Part One: Two years ago and about 30 births into my doula career I witnessed my first Cesarean Section.

Two years ago and about 30 births into my doula career I witnessed my first Cesarean Section.  Since then I think I’ve attended about 10 more Cesarean births and about 150 births all together.  It is an amazing ratio 1:15 births, much different than the statistics a mother delivering in today’s US hospital setting faces 1:3. My amazing stats are due to the caring providers and facility in which I served.  So before I delve into the story I have to give some background on my set up.  In the early years of my doula career I worked for Maple City Health Care Center (MCHCC), a low-income neighborhood based clinic that provides doula care to all of their pregnant patients.

My Set Up:  Maple City Health Care Center circa 2004-2006

The providers at MCHCC were a general family physician and a certified nurse midwife (CNM).  Both the doctor and midwife worked tirelessly to educate their clients about what kind of birth experience was available to them here in Goshen.  All clients delivered at then Goshen General Hospital, now IU Health Goshen, a facility with caring nursing staff and dedication to honoring a supporting mother/baby experience.

MCHCC recruited me for doula training.  I still remember the conversation with Ellie the prenatal care coordinator.  She pulled me aside one day as the clinic was closing up and wondered if maybe I’d consider training as a doula and attending births with the clinic’s pregnant patients.  The majority of OB patients during this time period were undocumented women from Mexico.  These women lived in the states for less than one year, isolated from their mothers/sisters/friends back home and speaking only Spanish. Their circumstances made a good match for the labor support and translation services of a doula.

It was 2004 and there were 5 or 6 doulas each attending least one birth a month for the patients at the clinic.  We were each individually contracted with the clinic, but supported each other through regular meetings, backup coverage and a general listening ear.  It was ideal for my novice self.  There were so many layers to the work.  There was labor support and navigating hospital birthing, but also the language and culture were a challenge.  Understanding my client’s expectations and needs took intentional effort.  And I loved it.  I thrived.  I was passionate about it enough to scramble to find a sitter for my 3 and 1 year old children each time the labor call came.   

At the clinic all pregnant patients were encouraged to attend prenatal care in the Centering Pregnancy groups. The Centering Pregnancy group was adapted a model to enhance the mother’s experience of her pregnancy and improve health outcomes for her and her baby.  More information on this program is available online at Centering Pregnancy.

This format was perfect for women who were new to our area and living far from their maternal support system.  Educational topics included nutrition, pregnancy discomforts, labor support, VBAC (Vaginal Birth after Cesarean), and breastfeeding.   Ten sessions in total were all presented in English and Spanish.  This information helped women discuss their questions and concerns, process the culture of the US medical system and enable them to feel more confident in the care they were receiving and the birth they anticipated. 

The Outcome:

The effort that the providers and clinic put into offering this service demonstrated each woman is valued and respected in the healthcare setting.   The care provided by the doctor and midwife went a long way to decrease unnecessary cesarean deliveries and increased VBACs (vaginal birth after cesarean).  Doula support was utilized by many of the patients, this support didn’t always mean the birth was short and easy, but it was an experience where women felt cared for and supported.  This is the lesson I learned as I doulaed (this is a word in the birth world) Leticia through Caroline’s birth.  See my next post to read that birth story.