being
urban, being a research hospital, being a teaching hospital,
being a small community hospitalthere's lots of different
hospital settings.
This is in, but here's the mainobjectives from the place,
(05:57):
right?
So all the drivers that go intothis, from hospital
administration to the hospitalmarketing team, to your medical
director, to your teams of OBs,midwives, to your nurse manager,
to all the teams of nurses, tothe housekeepers, to the you
know we've got kitchen and foodservices, nutrition services All
of that is the place.
There's so much tied up intoplace.
(06:19):
So here's what they want out ofthis Getting a little human here
.
Here's what they're looking forSafety of parent and baby Great
overlap.
That's what the patient wantedas well, the people being the
patient.
So that would be clinicaloutcomes.
The clinical outcomes are good.
That means we're having healthymoms, healthy babies.
Everyone's safe medically atthe end of the day.
(06:39):
They also are looking at riskmanagement and liability
avoidance, right.
So they're going to setpolicies into place that are
going to keep their personal,well, financial, corporate,
bureaucratic risk low.
They want to manage their riskand they want to avoid liability
so that if any mistakes aremade, anything's done.
(07:01):
That shouldn't, that that isnot going to cost them a whole
lot of money in a lawsuit or incourt, right?
So risk management, liabilityavoidance, efficiency they want
efficiency.
This is a machine, thesehospitals, and regardless of
their size, they want efficiencyand throughput.
That means like systems goingthrough as we're putting
(07:22):
patients on the conveyor belt,getting them through, and we've
kind of standardized care to dothat right.
Another objective is protocoladherence and standardization.
When we are cranking a bunch ofmoms and babies through a
system to be efficient we haveto have some systems in place.
So standardization of care andprotocol adherence.
So that's protocol for everypiece of the team and that
(07:47):
includes all the people wetalked about labs, pharmacists,
nutrition and food services,nurses, providers.
There's protocol adherence.
So your staff is being reallywell trained on what to do, how
to do it, why to do it, when todo it and, of course, how to
document it right.
So we crank people through onthis pretty standard system.
That doesn't always overlap wellwith what people may want.
(08:09):
They may want something alittle different outside of that
standardization, and a curiousthing is how are they treated?
How are they, you know, doesthat compassion remain in place?
If somebody wants something alittle bit different, it depends
on the place in the hospital.
So another objective for thehospital is data collection and
reporting.
So they are collecting data.
You know that every singlething is being documented.
(08:29):
Charting is going on, almostmore than patient care charting
is going on, so that they'recollecting data.
They can learn a lot from thedata that they collect, because
a lot of places they're workingin higher volumes, right, and
they're gonna report that datato different entities, to
themselves, to their corporation, to the NIH, to the CDC.
(08:50):
Like there's data collectiongoing on.
We're kind of being data minedas being a patient, any patient
is being data mined.
And then also resourceallocation and staffing.
So they have a certain numberof people that they have to do a
certain amount of work with.
So a lot of human hours go intoresource allocation and
staffing and that's resourcesall the way down to your linens,
(09:10):
to the foods, to themedications, things available
from the pharmacy to the manhours available, woman hours in
many cases.
So staffing with a certainamount of nurses, other staff,
that's if we have techs, if wehave providers on call, all that
resource allocation andstaffing.
That is because of the size ofthe system.
(09:34):
That is a whole lot of humanhours going into getting a baby
here, right, they make acorporation out of it.
They make a whole big to-doabout it and it's a billions and
billions of dollar corporationdoing that.
Okay, we're going to move to thethird P and that's policy.
So policy can come from acouple of different places.
(09:54):
I'm going to speak specificallyto policies generally from
healthcare providers.
So this would be like yourinsurance companies, your
healthcare plans.
These are pretty big players aswell who are definitely
interested.
They have, you know, a lot ofskin in the game when a patient
(10:16):
is delivering a baby.
Another piece of policy we'renot going to talk a whole lot
about is legislative policy.
So every state and on a federallevel there's also legislation,
of course, that affects policy.
But for now, for the purposesof today, we're going to talk
about policy as coming fromhealth plans and insurance
companies who provide medicalinsurance.
(10:37):
So your private employers aregoing to be involved with this
Also.
We might have definitelyMedicaid involved with this, and
here are some things, theobjectives that they're
interested in Cost managementand risk reduction, all right.
So whatever happens at the place, at the hospital.
This is who's paying for it byand large, right.
So cost management theinsurance policy is going to be
(11:01):
very alarmed with a c-sectionrate that's extremely high or
NICU stays that are extremelyhigh.
They want to reduce costs andreduce risks, right?
So the more interventions wehave and the more risks,
sometimes, the more the cost.
Of course, they also want topromote preventative and
value-based care.
(11:21):
So this is awesome.
This is kind of goes to whatthe people want in a lot of
cases and, because this is adoula podcast want in a lot of
cases, and because this is adoula podcast, this aligns
really well with what doulasobjectives are as well to
promote preventative andvalue-based care.
So a doula is a cost item.
It takes, you know, a doularequires some money from someone
(11:42):
that that doula is getting paid, but the value of that can
really prevent a lot of othercost management, extremely high
cost management things by havinga value-based care system in
place.
So the insurance companies arepretty interested in that and
that can include, like it says,preventative things childbirth
education, lactation support,doula support.
(12:06):
Hopefully those go into thepostpartum period as well.
Another objective from thepolicy the health plans the
insurance companies is networkmanagement and utilization
control.
So they may have a certainnumber of members or lives, they
call them, maybe it's 30,000,100,000, we can get up into the
millions.
They need to manage thatnetwork.
Also, systems are requiredthere because of the size of
(12:28):
things and then utilizationcontrol.
So, depending on what theirmembers and those who have that
health plan are doing, um, theirpopulation, whatever their
population is doing, they haveto you know what are they're
going to assess data all thetime too, like what are we
utilizing?
Are we ever utilizing, um, youknow, coverage for uh, urology
(12:50):
or for ortho?
Like there's all differentkinds of things we could look at
.
They're also very interested indata collection and quality
control for a little bitdifferent reasons, but they want
to know where's our money going, where's our pain points,
where's our value-based points,when can we kind of reallocate
that?
Another objective of theirswhich I absolutely love and
where they align really wellwith doulas is reducing cesarean
(13:11):
rates and unnecessaryinterventions.
Their purpose might bedifferent than the patient's
purpose, but that's great.
We're on the same page thereabout reducing cesarean rates,
which in turn reduces costs,right, can reduce NICU stays and
unnecessary interventions.
That can be anything from, youknow, internal monitors to
(13:34):
forceps, vacuum delivery, anyinstrument, assisted deliveries
but they want to reduce thosekinds of things.
For them it's about money, butwe love that it aligns with what
the patient wants.
They also want to encouragealternative care models when
it's cost effective, right.
So alternative care modelsmight be kind of thinking
outside the box.
I work for an insurance companyright now who happens to provide
(13:55):
doula services on their healthplans Awesome, they're thinking
outside the box and that's avalue-based preventative
promotion where they can providedoula services to encourage
more cost-effective care, tokeep down those costs and other
risks that can be involved withchildbirth with higher
(14:16):
interventions.
And then member satisfactionand retention that kind of comes
last on the list, but they wantpeople to be satisfied with
their care.
They want to provide qualityproducts at quality places so
that their population remainshealthy right, so that they are
taking care of their people atthe lowest possible to them.
(14:38):
So kind of interesting as welook at that simple act of
getting a baby to Earthside andall the different players
involved in that, it's kind ofmore complicated and there's a
lot more fingers in the pie, ifyou will, than we sometimes
realize, but it's interesting tonote that, again from a doula
standpoint, doulas and insurancecompanies have a whole lot of
(15:01):
overlap when it comes to theobjectives they're trying to
achieve.
So, going back to and this isto impact and affect all people,
right, people of all differentbackgrounds, around different
parts of the country when we canadd a value-based care item,
which a doula is and that canhave good impacts on birth
(15:24):
outcomes, which has good impactson costs, that's going to be
very helpful.
It helps everyone out.
So keep in mind the people, theplace and the policy.
Wherever you're having a baby,kind of dig into those things,
do a little research, ask somequestions.
(15:46):
What people are going to beinvolved, of course you know you
yourself having a baby and orthe people you choose to
surround you with from yourimmediate circle, the place
you're in.
Now, this is all different fora birth center, right.
This is kind of looks a lotdifferent for a birth center,
where there's a whole lot moreoverlap in objectives between
birth centers and people thanthere is from hospitals and
people, for a variety of reasons.
(16:07):
And then policy, whether that'slegislative policy based on this
particular place you live orthe healthcare that is available
to you and not everybody hasamazing healthcare available to
them.
That also is going to affectthe experience as we look at
getting a little human earthside.
So take a look at those things.
They're very important.
(16:28):
People play some policy.
Hopefully you can have goodoptions available to you.
You can tweak a few things,make a few requests Even in
these big systems we can makesome requests that might go
against quote unquote policy sothat you have a more
compassionate experience, usesome continuity of care and have
(16:49):
high quality care given to you.
That's my desire and goal foreveryone that I work with is
that they have stellar healthcare given to them, not just
clinically, but human to human.
That human to human contact andconnection is going to be
important in their experience.
So we'll wrap this up today.
Again.
I want to end with as I do withall episodes please reach out
(17:12):
today, make a human connection,whether that's with a stranger
or someone you know.
Reach out and touch the life ofsomeone around you, do
something kind for someonenearby and you won't regret it.
Thanks for being with me heretoday.
Again, this is Angie Rozierwith the Ordinary Doula Podcast
Looking forward to seeing younext time.
Speaker 1 (17:44):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving Birth.
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