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.
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.
