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WHITE CENTER PROGRAM TO COMFORT NEW MOMS. Jeretha McKinley presented the Chicago-based "Outreach Doula Program" to a group interested in perinatal care for low-income mothers. Doulas care and comfort pregnant women and continue care, sometimes until the child is as old as two. Photo by Steve Shay

Doulas have important role

Tuesday, July 08, 2008

The White Center residents recently were invited to Mount View Presbyterian Church to hear a presentation by Jeretha McKinley of the Chicago Health Connection to hear about the Doula Outreach Program through Open Arms Perinatal Services.

Sheila Capistany, spokesperson for Open Arms and herself a doula (from the ancient Greek word meaning "woman's servant") for 17 years, says Open Arms Perinatal Services, through their doula support program, has been providing doula support to families in the area since 1997.

The impetus for this presentation was the result of Open Arms alliance with Chicago Health Connections who pioneered the groundbreaking Outreach doula Model for women and families who need intensive support during pregnancy and early parenting.

This community has seen an influx of immigrants and refugees fleeing their homelands as the result of war and poverty. As with many of our great grandmothers and grandmothers, these women are strangers in a strange land who are na•ve and ignorant of language, culture and customs, and with this up-rootedness families are separated and fragmented. As a result women leave behind mothers, sisters, aunts, and even children.

How does a mother-to-be care for herself, and her un-born child under such circumstances?

In my mother's family when she or one of her five sisters was pregnant and after the baby was born, my grandmother and my mother's sisters carried out the role of a doula.

When my first child was born, my mother was with me in the role of a doula, and now my niece has asked me to be one of her doulas for the upcoming birth of her second child.

To women giving birth and being responsible for new life it can be a frightening and overwhelming experience especially with the birth of the first child. There is the roller coaster ride of the range of physical and emotional changes that occur in a woman's body during and after childbirth. There is the uncertainty and fear of doing things the wrong way. And there is the fatigue. New mothers need someone to turn to, someone wise to be there with them to share experiences, wisdom, reassurance, and comfort. New mothers need a doula.

Any woman dropped into a culture, who has had to navigate her way around the medical establishment: available benefits, medical coverage, pre- and post-natal care, accepted ways of doing things, and routine procedures (who for these women may not be routine at all), soon realizes how intimidating the process of receiving care can be. This is where the role of a doula is invaluable.

The Outreach Doula Program available to women and children for up to two years is employing women from within the community, women who share the cultures of women coming into the community as immigrants and refugees. These are women who want the role of a doula, women who have gained wisdom from their own life experiences, experiences made stronger by the 60 hours of training they receive: knowledge of physiology and anatomy, home visiting techniques, breast feeding, and non-medical pain relief.

Over a short span of time-half a century-we have learned so many new things, but we have also come to distrust our intuitive, innate knowledge and come to rely more and more on experts and modern technology. In too many instances the experience of childbirth and being a mother has gone from a normal life occurrence to a medical experience akin to an illness. But this statement is inaccurate in its over-simplification. Yes, childbirth is as old as time, and if all goes well a normal, happy experience. But a mid-wife or a doula can't perform a Caesarean Section in the event of fetal distress, or save a mother from a post-partum hemorrhage. But today a mother can have both: all the advantages that modern medicine has to offer as well as the experience and training of a woman in the role of a doula.

Research has been and is being done which seems to indicate that women and their children who have the support of a doula during pregnancy and after childbirth fare better. According to the World Health Organization, women with a doula experience happier and healthier pregnancies, easier childbirth with non-medical pain relief, and fewer surgical interventions than those without a doula.

The new mother and child also don't suffer the same degree of emotional side-effects of anxiety and fear. Studies are also being initiated to see what effect Doulas may have on lessening the percentage of women who suffer post-partum depression.

Open Arms alliance with the Chicago Health Connection as well as other community and government agencies such as Thrive By Five, The White Center Early Learning Initiative, and, one of their strongest supporters, The Public Health Department of King County, the hope is that The doula Outreach Program will leave a lasting, positive impact on the overall health and well being of The White Center Community for generations to come.

The White Center Early Learning Initiative is a partnership of community members and public and private organizations working for sustainable, integrated and accessible child development and family support funded by Thrive By Five Washington and Bill and Melinda Gates Foundation.

Maureen Kearney is a registered nurse and a freelance writer in West Seattle and may be reached via wseditor@robinsonnews.com


Please share your point of view on this story. Comments posted with First and Last names will be considered for publication in the print edition. You may request that your name not be published. You may also send your comment directly to the editor at wseditor@robinsonnews.com.


Betsy Hoffmeister wrote on Jul 15, 2008 7:58 AM:

" Thank you for this article raising awareness of the importance of doulas and the wonderful program from Open Arms. I read this article over and over again, as I am myself a doula, childbirth educator, and provide lactation support. I'd like to add a little bit more. As the article alludes, there are two types of doulas, birth doulas and postpartum doulas. A birth doula visits with a pregnant woman, sometimes offering massage, and learns what the mother hopes for in her birth. Does she want to take full advantage of the medical pain relief available to her at a hospital? does she want to avoid the drugs? Does she plan to birth at an out of hospital birth center with a midwife, or at home? The doula is on call, along with the midwife or doctor, until the mother goes into labor. The doula is often the first person to attend the laboring mother. If mom is intending to birth outside of her home, the doula normally goes to her home in early-to-mid labor, to support the family and help ease the challenges of this part of labor. She also helps the family pack last minute items to take, and helps them decide when to call in the midwife or leave for the birthplace. Doulas do laundry, cook meals, massage moms (and partners), help mom in and out of the tub or shower, go for walks with mom, remember the little details like drying off her legs, changing the CD in the player, offering her a drink, putting food in her mouth, keeping her hair out of her eyes and putting on her lip balm. These small but important details may seem trivial, but they emphasize that the laboring woman is not in any way suffering from a disease. She is a normal person undergoing a physically daunting event. When the family moves on to their birth place, the doula goes along, helping ease the transition into the bright lights of the hospital or the excitement of the birth center. She helps the mom stay calm and find her center once she has transferred, and continues offering massage, helping mom stay upright and active, suggesting non-drug pain management techniques such as relaxation and visualization, and helping the mom (and partner) ask questions of the birth team. If anesthesia is wanted, the doula may help mom stay in the proper position for the insertion of the catheter. The doula is totally hands on! During the pushing stage the doula is often holding one of mom's legs or helping mom stand or squat. Doulas help remember the little details throughout the birth.
In contrast, a post-partum doula serves in the capacity of an old-fashioned baby nurse, comforting baby at night and bringing baby to mom for night breastfeeding, helping parents become comfortable with bathing, cord care, and diaper change, supporting breastfeeding, providing meals, doing laundry, baking cookies, and generally acting as a grandma but who may stay up all night AND has detailed knowledge of breastfeeding!
I take exception to the comment "But a mid-wife or a doula can't perform a Caesarean Section in the event of fetal distress, or save a mother from a post-partum hemorrhage." This comment is not relevant to the article. Midwives have a far lower rate of cesarean birth outcomes than do their obstetric colleagues. Midwives are professionals trained in and dedicated to normal birth outcomes, that is, vaginal birth, normally without medication. In the rare, unlikely situation that baby is not responding well and needs assistance, midwives in out of hospital settings are extremely conservative. Laboring moms are transferred to the hospital at the earliest sign of challenge to the baby and no risks are taken. Midwives do not perform cesarean surgeries, but they are trained to recognize risks and take steps to avoid them. In the case of post-partum hemorrhage, midwives know that the first step is to get the baby breastfeeding, the second step is to vigorously massage the uterus, and the third step is to get rapid emergency transport to an appropriate hospital for Pitocin and other treatment. Some midwives do have Pitocin with them. Midwives all have oxygen tanks on hand along with an enormous assortment of medical gear, as well as alternative remedies such as homeopathics, herbs, and even acupuncture.
No doula would ever be expected to perform surgery!
Every laboring and new mother deserves a doula, and I applaud this initiative to provide doula services to the White Center Community. Thank you for providing more information about the program! "

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