The Register Citizen (Torrington, CT)
For volunteer doulas, helping new moms is a labor of love
Volunteer doulas provide support to birthing mothers
NEW HAVEN — When someone arrives at Vidone Birth Center in labor and in need of additional support, the medical staff can call one of their on-call doulas — a group of women professionally trained to provide physical, emotional and educational support to laboring mothers.
This group of birth workers has committed themselves to serving the segment of Yale New Haven Hospital’s pregnant population who would not normally be able to afford doula services. It is in these gaps of access to equal care that these volunteers enter into an intersection of birth work and social activism.
The Vidone Volunteer Doulas at Vidone Birth Center at YNHH came into existence in 2016 when nurse-midwife Erin CourtMorelli recognized a gap in access and care in her patient population. Morelli believedthe presence of doulas could provide her patients with the additional support they needed for a better birth experience.
Doulas are called into Vidone for a myriad of reasons such as a laboring woman who is unaccompanied, experiencing anxiety, or a survivor of trauma. Doulas can be pivotal in addressing language or communication barriers between medical staff and patients allowing a laboring mother to better articulate her own needs as she experiences stress, discomfort and fear. Doulas work with a laboring mother to create an environment in which she feels safe and to provide the affirmation and companionship that she needs to birth confidently. Many doulas are trained to provide physical relief using measures like massage and helping the patient work through her discomfort as she delivers.
Morelli estimates that around 75 percent of the patient population who seek care at Vidone Birth Center are on Medicaid and she believes that professional doula support services should be available regardless of economic status. Morelli says that the success of doulas in improving both patient experience and birth outcomes for mother and baby is supported by medical research. In the state of Connecticut, a professional labor doula can cost anywhere between $500 and $1500, making the service inaccessible to economically vulnerable mothers.
Morelli said medical staff are responsible for the healthcare and charting of multiple patients at once. On the other hand, each doula is focused only on their client allowing them to provide support in ways the medical staff are not always able. “Of course, the midwives, nurses and midwifery students will provide labor support whenever possible, but it’s different from a doula.”Morelli said.
The doulas’ commitment to the women they serve is a reflection of the model of care that Vidone Birth Center works to honor. “The Vidone philosophy is a collaborative practice model with the patient in the middle and her care team surrounding her. With all members of the team having a voice and giving input into the patient’s care, including the patient,” said Morelli.
Morelli said that most families don’t know what a doula is because of what she called “a gap in doula awareness.” Carmen Maria Conroy agrees that this gap exists. Conroy began working as a doula in her hometown of San Francisco before coming to Yale as a post-baccalaureate biology student. She has been volunteering with the program since its inception.
Conroy spoke to the inequities in awareness. “What I have found is that most of the people who know what a doula is are not necessarily the target population that has the most to gain from doula support.”
Conroy referenced a 2015 study by Katy Backes Kozhimannil titled “Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries,” which she said con- cluded that “studies show that upper-middle class, middle-aged white women are most likely to know what a doula is and seek one out, but these are also the women who have traditionally ‘better’ labor outcomes, as measured by rates of adverse birth outcomes.”
Conroy spoke about her role as a volunteer doula.
“My philosophy as a doula is that my role is to inform, empower, and support a mother during labor, no matter what her decisions are and what her ideal labor looks like. I believe that — just as accessibility to health care is a fundamental human right — access to doula care should be a basic right for pregnant people.”
Conroy believes that in the world of obstetric research and practice, babies’ health has taken precedence while the wellbeing of the mother is often overlooked. “Part of my goal as a doula is to restore the focus of labor to the mother as the centerpiece of the labor experience,” said Conroy.
Conroy said the impact of the doula is often dismissed or seen as not being based in science and referenced a 2013 study by Kenneth Gruber, Susan Cupito and Christina Dobson, titled “The Impact of Doulas on Healthy Birth Outcomes.” “Multiple studies have validated the utility of doula care, and have shown that it measurably improves maternal satisfaction with the labor experience, reduces the need for medical interventions such as forceps, vacuum-assisted deliveries, or Cesarean sections, increases the likelihood of successful breastfeeding, and decreases time spent in active labor.”
In 2012, “The Status of Women and Girls,” a report published in by The Institute of Women’s Policy Research stated New Haven has a higher rate of single female households than the rest of the state: 23 percent compared to 13 percent statewide and that these households have the lowest median income of all household types at $22,660 and the highest poverty rates among household types at 44 percent. While there has been little additional research into this segment of the population since, Conroy says that these findings are consistent with what she sees and that her work at Vidone has been with the population that the report describes. Morelli said that response from patients has been overwhelmingly positive. “I think in my practice patients appreciate that they are respected, have access to family planning and quality prenatal care,” said Morelli,
“The women we have served have been tremendously grateful.”