Tag: owensboro doula

Meet Doula Courtney Winkle!

Here we grow again!

After living in Owensboro her whole life and working as a doula there since 2022, Courtney reached out to us when she recently moved even closer to Evansville. I was instantly charmed when we met for coffee, and that was definitely partly because she’s from south of the Ohio River , but also because she’s an incredibly genuine person who tells it like it is. Courtney has a great head on her shoulders and a low B.S. threshold, which of course endeared her to me too. I’m so excited to be able to welcome her as the newest team member here at Doula Group of Evansville!

About Courtney

Courtney is a photographer, birth doula, and mom to two toddlers. She has been a doula for over two years, and is now working on her DONA certification. She has lived in Owensboro, KY nearly her whole life and has recently moved just outside the Evansville area. After the birth of her first child, Courtney truly realized how important birth support truly is. Courtney’s mission as a doula is to ensure that all of her clients feel informed, nurtured and safe throughout their birthing journey

In Her Own Words:

Why did you want to become a birth doula? After having my first child, I struggled deeply with postpartum depression due to lack of support. I quickly realized that I was not the only one. After lots of healing and inner work, I became a certified doula so I could be that support for the birthing people in my
community.


What do you love about living in Evansville? I love having so many activities for my kids to do! We spend a lot of time at the local museums, parks and zoo!


Where can we find you on a regular Saturday? Having family time outdoors!

Courtney is available!!

Courtney has already jumped into interviews with clients for DGoE & we’re so excited to have her as part of our team! Courtney’s summer is almost full so don’t wait if you’re due date is in July or August. Courtney is working to get all the paperwork finished to be on the list of approved birth doulas for The Women’s Hospital in Newburgh, and will of course be taking clients planning to give birth at Owensboro Regional Health Hospital, Ascension St. Vincent, Baptist Health Deaconess Madisonville, and everywhere else that DGoE doulas travel to support expecting families. Welcome to our team Courtney!!

Resources for Black Families

Four resources by and for black families!

We’re celebrating a different type of Black Friday today by sharing four resources that we want ALL black families to know exist! With all the scary statistics about maternal and infant mortality and morbidity for black families here in the United States, we know that getting pregnant, giving birth, and getting through postpartum can be a stressful time. Honestly, the statistics that are constantly bantered around scare us too, but instead of focusing on the problem, we’d like to take the time to focus on solutions specifically developed by members of the black community for black families. Even if you don’t identify as black, you should honestly know about these resources too!

Irth App

Conceptualized by author and activist Kimberly Seals Allers, the Irth App aims to knock out racism in maternity care. Through reviews by black and brown families, you can search your area for providers from pregnancy through pediatrics. I love that they are also turning those reviews around to push for policy changes at the systemic level too. This tool is only as good as the information we give it, so if you have experienced racism in your care at a specific hospital or with a specific provider please share your experience in the app. This is a tool for disrupting the system that protects the powerful.

Count the Kicks

Have you ever worried about your baby’s movements but counting them is confusing? Worried about your concerns being dismissed? Count the Kicks is an outstanding resource for ALL families that not only educates you about baby’s movements, but also documents them for you to be able to share with your provider or anyone caring for you in the healthcare system. This app will track the trends of your baby’s movement so that you have a record to be able to pull up to show anyone asking. I love this app especially for black families, because sadly the risk of you concerns being dismissed can become too real, and this helps you have a tool to point to data.

Reproductive Health Impact

Looking for resources on respectful maternity care and things to think about when you are building your maternity care team? Reproductive Health Impact has you covered! This outstanding non-profit is doing the work in not only advocacy but also capacity and power-building within the black community. Their work on reproductive health equity is widely celebrated, especially for their focus on black produced scholarship, activism, and experiences. If you work in healthcare, they are also developing tools to help reduce inequity and improve birth outcomes for black families. Check out their resources, and definitely keep them on your donation list!

Black Mamas Matter Alliance

Working to shift culture so that black families can THRIVE is what Black Mamas Matter Alliance is doing, and that is no easy task. Through advocacy, education, scholarship, and policy work BMMA places black voices and experiences at the center of their work. The resources & literature available on their website are helpful for all black families looking for how to navigate the healthcare system. If you are looking for how to not only come out alive but how to thrive, BMMA is a great place to start that journey by and for black families.

Being anti-racist in a capitalist patriarchy to us means being cautious about where we put our money, time, and all other types of support. There are plenty of other amazing resources out there too, 4Kira4Moms for example, and these four resources listed above could definitely send you down an entire rabbit-hole of information. These four resources specifically are by and for black families and help put tools in black families’ hands. We know that having someone on your team who understands your experience from the inside is invaluable, and these resources are excellent parts to add to that equation that can help your entire experience add up to one of JOY!

Something Stinks!

Do you have a super sniffer during pregnancy? Why? How do you cope with it?

Pregnancy can be really challenging when all of a sudden your sense of smell seems to be supercharged. For many people, super-smell is one of the first symptoms that they notice in their first trimester. When I was pregnant with my first child, I had an immediate reaction if anyone in my midwife’s waiting room was wearing perfume. YUCK! All of a sudden my husband smelled like he was a bathing in sausage water and walking into our pantry would instantly make me run to the sink. When my husband brought me a beautiful bouquet of stargazer lilies that I used to LOVE, I couldn’t even walk into the house with them there. Your sense of smell makes a huge difference in what you eat and how well you can keep the contents of your stomach inside of you too.

Why??

I found this article that reviewed all the scientific evidence about pregnancy and the sense of smell. What we know from science is that most people (90%) report having a sudden repulsion to certain smells, while only 10% find any smells better than when they weren’t pregnant. There are several theories as to why, the leading one which seems to be that it possibly helps you avoid toxins to protect the growing baby inside of you. They even gave people pregnancy hormones to try to see if it was hormonally related, and the results weren’t very conclusive. Another study summarized there didn’t find any heightened sense of smell in their participants between first trimester and postpartum. The author of course also adamantly notes that an abundance of anecdotal evidence exists to support increased olfactory senses during pregnancy, and suggests further research into the phenomenon. There are plenty of other theories, but no true abundance of evidence points to one simple explanation why 2/3 of people report super-smellers during pregnancy.

What Can You Do?

Stink happens, but how can you really deal with ALL the smells that make you want to hold your nose? I personally took a page out of the Victorian era playbook: I kept something good smelling in my pocket. This could be a favorite lip balm, a handkerchief with some essential oils on it, or even a vapor inhaler if that menthol smell is still appealing to you. Wearing a tight fitting N95 mask is another option that we should all be familiar with now too. I knew one friend who suffered so much with Hyperemesis Gravidarum that she actually kept alcohol wipes in her pocket in case a wave of nausea overtook her. Trying to keep track of all the smells that are terrible isn’t honestly worth your time though, because they could change and you’re sure to encounter some unexpectedly. Be prepared, and don’t be shy about keeping emesis bags in your car and purse in case you need them. Maybe your super sniffer would feel better going to somewhere that will 100% smell good, like a spa?

Rest assured, most people report that their super sniffer skills fade when they aren’t pregnant anymore. I promise you that my husband doesn’t still smell like he’s sweating sausage water and grandma perfume doesn’t make me instantly hurl anymore. Some aversions might stick with you, like I still can’t smell stargazer lilies, despite the fact that I really do think they are beautiful. I also can’t eat saltines anymore, but that has nothing to do with smell and more to do with the memory associated with eating far too many in my first trimester. You may be too busy changing diapers to even notice when your sense of smell goes back to normal, but you will 100% appreciate that fact when your baby starts eating solids and their poo changes smells again.

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.

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.

Want more? Sign up for our FREE Biweekly Newsletter.

One Size Fits None?

Hospital Gowns are terrible. First there is the fact that they leave your bum hanging out for the whole world to see, but they are also one-size-fits-none! Putting on a hospital gown is symbolic. It strips away your normal role of the clothes that you put on that morning and magically transforms you into a “patient” without any form of individuality or expression. Putting on that gown also visually communicates to anyone in the room what your “role” is there, and honestly strips away more than just your dignity. Studies have shown that when you put on that gown, you also strip away some of your perceived control and feel more vulnerable. What you wear affects how you feel, and it turns out that hospital gowns aren’t likely to make anyone feel powerful or better. 

Standard Operating Policies & Procedures 

Similar to those gowns, many other policies and procedures in the hospital make people feel bad unnecessarily. Standards are put in place for a reason, but many people have argued that hospital birthing policies and procedures are more often than not written primarily to protect the hospital from liability. That subject is a whole can of worms that I’m not opening right now, but my point to you is this: just because something is standard, doesn’t mean that it is required, evidence based, or that it fits with your plans/desires/wishes. Standard is the mold and you don’t have to try to force yourself into it. You can decline things and say, “no thank you.” Maybe you aren’t planning a “standard” birth or approach to your birth. Maybe your  postpartum and parenting plans and priorities are different from your pediatrician’s approach. That’s ok! One size honestly fits NONE and even as a parent with older kids, I still have to be a different parent to each kid. 

This is not to say that all Standard Operating Procedures (SOPs) are the exact same at every hospital or birthing location. In fact, we KNOW they aren’t and have seen that in action. A great example is the SOP for eating and drinking during labor. One local hospital doesn’t allow anything other than ice chips during labor, a practice not at all supported by evidence by the way. At another hospital where we attend a births, the labor and delivery nurses there taught me how they make “slushies” for laboring parents out of popsicles. At a 3rd hospital, they have a standard laboring mom tray of snacks and drinks that they bring. What are the policies and procedures where you are delivering? Are they followed all the time?  

What size fits you? 

There are so many lies that are told to us about pregnancy, birth, and postpartum, and one of those is that the standards are in place to protect everyone, evidence based, and enforced equally. I can tell you that is definitely not the case from what I have observed as a doula. In a medical system that is forced to treat patients as consumers though, you do have some power if you decide to hold onto it. If it helps, bring your own gown to wear during labor or go buck naked to remind yourself (and signal to the staff too) that you are not sick and are indeed powerful. It also sends a visual signal that you want something other than the SOP, whether you choose to say anything about it or not. Spend some time finding out what the policy is where you are planning to deliver and what aligns with your approach. Humans are not all the same, and figuring out what size fits your needs and wants is helpful to do before the big day. That is one of the things that doulas do too, help you find what works for you and your family. Keep asking questions and demanding the individualized care that you deserve just for being an awesome human being with a new one in your care.