Tag: Birth Doula

Know Better, Do Better

When I was pregnant the first time, I was completely overwhelmed by the process that seemed to be shrouded in mystery. No, not the birth part, that I could find good information about. The great unknowns of how to find a provider, navigating where to go, what to ask, & evaluating my options were the real frustration for me. I did seriously look at the person doing my intake forms with me and say, “this is really confusing, and I’m a graduate student! I can’t even imagine how confusing this system would be for someone with less resources!” No, a doula can’t help you figure out your insurance, BUT here are 3 ways that doulas help demystify things for you:

We’ve Been There!

Yes, most of us have kids and have been there personally, but we’ve ALL been there professionally. As a team, if someone hasn’t been to a birthing location before, we fill each other in on all the details. It’s important to know which door to go to in the middle of the night or if you as the doula are going to be allowed into the triage room with your client. Our experience helps demystify the specifics with each other, but also with our clients. One thing that we focus on during our 2nd prenatal visit with our birth doula clients is discussing logistics. When should you call your doula? Where will we meet up when you’re in labor? All our birth doula clients also get postpartum planning sessions, to try to get your brain thinking about life with a newborn. Having been there, we know how important it is to have a roadmap for when things get foggy. We also know that talking about options and preferences helps take away the mystery and get you started thinking about resources and questions.

Resources Galore

Even if you have great questions, that doesn’t always mean you know where to ask them. Sharing local resources and connections are things that doulas do. I remember being a first time parent and struggling with lactation and not knowing who was knowledgeable enough to help me. Feeding resources are just one place that doulas can help point you in the right direction. This may not sound like a big deal, but doulas make having those resource lists for you a priority so that you don’t have to go searching. We don’t have an opinion about how you do things either, which as a new parent is pretty priceless really.

We hold YOU!

As you’re navigating your life that’s shifted 30 different ways since you got pregnant, your doula holds you. We remind you that shifting is normal and help you find your way forward. This is the kind of demystifying that you don’t often appreciate until it happens to you. Validating your feelings and helping you know that you’re not alone is what having a doula on your team does for you. We remind you that you don’t have to have it all figured out and that pausing in the unknown is ok too. My doula held me as I wrestled with all the options, my doula not only gave me the information to come to my own understanding and decisions, but also the space to do so without pressure. That was so helpful for me, and I know our clients really appreciate it.

How we work

If you’re interested in talking about having a doula for your birth or postpartum team (or both), we’d love to talk to you. You can use this link to schedule a FREE 30 minute call to talk about your needs and who on our team might be a good fit to work with you. We’d love to demystify the doula process for you too.

Don’t Worry, Be Picky

Choosing a care provider that fits isn’t always easy.

After the shock of the positive pregnancy test wears off a little bit, one of the first things you will need to decide is WHO you are going to have as your care provider for this pregnancy and birth. If you’re like me, you start by asking your friends who they used for their pregnancies, and then you make an appointment. Other people make an appointment with their usual GYN and leave it at that. Here are a few things you want to think about when you’re choosing a provider:

Does their idea of birth align with yours?

All providers have ideas about birth based on their training and experience (both professional and personal btw). Generally, OBs are watching to make sure nothing goes wrong and midwives are watching to make sure everything goes right. While that may not sound like a huge difference, I urge you to think about what their expectations might be with each of those approaches. OBs are generally looking to DO something to help while midwives are looking to NOT have to do anything to help. This is a really broad generalization, but an important distinction when you’re thinking about the kind of care that you’re looking for, and the same answer isn’t right for everyone. Think about your specific situation and how you’d like to approach birth. Research has shown, that the provider you choose can make a difference in how your baby comes out in case you didn’t know that already. Here are a few things you might want to know your provider’s attitude about:

  1. Weight Gain: What limits do they have for you? When do they get concerned about baby’s weight in utero?
  2. Ultrasound: How many & when? Why?
  3. Induction: When? Why? How?
  4. Questions: When & where can you ask them? How long are usual appointments?
  5. Schedule: How often are you on call? Who do you share call with? Surgery days?

Location AND Provider Matter

Many times your insurance will dictate which hospital or group of providers they will cover. Look at some of the stats for the location where you’re planning to delivery. You won’t be able to look at provider specific data, but you can definitely ask potential providers their cesarean and episiotomy rates by the way. What about their induction rates? All of these things add up to the way that pregnancy and birth are handled at an institutional level. Is birth handled like an emergency no matter what? Is the staff trained in trauma-informed care? What does it look like to arrive in labor and to go through triage? Can you get a tour before the big day? You’ll have plenty of unexpected things to navigate during your pregnancy and birth, but the location and your treatment shouldn’t honestly be one of them. What are their policies about eating and drinking during labor? What kind of pain relief options do they have? Is anesthesia on site at all times? Do they support VBAC?

This can all seem really overwhelming, especially to first time parents that haven’t ever had to deal with any of these questions. Maybe you’re still trying to figure out how YOU feel about these things before you even can have an opinion about how your provider does. That’s ok, seriously. As doulas, we want you to feel ready to make these decisions. We want to give you all the information you might need to figure out how YOU want to approach pregnancy and birth without any bias. This is one of the reasons we highly recommend a quality childbirth education course for everyone by the way.

Not the vibe?

Finally, it needs to be said that if a provider isn’t the right fit for you, then it’s ok to move on and find someone else. You have NO OBLIGATION to stay with a provider just because you’ve established care or even because you’ve been seeing them since you were a teenager for GYN services. Chances are, they’re so busy they may not even realize you’ve stopped coming to them. Also of note: YOU HAVE A RIGHT TO SWITCH AT ANY TIME, including during labor. You are under ZERO obligation to be cared for by anyone who is not the right fit. You have the right to fire them on the spot and ask for someone else, yes, seriously…including your nurse btw. While that might sound scary, so is being cared for by someone you don’t trust during labor and delivery! You’re the boss applesauce, and if anyone in your space makes you feel anything other than that, you can make a change at any time!

Choosing a provider doesn’t have to be overwhelming. This is one of the things we cover in our FREE E-Book: Getting Started. We also talk about this stuff with all of our clients. Even if you have a limited pool to choose from, we can talk to you about our experiences with different providers. Yes, we do have a list of providers we won’t work with too, and we’re happy to tell you who they are if you ask! You deserve the best, no matter what your skin color, income, or insurance situation is. Demanding better options and hitting the bad providers in the pocketbook is the only way we’re going to make change here, clearly.

After a Cesarean Birth

CBAC, HBAC, or VBAC?

April is Cesarean & VBAC Awareness month, and we know exactly how important it is to recognize both of these ways of giving birth. We know that nationally, around 1 in 3 births happen via cesarean section, and locally that holds fairly true according to the latest available data. While we don’t know the full extent as to WHY the planned hospital birth cesarean rate is so high, “It seems increasingly clear that anxiety and easy access to many medical procedures at hospital may lead to increased levels of intervention, which in turn may lead to further interventions and finally to unnecessary complications (Olsen & Clausen 2023).” All of that is big picture stuff though, and this post is really seeking to speak to the patient side of things. We celebrate ALL births, no matter how they happen. Let’s talk about 3 big areas where doulas can help after a cesarean birth.

Postpartum

The first 6 weeks after cesarean surgery can be challenging. Your body really needs to rest, but you have a newborn to take care of too. Maybe you’re still dealing with pain when you get home and timing medications, or your other kids really want to cuddle but you’re worried they might bust your incision. Lifting restrictions make moving baby, other kids, laundry baskets, etc challenging after a cesarean birth too. Hiring a postpartum doula, even when you didn’t plan to, can be a huge help to your family and your health in those first 6 weeks. Whether you get a doula or not, delegating should definitely be in your wheelhouse, because your body needs TIME to recover properly in this postpartum period at home.

Recovery

Physical recovery is what most people think about after a cesarean birth, and yes that is really important. After that initial 6 weeks, you may want to talk to your provider about physical therapy to work on scar mobilization and pelvic floor therapy too. Yes, even after having cesarean surgery your pelvic floor might need some work. Honestly, I don’t know why pelvic floor PT isn’t a standard referral after having a baby, but that is a blog for another day.

Mental recovery after a cesarean birth is something that we need to talk about more. I often find myself processing with my clients who’ve had cesarean surgery to talk about how things went, even if I wasn’t there for that birth. People react very differently to having cesarean surgery, and we truly believe all feelings are 100% valid. Mental recovery can be very easy for some and others struggle with it for a long time. Processing with a birth professional like a doula or with a therapist trained in birth trauma can be really validating and helpful for some people. This is a service we offer for clients all the time!

Next time

The big question that many people have after a cesarean birth is often, what should they do next time. Should you try for a VBAC (vaginal birth after cesarean), maybe an HBAC (home birth after cesarean), or maybe a planned CBAC (cesarean birth after cesarean) is for you. There is no one right answer that will work for everyone in this situation, and there are many many factors that go into making that decision. As doulas, we tend to nudge people to think about 4 things when they’re discussing what to do for their next birth:

  1. What were the factors that lead to your cesarean surgery?
  2. How do you feel about giving birth again?
  3. Is there information or other support that would be helpful for you to know when making this decision?
  4. How will you feel about your choice in 10 years?

Everyone answers those questions differently, and honestly there is no one right answer that will work for everyone. One thing we can say with the utmost certainty is that no matter what your choices are, our doulas will be there to support you 100% of the way. We’re working to try to help hospitals understand the value of having your doula in the operating room to support you during your surgical birth too, and will keep pushing for this here locally!

We’re very grateful that cesarean surgery exists, as we’ve seen it save lives. At the same time, we know that it is often over used. We LOVE that VBAC is a truly viable option here locally with many providers, and have seen some amazing HBAC births too. Birth is honestly just amazing in all the different ways it happens. If you’ve had a cesarean birth and want support in any of the above ways, don’t hesitate to reach out to us!

I <3 This Community

11 days ago my family, including our sweet dog Buzz was safely outside staring at our house burning down. We lost almost everyTHING in that fire, including our cars. Everyone is ok, and honestly as quickly as it happened, I’m so very grateful for that. That is a picture of my living room the next day. I’ve met with clients in that living room. There is an antique birth stool on the table in the center of the picture that was a gift to me from my mother in law. I do NOT recommend losing your home and everything in it, including your cars, in a house fire, but I want to share a few lessons with you about it here:

Our Community is Amazing!

There were 7 fire trucks at my house in less than 15 minutes. That was impressive. They were all so incredibly kind, and I even got to see a familiar face who took a selfie with me…yes, seriously. Our neighbors came out to put clothes and shoes and blankets on us immediately. We sat in one neighbors’ house when it started to rain. We have had an endless stream of kindness coming our way ever since, and honestly have never felt so surrounded in love.

My doula community both here and around the world has also come together to help us feel the love. My doula mentor Robin Elise Weiss, who many moons ago also had a house fire, has been indispensable! She seriously ran a board meeting for me y’all. I’ve gotten messages from Australia, Germany, California, Canada, Mexico, and sooo many other places, and my heart is so full right now because of them.

2 Small Things

We had a small fire-proof box with all our important documents inside it like our marriage certificate, passports, etc. Get one if you don’t already have one and go make sure all your important documents are actually in it if you do. Change the batteries in your smoke detectors. Seriously, go check them! They can save you. If you don’t have one in your garage already, do that too!

Choose Kindness

There have been incredibly kind people that we’ve interacted with, and then there have been the outlier jerks. When in doubt, choose kindness every single time. I have learned so much about trauma and recognized much of it in myself and my family these past 11 days. We will continue to focus on the goodness and laugh about the ridiculous people, but seriously, choose to be kind to everyone you meet. You never truly know what someone else is dealing with in their life.

Pieces are starting to fall into place for what our life is going to look like for now. We’ve rented a house already where we can stay for the next year if we need to. Life goes on, and we are so thankful for all the kindnesses and for each other more than ever before really. Thank you to everyone who has reached out to us. Doula life continues, and I’m so grateful for the awesome team here that has provided seamless services as I’ve worked to get back to my managerial role. They have continually amazed me as I asked them to step into some roles that I typically have filled. I seriously LOVE this community more now than I even probably could have before this fire. Thank you.

Insider Information

Doulas have the inside scoop on local options without any of the insider bias and protections.

As a doula who has been working here since 2014, I’ve learned quite a bit of insider information that can be really helpful in several situations for expecting families. I recently had a great conversation with a nurse friend who was bemoaning the fact that because she works at a specific facility, she can’t warn people about specific provider habits or tell them all the things that she wishes she could because of policy. My reply, “I do that!” As doulas we are employed by our clients, therefore we answer to them. We get to say the quiet part that hospital employees might know but can’t say out loud, and that’s a pretty valuable service that doulas can offer. Here are three ways that we use that type of insider information with our outside voices.

Provider Selection

Have you ever wondered if your provider is the one driving up the episiotomy rate? The biggest issue I see is a lack of transparency regarding individual practice statistics. Until that issue gets solved, we doulas are happy to tell you what we’ve seen with our clients’ providers. Since 2014, we’ve had the privilege to be able to see most of the providers in our service area catch babies. That means that we know which ones like to pull the old bait and switch–telling you what you want to hear your whole pregnancy and switching gears to their agenda at the end, so late that you don’t even feel like you have a choice to switch to another provider. We know which providers deal well with push back and which ones don’t. We know which ones love to help you have a great experience in the OR and which ones will talk about sports ignoring all of your wishes. Wondering if your pediatrician is going to judge you for exclusively pumping or using a supplementary nursing system? We can tell you that! If you’re looking for a provider, don’t ask your friends or some random group of strangers on the internet all of whom probably only have experience with one or two providers max; ask a group of doulas who’ve actually seen them work and can talk to you about those experiences.

Policy vs Evidence

In case you don’t know, there are a TON of maternity care policies and practices that aren’t based on the scientific evidence at all. As doulas, we can not only tell you what the policies are, but we can also remind you that a hospital policy is not the law. In case nobody has ever told you: you cannot be arrested for drinking water during labor. We work for you, and know that not only is this type of policy not based on the latest scientific evidence or statements from organizations like the American Society of Anesthesiology, but also that it is cruel. We’ll remind you that you are the boss of your own body and you get to make all the decisions regarding what goes in and how things come out too. That’s doesn’t always make us popular, but it does make our clients happy.

Reporting

Whenever we repeat stories of medical mistreatment, we often hear the refrain, “oh I hope they will report them.” It’s pretty hard to report behavior if you don’t know how to do the actual reporting. Not only will we doulas help point out bad behavior, but we’ll help you know how to report it if that is something that you want to pursue. Seriously, we know what to do and will be happy to help you write the correct letters and deliver them to the correct people to help make sure people are held responsible. Reporting obstetric violence is really important to us by the way, and even if the information is supposedly publicly available, we know that finding it can be challenging and especially overwhelming when you have a new baby.

One of the benefits of being a doula is that we get this insider perspective without having any of the bias that comes from being employed by the facility or providers that we work with regularly. We’re employed by our clients. That kind of freedom comes with all the usual self-employment caveats, but it also means that we’re free to say the quiet part out loud. We’re free to talk about our experiences and let people know about which providers we wouldn’t send our worst enemy to versus who we’d let catch our babies. (Yes, there are a few locally that I’d still let do that.) That essence of doula service, the outsider with insider knowledge, is KEY to why we’re such a valuable part of your team!

Is your Cervix ready?

Preparing your cervix for birth might be something to think about and discuss with your provider.

The cervix is the narrow passage at the lower end of the uterus that changes to open and allow the baby (or babies and hopefully the placenta[s] too) to come out for a vaginal birth. Your cervix has a whole bunch of changing to do to get that to happen, including thinning out (effacement), moving from pointing toward your back to your front (posterior to anterior), and opening from 0cm dilation to 10cms. That’s a whole lot of change to happen in a relatively short amount of time for most people. But cervixes can also be confusing, especially when you’re trying to determine if you’re ready to give birth or not. Here are 3 consternating things about cervixes that you might not know!

1. Checks

Checking your cervix is a really common thing for providers to want to do in the office before you ever go into labor. Practices vary as to when this happens, BUT what we do know is that your cervix is NOT a crystal ball. Checking your cervix when you aren’t in labor isn’t necessary, especially if you are planning to wait to go into labor on your own. If you’re planning an induction, getting a cervical exam in the office is a great thing to do so you can talk about your Bishop Score with your provider. If you’re planning to wait, then saying “no thanks” is perfectly ok, as is just keeping on your pants.

Cervical checks when you are in labor are fairly standard. All the hospitals where we attend births require a cervical exam when you arrive to confirm that you are indeed in labor. It is really common to think that you’re in labor, when in fact your cervix isn’t changing at all. Since labor is defined as contractions that cause cervical change, that is why checking your cervix helps confirm this. I have of course seen people have babies without ever getting their cervix checked, mostly at home births and once at a hospital birth where the baby was pretty much born right after the clients arrived, but you should definitely expect to have your cervix examined by someone’s fingers when in labor.

2. Changes

Contractions commonly help your cervix change, BUT there are all kinds of factors that go into when and how your cervix changes. Some people have a cervix that doesn’t like to stay closed. The terrible medical term for this is “incompetent cervix.” Many people with this issue have a medical procedure called a cerclage to hold their cervix together until their baby is developed enough to be born. On the opposite end of that spectrum are people who have had a LEEP procedure. Often times those people have consistent powerful contractions yet struggle to realize change in their cervical dilation due to the buildup of scar tissue from that procedure. There are all kinds of other changes that can cause changes to your cervix to either speed up or slow down such as having had multiple previous births or other cervical procedures. These are definitely something to consider when you are thinking about your birth plan and when you’re preparing your body for birth.

3. Taking Charge

Have I peaked your interest? Did you know there are actually things that you can do to help get your cervix ready for labor? Evening Primrose oil capsules have been shown to help ripen your cervix and shorten the length of the first stage of labor. If you have scar tissue on your cervix, after a LEEP procedure for example, you can also talk to your provider about cervical massage for preparation and during labor too. These are just two of the methods that we know help people take charge of their cervical change before it even has a chance to hinder them.

The other thing we always suggest for people: educate yourself. If you don’t know what all the numbers that are being thrown around you in labor are because you didn’t get a chance to learn before, ASK! The people caring for you WANT you to know what’s going on so you can be an active participant in your care. Your cervix doesn’t have to be one more confusing thing about having a baby. It isn’t some cryptic cone that nobody knows anything about, its a body part that we actually understand fairly well. Pssst, even if you aren’t having a baby, your cervix is a pretty cool thing to understand regarding your fertility too. So take charge of your learning and get to know your cervix. You’ll feel so much better prepared to talk to your provider, ask better questions, & know what’s going on when the big birth day comes.

Black Birth Matters

This Black History Month I want to celebrate the 3 amazing black doulas on our team who are making history every single day! Tamika, Jessica, & Norma are 3 of the kindest humans you will ever meet. All 3 are birth doulas who love serving all kinds of families, but definitely have a very special heart to be able to serve families from the Black Community especially. We know how important culturally congruent care can be to all families, but especially here in the US where maternal mortality is 3-4 times higher for black birthing families than everyone else, and where racism is a daily fact of life.

These 3 doulas are all so very different, but the one thing they have in common is a personal understanding of the black experience here in Evansville. Their experiences help shape the type of doulas they are with all of their clients of course. Their compassion for the struggle of navigating the healthcare system all while worrying that whoever is in charge of your care might be judging you based on your skin color is impeccable. We LOVE the questions that they ask and their approach to helping families, and I learn from every single conversation that I get the chance to have with each of them.

I celebrate these doulas because of their bravery and knowing that this work is about so much more than representation. The human connection is what doula work is all about, and these 3 get it on a cellular level. They are proud black doulas here serving our community and raising beautiful children in a sometimes very challenging place.

I asked one of them what was hard about living here, and her reply was, “I think its because the racism is hidden, so its harder to decide who is trustworthy.” That was a gut punch of a statement, but of course a sentiment shared by many families of color. These doulas get it, because they live it. The best part though, “that we have such a great group of doulas supporting each other who all get it.”

We see you Tamika, Jessica, & Norma out here being the change you want to see in the world. Thank you for trusting this group to be part of your doula community. We appreciate your perspective and work so very much, and are here to support you in every way we can.

Becoming a Doula

Way back in 2014, a mere month after walking the stage to receive my PhD in Medical Anthropology, I traveled to Louisville, KY to attend a birth doula training with the brilliant Robin Elise Weiss. Since then I’ve attended more than 200 doula client births and learned so much along the way. This is the story of how I became a doula.

When I got pregnant during graduate school (not something I recommend btw), I voraciously read everything I could about pregnancy, birth, and postpartum. I could not get enough, and I even had professors sending me articles about how babies learn language before they are born. Naturally I scheduled my German conversation course for the spring semester while I was pregnant. By the time I neared the end graduate school I’d had 2 children and wasn’t sure I wanted to be an academic. That was when the idea to become a doula really started to take hold.

I started in 2013 by networking with other doulas in Evansville, and oh my goodness they were all soo nice to me. They invited me to a “doula night” at one of their houses where they talked business, trainings, & all things doula. One of them even had a placenta in their freezer, and I knew these were my people. I was hooked. I went to the training in June 2014, and have been taking clients ever since then. None of those doulas I met that night are still taking clients, which speaks so much to how challenging this job can be, especially the unexpected bits of it.

The Unexpected Bits

I didn’t expect to need to run my own business. I know that sounds naïve, even to me now, but it is the truth. I wanted to help birthing families sure, but finding clients, building & maintaining a website, setting up the proper legal paperwork, social media, paying taxes, networking, and all that jazz were not part of the thought process of getting started. I may have had a PhD, but I had much to learn about business. I’m happy to say that I feel much more confident now, though the imposter syndrome does sneak in occasionally.

The challenge of life on call was not something I was wholly prepared for in the beginning. As a birth doula, I have to be ready to leave my life for a couple days with sometimes not much warning. I have to be willing to miss holidays and plays and family events to go be with my clients. When my kids were little, the biggest challenge was having childcare ready at any moment of the day for possibly an entire month of 24/7 on-call time. This is the part that I always talk to people thinking about becoming a doula about, because not everyone has the resources to be able to do that. The reality of how much energy being a doula takes also almost always has new doulas re-thinking how much they charge for their services, though that is a topic for another time.

The best unexpected bits have been the amazing connections that I’ve been able to make with clients and their families. I’m forever grateful to be a part of some of the most memorable moments of their lives. There are so many families that I’ve had the chance to meet and be part of that I would never have met otherwise. That is something so beautiful about this job and I’ll never take it for granted. Though it does sometimes make it challenging to walk through a crowd without someone yelling my name and getting random hugs. (BONUS!!)

Learning

I’ve continued learning from some of the best doulas around the world, and I’m going to keep learning probably forever, because that’s just my style. I’ve gotten amazing doula agency business advice from Jessica English. I took a brilliant postpartum doula training from Jen Chandlee. I continue to learn from Ann Grauer, who also trained the 2 other postpartum doulas on my team. I am learning about leadership in the doula world from Melissa Harley & Nikia Lawson all the time too. I’m sure this year will be a huge one of learning, as I step into the role of President at DONA International.

I’m asked all the time about how to become a doula. This is my story. I started with DONA International, and have worked hard to keep learning and growing as a doula. I have an abundance mindset, and I honestly feel like that has helped bridge so much learning and connection for me. It is also why I’m passionate that more people in Evansville should learn to be doulas too! I love talking to new doulas and am HAPPY when more doulas are trained here. I started Doula Group of Evansville so that more families could be supported by doulas and more doulas could feel supported by each other.

Ever thought of becoming a doula?

Becoming a doula has been one of the best decisions that I’ve ever made. It hasn’t been easy, but it has honestly been more rewarding that I ever could have imagined. If you’re thinking about becoming a doula, please feel free to reach out to talk to me. I will continue to pass on the kindness shown to me by the doulas here back in 2014 by always being willing to share my experience with others who might be interested in traveling this path too.

Approved Doulas: Kentucky Medicaid

Hey there friends in the Bluegrass state! We are now part of Humana’s healthy Horizons Kentucky Medicaid doula program!! This is seriously exciting news, as we know doula services so often aren’t affordable for the people who really need them most. This is part of the value added benefits of this program, and we’re really excited to be part of this initiative.

What does this mean?

If you have Kentucky Medicaid through Humana, then you can hire one of our doulas and they will pay us! We had an awesome meeting with the team at Humana who walked us through the entire Healthy Horizon program and how it all works. Honestly, I was pretty impressed by the resources included in their program for expecting parents.

This program covers both birth and postpartum doula services too, which might be what had my jaw on the floor to be honest. We love that birth doulas are getting so much love right now, but know that the value of postpartum doulas is also imperative for new families. Through this plan, you can actually get 4 visits with a postpartum doula, even if you don’t employ a birth doula at all. That’s HUGE! That also includes miscarriage support by the way. Your doula can even speak to your care manager if you give them permission, so coordinating care is even more well rounded.

How do we make it happen?

If you are planning to deliver in Owensboro, Henderson, or Madisonville and are part of the Humana Healthy Horizons program, we’re here to help you! Contact your care coordinator to find us on the referral list. That’s it! Once you hire us, you get all same exact benefits of ALL our clients including access to our online client classroom, 24/7 unlimited virtual support from your doula, and all that jazz.

We’re new to this, but soo excited to be able to offer these services. We got very excited a few years ago when Indiana passes a bill to provide doula services to Medicaid recipients, but then they pulled the funding in a committee meeting. Way to go Kentucky for putting your money where it is most needed to combat maternal mortality and morbidity!!

Coming Soon?

We hope Indiana will get its act together so we can start offering more services like this to our expecting families here in Hoosier-land too. We’re working to also get added to Anthem’s Kentucky Medicaid program and to Tri-Care too for our military families. We know doula services aren’t in everyone’s budget, and we’re really excited to see more recognition of the value of doula services regardless of someone’s ability to pay.

For now: Kentucky, we’re ready to serve you!

The Latest Local Maternity Statistics

Statistics reflect the culture of a hospital and the institutional priorities. What has changed here since 2017?

Anyone who has met me can tell you that I’m a huge fan of data! Words and images can hide a multitude of things, and opinions can be influenced by those too. But basing ideas and approaches to things on DATA is honestly my jam. Seriously, I get very excited about this stuff. Every year, Leapfrog Group publishes data they collect from hospital surveys about standards of practice. They measure all kinds of things, but naturally as a doula I’m the most excited to learn about the maternity care statistics. I’ve been collecting this information for our area hospitals since 2017, which is exciting because we’re definitely seeing some changes in the data. If you’d like to read my previous posts, you can do so here, here, and here. Please note, I did not collect the 2019 statistics because they were published in April 2020, and well, you all remember that year right? Without further fanfare, here are the 3 data points I’m always interested in seeing for our local hospitals.

Episiotomy

data from https://ratings.leapfroggroup.org/

I’m REALLY excited to see the episiotomy rate in serious decline because the evidence has been telling us they aren’t an evidence based routine procedure since the late 1980s!! It shouldn’t take this long to change, but at least it is changing. Don’t take my word for it, this paper concluded that, “Our systematic review finds no health benefits from episiotomy,” in 2005. Despite that scientific fact that has been repeatedly proven, as a doula in 2021 I heard a provider at a local hospital say that cutting an episiotomy would help prevent my client from “tearing too much.” I’m not naming names here, but I will if you call me. I have heard that the hospital this doctor works at requires all their physicians to provide explanation for every episiotomy they cut, so this particular doctor must be quite busy with those reports.

Early Elective Induction

Defined as scheduled cesarean sections or induction of labor prior to 39 weeks gestation without a medical reason, early elective induction can happen for a lot of reasons, but there are definite consequences to it. Here is what the picture looks like in our local facilities:

Hospital Goal: 5% or less2017201820202021
The Women’s Hospital Newburgh, IN1.4%1.7%6.8%4.1%
Ascension St. Vincent Evansville2.1%.8%0%0%
Owensboro Health2.1%1.4%.7%1.6%
Memorial Hospital & Healthcare Center Jasper, IN–0%5.9%6.3%
Daviess Community Hospital Washington, IN–1.9%0%Declined 
Deaconess Henderson Hospital–2.4%0%0.0%
Good Samaritan Hospital Vincennes, IN––4%0%
Local Statistics for Early Elective Induction

Cesarean Rates: what everyone really wants to know

Before you look at this chart, I want you to know what the data is telling us. An NSTV Cesarean is defined as first-time low-risk mothers giving birth to a single baby at full-term in the head-down position delivering their baby by C-section. Hospitals should have a rate of C-sections of 23.6% or less according to Leapfrog Group. Some people will argue that this rate should be 10% according to the WHO, but honestly that isn’t true. So what does this data tell you then? This chart shows you how many people pregnant for the first time with a low-risk pregnancy with one head down baby delivered their baby via cesarean surgery. This is also retrospective data, so it really isn’t predictive of the future or exactly what will happen to you either, but it does at least give you an idea of the culture of a place and what their staff sees.
The actual NSTV Cesarean Rates for 2021 are as follows:
  • 36.6% Ascension St. Vincent
  • 30.5% Deaconess Henderson
  • 28.9% Owensboro Regional Health
  • 24.5% Deaconess The Women’s Hospital
  • 17.6% Good Samaritan
  • 17.5% Memorial Hospital in Jasper
  • Daviess Community Hospital declined the survey this year.

What I Wish We Knew

As a doula, I always try to make sure my clients have the best most up-to-date information about their decisions. There is of course such a thing as having too much information, but I don’t think we’re anywhere near that right now with regards to choosing providers and birthing locations. These numbers honestly hide sooo much in the aggregated hospital data. How do I know what my provider’s rates specifically are for these things? They know them, but I have yet to find any providers willing to share that information readily with us. In fact, I’ve encountered a bunch of providers willing to say they don’t know them, when they get monthly reports from the hospital about their own statistics. What are they hiding & why? Why isn’t that information made public so that we can make more informed choices? I’d love to know about VBAC rates, induction rates, & percentage of high-risk vs low-risk deliveries. What about NICU admissions percentages and average length of stay in the NICU? Are there numbers you wish you could see when deciding on a provider and birthing location?

I’m going to keep watching to see how and if things change. I’m going to keep asking questions, as annoying as they might be. I’m a data geek after all. Transparency helps build accountability. Accountability can help push change and improvements. We’re all about improving the way things are done in our area, because seriously it is past time.

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