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!

Hiring a Doula

We know that the decision to hire a doula can be a BIG one for many families. Maybe you’ve been thinking about it for a long time and trying to decide if adding a doula to your team is something you want to do. Maybe hiring a doula for your birth isn’t really that important to you, but planning to have help around the house and someone to ask all the questions postpartum would be nice. We know hiring a doula is a big investment, but we also know that doulas help not only improve outcomes, but also improve parental stress levels, mental health, & overall confidence.

How does it work?

We have 2 types of doulas on our team: Birth doulas & Postpartum doulas. (One of our doulas does both, for those families that want that continuity of care too.) Our manager, Hillary, talks to every person who inquires about doula services to see what they are looking for and match them with a doula on our team who will be a good fit for that family. She’s kind of like a doula match maker that way. The family then gets to interview the doula to decide if they’d like to work with that doula. Once you make the decision to hire your doula, then we send you a digital contract & invoice. You pay a deposit to reserve your time on your doula’s calendar, sign the contract, & then get access to our online client classroom filled with resources and information for you.

Every doula in the group is mentored by Hillary, who has been a doula here in Evansville, IN since 2014. She’s served at more than 200 births and has been invited to speak about doulas at both our local Evansville hospitals. At this point, she takes less clients so that she can run the business side of things for our group including all the emails, contracts, invoices, website, social media, bookkeeping, outreach, etc. Clients interact with her as the primary point of contact, but then move to interacting with their specific doula for birth and postpartum services.

Birth Doulas

8 birth doulas of Doula Group of Evansville

Our birth doulas are phenomenal! Their experience ranges from brand new to very experienced, and they set their own prices. Each and every birth doula client gets two prenatal meetings to get to know their doula, to talk about birth planning & logistics, to practice comfort techniques, & more. Birth doulas are there with you for the big birthing day to help with all the things like movement, deciding when to go to the hospital, handing you things you didn’t ask for yet, suggesting positions, offering information about options, and so much more. After baby is born, birth doulas typically stay for 1-2 hours to help with the initial feeding and bonding time before they skedaddle out of there to give you time alone as a family. Your birth doula will come visit you once more after baby is born to check on you, talk about how things went, and offer any resources that you might need at that time. We might even bring you a little present too. Hiring a doula means you not only have someone to text with random questions throughout your pregnancy, but you also have someone to walk with you for the journey from expecting to beginning. All of our birth doula clients will also be getting a postpartum planning session with one of our postpartum doulas.

Postpartum Doulas

Christina Renock postpartum doula, green leaf on white background, Kristyn Tromley Postpartum Doula

If everyone knew about postpartum doulas, then honestly EVERYONE would hire one! Postpartum doulas come for 3-4 hour daytime shifts to help you with light housework that might be piling up because you’re busy taking care of your new human. They answer questions without any judgement & help with resources if you’re concerned that something isn’t normal. They hold the baby while you shower and help with meal planning too. Postpartum doulas help the family as a whole to transition to having a new baby in the house, because postpartum can be challenging for everyone. So whether you would like an in-home postpartum massage, help with meal planning & grocery orders, someone to look at your surgical scar or help you off the couch, then one of our postpartum doulas would be happy to help. We currently have one postpartum doula who is also able to do overnight shifts for families that would like help throughout the night for feedings & baby care too, so feel free to inquire if that is something you are interested in learning more about. Postpartum doulas are a little big magic and also *ahem* one of the BEST gifts you can get for your friend who already has everything they need for baby and could just use some extra TLC in those first weeks at home.

Don’t Wait

If you’re thinking about hiring a doula, don’t wait! We have an awesome team that is pretty flexible in being able to accommodate all schedules, but sometimes we really do ALL get booked up. July-October are the most busy times of year for us, so definitely reach out early if your due date falls in that range. (In case you’re wondering, September is the most popular birth month in the United States for several reasons.) As I write this, it is June 2022, & we’ve started booking clients into February 2023 already!

Hiring a doula takes some courage, and we know that. We also know that hiring a doula can help the entire process of bringing a new baby into the world feel much more personal and cozy when you have a doula by your side. We’re here to help you navigate it all like a tour guide who’s been down this path many times before. If that sounds like something you’d be interested in exploring, then hiring a doula might be right for you. Reach out to us if you’re interested. You can even see some great videos of our doulas on our YouTube channel before you reach out too!

AND, if hiring a doula isn’t in your comfort zone, we really do try to put out a lot of FREE content on our Instagram & Facebook pages too. Find us there! We have a FREE e-book available here on our website, as well as lots of free blog posts, including this perennial favorite about how to have a good conversation about induction with your provider. Oh yeah, and we do placenta encapsulation too if that is something you want to explore. We want to be a one stop shop for helping expecting families in the tri-state area.

FREE Online Class 2/28/22

I’ve learned a few things that I want you to know!

In 2014 I became a birth doula, and I’ve since attended more than 200 births at 7 different hospitals in this area. I’ve attended home births where the baby showed up before the midwife, planned cesarean births in the OR, amazing VBACs with (and without epidurals), and soo many variations between. I’ve learned some things that can be helpful for you to know, & I want to share them with you!

Hillary Melchiors DoulasEVV Evansville Doula Newburgh
Hillary Melchiors PhD, MPH, LCCE, CD(DONA)

My name is Hillary. I have a whole lot of letters after my name, but I’m really the most proud of all the families that I’ve had the privilege to serve in my capacity as a birth doula. I’m the manager here at Doula Group of Evansville too, which is honestly so much fun!

In this online class, you’ll learn about different local birthing locations and what tools they have to help you during labor and delivery. Do you know which providers share call with each other and who else might be there helping at your delivery? What are the differences between locations for birth and postpartum? What about your rights as a patient? What does informed consent look like and how can you advocate for yourself? This class will also go over routine care and how to ask great questions to get the care you need.

One thing I want you to know even if you don’t come to the class: YOU are the boss! You make the calls when it comes to your care and consent is an on-going process. Nobody should do anything to your body or baby without your express enthusiastic consent. If rights are something you are really interested in learning more about, you should check out this class by Birth Monopoly. I’ve taken it and definitely learned so much helpful information as a birth worker:

DoulasEVV Evansville Doula Newburgh

I hope to see you on Monday 2/28/22 for this class, but if you can’t make it, don’t despair! I will be recording the class & it will be free to watch for anyone who signed up before the recording. I want this information out in the world to benefit our local birthing parents. I want everyone to know all their options and how they compare. I want everyone to know their rights as patients & have great conversations with their provider. This class is a step in that direction, & I hope you’ll join me.

Measuring Change: Local 2020 Hospital Statistics

That numbers are out for 2020, and they might surprise you.

Statistics tell us part of the story of how a hospital cares for their patients and about the culture of a place. They do not tell us the entire story in any way shape or form, but they are a way to measure change and track goals. Leapfrog is a group that tracks statistics about hospitals around the country using a survey that 75% of hospitals participate in each year. Today was the day that they published this data for 2020.

You can find the 2018 Statistics in this post we wrote. I did not write a post for 2019’s statistics, but I think we all remember April 2020 right? You can look these statistics up for yourself here, because you really don’t have to just take my word for it.

Definitions & notes for you:

  1. This Cesarean Section data  is for NSTV (research speak for 1st time parents, 38+ weeks pregnant, with a single head-down baby) cesarean rates and does not include repeat cesarean deliveries or 1st time cesarean deliveries in people who have had previous vaginal deliveries. This is an important distinction. Leapfrog Group uses the Healthy People 2020 goal of 23.9% for primary cesarean deliveries in this category. I want to note here that the WHO stated target NSTV cesarean rate is 10-15%, so that is something to also think about when looking at this data.
  2. Early Elective Deliveries are defined as elective induction or cesarean sections before 39 weeks.  This does not include medically indicated early deliveries, therefore the goal is for these to be less than 5%.
  3. Episiotomies are a cut made to the perineum during the birth process.  While sometimes necessary, routine episiotomies are not evidence-based practice, and Leapfrog sets their goal as less than 5%.
  4. The numbers in (parentheses) are the previous numbers reported in 2018. I did not include numbers for Good Samaritan Hospital previously, so apologies to our friends in Vincennes for the lack of change comparison possible in this table.
  5. New numbers that reach or exceed the Leapfrog goals are in blue.
Hospital NSTV Cesarean SectionsEarly Elective DeliveriesEpisiotomies
The Women’s Hospital
Newburgh, IN
26.2% (22.9%) 6.8% (1.7%)11.5% (14.8%)
Ascension St. Vincent Evansville*25.3%
(27.2%)
0.0% (.8%)5.9% (6.8%)
Owensboro Health29.5% (29.7%).7% (1.4%)5.7% (12.7% )
Deaconess Henderson Hospital**25.5% (26.1%)0.0% (2.4%)2.8% (2.4%)
Memorial Hospital & Healthcare Center Jasper, IN11.1% (12.8%)5.9% (0.0%)7.9% (9.8%)
Daviess Community Hospital Washington, IN17.9% (15.2%)0.0% 1.9%)8.2% (13.1%)
Good Samaritan Hospital Vincennes, IN20.7%4.0%14.2%
*Previously St. Vincent’s Medical Center of Evansville
**Previously Methodist Hospital of Henderson
DoulasEVV Evansville Doula Newburgh

What the Numbers Don’t Say

What these numbers don’t say is what an incredible strain 2o20 was on all hospitals, including in maternity care. While there were clearly jumps in early elective deliveries at Memorial in Jasper and The Women’s Hospital in Newburgh, we don’t know when those happened. Were those elective deliveries in March and April last year when everything was locking down due to the growing pandemic and people were truly scared for their lives? Conversely, maybe the pandemic was an easy excuse to push for early elective induction too. We can’t know that from the numbers. These statistics represent thousands of birth stories that we can’t know just by reading them.

These statistics are also not the only ones worth looking at when making decisions regarding your care. Other important factors such as VBAC success rates, availability of lactation help, availability of anesthesia, proximity to your home, provider access, insurance coverage etc. Sometimes that last one ends up being the deciding factor no matter what your preferences are on location.

How to Use These Numbers

First use them to think about where you want to deliver. You do have options and choices on where to go, and we would be happy to talk to you about our experiences at these places as well. Know that these are overall statistics that paint a generalized picture, and start there. Even if you don’t have a choice on where to go to birth, because we know that happens, these statistics can help you look at the norm where you will be delivering. They can help you know what to expect and watch for during your delivery.

Next use the numbers to start a conversation with your provider. Where do they deliver? What are their personal statistics compared to the facility? How do they feel about episiotomies?

We ALWAYS encourage everyone to have open, honest, and frank conversations with their providers. Don’t be intimidated by the white coats, they are people too. Keep it positive and be inquisitive, and go with your gut when it comes to making decisions regarding your provider and location for delivery.

We look forward to comparing 2020 with 2021 when those numbers come out!

  • What is the first question that comes to mind looking at this table?
  • Do any of these numbers surprise you?
  • Which of these statistics most line up with what you previously thought about these facilities?