From WXXI news I'm Racquel Stevens filling in for Evan Dawson and this is connections.

On this hour we're talking about black maternal health and the life changing, often lifesaving role that doulas play in it.

For a long time, conversations about pregnancy and childbirth have focused on the medical system, doctors, hospitals, and what happens when things go wrong.

But what if we shifted the focus?

What if we asked who's there to support you emotionally?

Who's in your corner when you're in the most vulnerable, life changing moment of your life?

That's the work of a doula.

And for black mothers, that work can mean everything.

Black women are five times more likely to die from pregnancy related causes than white women.

Here in Monroe County, black babies are more likely to be born too small or too soon.

These disparities are not genetic.

Their systemic.

They come from generations of racism, neglect, dismissal, and a health care system that too often doesn't see or hear black women when they say something's not right.

But this hour isn't just about the crisis.

It's about the care and the people showing up every day to change the experience.

And we're asking, what does true support during child care look like, especially for black families?

What makes Dula care so effective?

And how do we build systems that center the needs, the voices, and the well-being of black birthing people?

Whether have you had a doula worked with one or you're just hearing the word for the first time?

We want to hear from you.

You can give us a call at 844295 talk.

That's 855.

Toll free.

Or you can call 2639994 or email us at connections that@wxxi.org.

Or if you're watching our YouTube stream you can leave us a comment.

Joining us today are three guests who live this work every day as doulas.

Jasmine Brewer is a program manager of the Black Doula Collaborative, an initiative through the Healthy Baby Network.

Thanks for joining us, Jasmine.

Thanks for having me.

And we also have Ayanna Alexander.

she's joining us, by the way, of the Healthy Baby Network.

She is a community based doula.

Hi, Hannah.

Hi.

Thank you for having me.

And Doctor Stephanie Hollenbeck, join us by phone.

Is an assistant professor of obstetrics and gynecology and biomedical engineering at the University of Rochester Medical Center.

Hey, Stephanie, are you there?

I am, thank you for having me.

Yes.

Thank you for joining us.

Thank you, ladies, for joining us today for this conversation.

A very important conversation.

Jasmine, let's start with you.

The black Doula collaborative.

And what is that and what does your work look like on a day to day basis?

Yeah.

So, the Black Doula Collaborative is, it's birth and housed a healthy baby network.

It consists of about 34, black doulas in the Rochester community, who are all community based doulas.

So there is a big difference between a doula and then a community based doulas, a healthy baby network.

That's what we have.

Community based doulas.

so from a day to day basis, I come in and I receive referrals from a different, a variety of agencies, hospital systems, whether it be the OB or someone's in that person's, care.

and it could be a self referral, but obviously receive referrals from women in the community who are afraid to birth alone or who, desire a doula and a healthy baby network.

We are able to provide those services, free of cost for women in the community.

We have serve close to 500 women over the last three years.

in that birthing space.

so, yeah, that's what I do on a day to day basis.

So I wanted to jump in and ask, what is the difference between a regular doula and a community based tool?

Because you did emphasize there is a difference.

Can you can you elaborate on that difference?

Yeah.

So a healthy baby network, a community based doula program, is a home visiting program.

so you get to meet the families, not just the birthing mom, but the families.

Anyone who's part of that support network with, with the mom and the family, you get to meet them ahead of time.

referrals come in as early as 12 weeks of pregnancy when mom just finding out that she's, with child.

Right?

So the community part of it is going in and, creating that birth plan.

a big part of that community based doula is, are the resources that we connect moms and families with during pregnancy.

and connecting with those resources, we take some of that stress off moms plate because sometimes mom may not have the things necessary to bring baby home, right?

Whether it's, clothing, bottles or, you know, mom can have everything she needs and maybe she just wants some support or, closer support for her, new breastfeeding journey.

Right.

So we go in, we go in, and we meet with moms several times before birth so she can get to know us and we can get to know her.

Right?

Is that connection and that trust that you build before labor and delivery that you really, really has mom prepared way more than she would be if she didn't have someone who was familiar with her going into that birth space.

So part of that, another part of that community based doula, aspect, is not just the trust but the education piece.

Right?

So when you go in and you're creating that birth plan with mom, sometimes this this could be her first birth or this could be her third birth, but you get to arm her with, different options that she may not know that she had.

Right.

And then after labor and delivery, we follow up within 24 hours.

If mom is deciding, you know, for postpartum care, see how she's doing, checking in with the family.

And then after that, we work with the family up into 12 weeks.

You know, that postpartum period.

So the big part of that community is we are women from the from the same communities of the women that we are serving.

and that's so important for that connection.

and that trust.

So that's the that's the big difference.

And that's, you know what I just want to talk about just in general, like what a doula is, right?

Because a lot of people are just probably hearing this word for the first time.

Right?

Doulas are not medical professionals.

Correct.

And they're not midwives.

No.

So who are you?

Yeah.

So we, We are.

What are you doing here?

Right.

We're providing social, emotional, psychological and physical support during that birth.

You know, depending on the goal, the birth plan, you know, mom may want to have different comfort measures during labor and delivery, right?

mom is there to help, support mom while she's advocating for herself, you know, but the professionals may come in the room and say, you know what?

Your plan A is not working.

We have to make go on with a plan B, right?

You and your doula have already discussed that before you hit that labor and delivery room, right?

You have already talked about the different options.

any you've talked about medical interventions, right.

You've talked about, different treatments, things like that.

But that doula is there as an added layer of support, to really amplify and support moms voice to make sure that she is seen and heard.

So what are some of the barriers that you see that black moms or black birthing people have to face while navigating, this health care system while pregnant?

so I would say number one is, voices being heard and respected.

You know, a lot of times we do find, and I'm going to let you know, Eliana, definitely chime in here.

but we do find that moms call us sometime and say, you know what?

Something is not right.

And I keep telling my provider, but, you know, they keep sending me home, but I don't feel comfortable going home.

Something is wrong.

You know, I need to be.

I need this to be investigated or looked at a little further, you know?

so, that is like top barrier, right?

Just not or will issue not being seen or heard.

and, you know, no one knows your body like yourself.

Yes.

So we have to listen to those voices.

Yes.

And if you do need a second opinion, we definitely advocate for you getting a second opinion.

you know, Alana, I definitely want you to chime in and tell us.

Tell us about, some of the some of the services that you provide.

Right.

When you're supporting, your clients.

what are some things that you usually, do?

one thing that I love to do with my clients is helping them learn how to advocate for themselves.

So I am helpful to help advocate for you.

But I want you to know how to do that for yourself, because not only is it a skill that is helpful in birth, but it's a life skill that goes way beyond the bathroom, right?

So, in regards to what Jasmine just mentioned, like knowing what your what your body is telling you is valid, one of the ways that I help them advocate for themselves is a acronym called brain.

And a lot of do is use it.

So I didn't make this up by any means.

But the B stands for the benefits of whatever intervention, is being presented.

So like, what are the that you at the doctor, the provider, what are what are the benefits of this intervention.

Right.

And that's usually what they lead with.

So making sure you get all of them from there you go on to the are what are the risks of this intervention.

So that way you are knowing what could possibly happen that you might not want to happen after that.

You have a what are the alternatives of the intervention?

So if you're saying I should, take my pain medication, right.

Yeah.

maybe I want to get in the tub instead to manage this pain in the in some warm water versus getting morphine or whatever the pain medication is.

and then the I stand for intuition.

And I really love this one because it's saying what I'm feeling inside is just as valid as the risk and the and the benefits and the alternatives.

This is valid information that I have in my body that you can't give me as the provider.

I've been living in this body for many years and it's the information that I have is so valid.

so that I very important.

And then the end stands for either I need time to think about this or no, depending on what it is.

And sometimes you can't get time.

If it's an emergent situation, then that might not be available.

But oftentimes you can ask for a little bit of time to think about it, because it can be very intimidating when there are five doctors or however many people in the room with white coats on and they have all this 50 years of education combined, and you might feel like, well, I barely graduated high school or whatever it is, I don't know.

they their information is more about than what I know in my body.

So you think I get some time?

I really just think about it, though.

Step out of the room.

And I always see the doctor for, like.

Sure.

Like I'll be back in this amount of time, or you call me when you are ready for me to come back.

And we can discuss this after you've had time to discuss it with your partner, with your family, with your doula.

And from there you can make a decision on what is best for you.

You can make an informed decision about what is best for you.

Yeah, that's that's very important.

Having that time to really reflect on it and to see, yes, what is what is best for me and to to to gather your support system and make that decision.

And I know you yourself.

I used a doula in the past, didn't you?

I did.

Is that what influenced you to become a dual or were you a doula before that?

So I was already getting certified to be a dual.

At the time I wasn't practicing it, but I knew that if this is what I want to do, I need to experience it from this side of it while I have the opportunity to.

And it was definitely a game changer for me.

Yeah.

Can you can you take us through that?

Like, how did you use your doula?

When when did you seek a doula?

Because I know you can you can get a doula as soon as you find out.

Like I took the pregnancy test, I already know.

Let me call my doula or like weeks before.

Right.

I'm going into labor next week.

I need a doula.

When did you decide to to get a doula?

And can you tell us how was that relationship as a pregnant person?

Yeah, so I want to say I was probably late first trimester, early second trimester.

and I reached out to a few people and then you kind of get a vibe of, like, who works best for you, who you can see yourself trusting.

And that's a really good part about the community doula aspect of, what I do, because you can really connect to these people, very easily.

but with my personal experience, I found someone and she walked me through, learning how to breastfeed and childbirth education and, you know, just what's going to happen in my body that makes that a lot less scary when you know what's going to happen.

So, like the stages of labor, okay, at this point you're probably going to be in transition, for instance.

That's probably when you're going to feel like you can't do it anymore, but that's when you're almost at the end.

So when I was experiencing that in my body and I literally said, I can't do this anymore, and she reminded me in that moment, you're almost there.

Remember we talked about this and I'm like, oh yeah, I am almost there.

And that remind her that encouragement, was help me get to the end of, you know, pushing him out and giving birth to my son and knowing that I can do this because I did unmedicated.

So having that extra oh, encouragement oh was needed was definitely New York tough, tough.

You're a tough, tough, I know I took that epidural immediately.

Like no questions asked.

Please.

Yes.

Come on in.

I want to touch on you saying that you found a right doula for you.

Because choosing the right doula is important, right?

there is a.

Do we go through an interview process?

How do you know that doula is right for you?

What are you looking for?

To find the right doula for you.

So through our program, all the referrals hit my desk first before they are assigned to, the doulas.

Right.

But me as a program manager, I have get an have got the great time to, you know, relay and build relationships with each doula and you know, as soon as a doula comes in and they start, working for a healthy baby network, I'm like, hey, you know, you know what?

Sure.

You are.

You are an expert at what you do.

But what are you passionate about?

Are you very, very passionate about breastfeeding, which we all are?

Or are you very, very passionate about prenatal yoga, which Ayanna is, are you very, very passionate with working with younger mothers?

Where do you fall in there.

Right.

and then we all have lived expertise.

the doula community, a healthy baby network between the full time, part time and black doula collaborative is very rich.

because everyone comes from different, you know, has different experiences.

They've worn different hats.

you've had a natural birth.

I've had to, you know, someone had an epidural.

So, and I like to touch on the collaborative meetings a little later, but, for right now, I do my best at having conversations with each client before they're assigned, because I would like to know, what do you how do you see your doula?

You know, would you like to work with someone?

who's a little, closer to your age or, you know, someone who, had a natural birth?

I do ask those questions because it's very it is very important.

Although I know for a fact that they will be in great hands with any of the doulas.

I do try my best to try to pair them with someone who is compatible, compatible?

because that makes a difference, I really does.

And as a doula, who do you ever have?

Did you ever have a client where you like, maybe you may want another.

May you send him to send that birthing person to a next tool.

Maybe that wasn't a good fit for you.

Not really.

Honestly.

the people that come through our program, like our first meeting with them, my first meeting with my clients, I always tell them, like, you can let me know how this feels for you, that the end of the day, this isn't this is a very intimate experience.

So if you tell me, Alana, this woman, thank you for coming.

But honestly, girl, I don't really want you in that role with me.

I won't take it personally because I understand that that's a sacred space.

And if I can't, I'm honored to be there.

But I also won't take it personally.

If you decide I don't want my partner in there, well, I just want a mother in there or whoever it is.

but no, I my job is to be the doodle that you need me to be.

I don't care if you want an epidural.

soon as you get to the hospital.

I'm okay with that.

I'm not going to say, oh, you shouldn't get an epidural because I did it natural.

So you can do a natural two.

That's not my job.

I'm going to be.

I'm going to help you get the birth plan, help you try to accomplish the birth that you want to happen.

And if that's an epidural on entrance, then I'm going to be supportive of that.

So yeah, I'm really open to my clients being whoever they want to be and whoever they are, I love that.

So I know giving birth is such a beautiful experience, right?

But there's some challenges that may occur.

Are doulas trained to handle the unfortunate circumstances where a mom's blood pressure may spike or, baby is breeched or are we?

Are we?

Do we know how to coach the mom through these challenges?

Challenges that may occur?

Absolutely.

so during Community-Based Doula Training in a variety of topics, I mean, A to Z, they're really, gone through, very thoroughly the training.

but although although doulas are not medical providers, we know the other side.

very, educate it on to look for what's what to look for.

Right.

So if a mom has preeclampsia before, the doctor may come in and say, you know, we're seeing signs of X, Y, and Z, we see those signs as well, right?

We're in there.

we've see it in real time, right?

Not just from reading it.

we are trained to provide support around mom's decision.

As far as her care.

Like, what do you know?

Your provider is going to come in and talk about X, Y, and Z?

We have those conversations that way.

we can always still, our mom with support and education on or answer some questions that she may have, like, I'm kind of scared.

My blood pressure is going out.

What happens after this?

No one can say what's going to happen next, right?

But just, to be able to give her some type of insight and support around what she's experiencing right now and letting her know, you know, birth is tricky.

You know, every experience is different, from person to person, from birth to birth.

I may have a totally, smooth sailing birth this time, right?

The next time I may have preeclampsia.

Right.

You may be considered high risk after that, but the next time it doesn't mean that I'm going to have preeclampsia, you know?

but, just to answer your question, yes, we are trained to identify and then support from that space to help mom make an informed decision on what's next.

Okay.

And I want to bring in, our medical professional on the phone, Stephanie Hollenbeck.

Stephanie, thank you for thank you for being so patient.

as far as doulas, what is as a physician, what do you see as a benefit of having a doula present, or involved in a patient's care?

You know, it's so nice to have that kind of continuous labor support in whatever format that is best for our families.

And so those are such a critical piece of that, and it's so nice to see that be part of it.

And then we look both in the experience of caring for patients.

That's such a rewarding experience to have that collaborative, and continuous support for patients.

But then additionally to when we look at what the evidence shows us, we also see that for both, there are those like complete medical benefits to having that continuous labor support.

And there's also more reported satisfaction with patients labor.

and so in so many ways, this is such an, comprehensive way to be able to support our birthing people.

And, Stephanie, can we I just want you to elaborate on that, because that's that's interesting.

you said the medical benefits of having a doula present when, can you can you speak on that a little bit more?

And what have you found to research in your experience?

Yeah.

so when we look at the now, a growing body of evidence, because there's great interest in how we can best, support our, our birthing people during the labor process.

and when people have looked at all of the different ways, including doulas, where you can provide continuous labor support in addition to the support of the bedside nurse and the medical care team, that continuous, personal labor support, it has been shown to be associated with shorten labor.

and decreased need for medications and fewer operative deliveries.

So there's a lot of benefits there.

But in addition and kind of in a parallel track and equally important is the fact that when we survey patients about what their labor experience was like for them, they also report more satisfaction.

Nice.

And and have you seen, an increase I guess anyone can answer an increase in in moms, black moms asking for for doulas.

Absolutely.

And what are what are you seen here where they ask?

They're walking in like, hey, I need a tool now.

And what does that looking like for you at the collaborative?

so we definitely see, or hear from more mothers, self referrals because you can get a referral from a hospital system.

Right.

and a lot of the, you know, kudos to our hospital systems in Rochester because they do a fine job with connecting moms to our services.

they may tell mom, hey, have you heard of a doula?

And a lot of the times, you know, it's becoming a lot more, more the norm, which I'm so happy about because I believe every woman who is birthing deserves a doula.

but we are definitely seeing, more moms interested in knowing, you know, she just know she needs a doula because she sees the news.

Right?

people are reading about the facts.

so moms are reaching out saying, hey, I'm going to be giving birth, and I need a doula.

I don't know why I need a doula.

Sometimes I have heard I don't know why I need a doula, but I need one.

So can you tell me more about that?

And I'm always happy to share.

Oh, absolutely.

You do need a doula, and I'm gonna tell you why you need a doula.

so we are definitely seeing an increase in interest.

and, you know, when we speak about community and community based doulas, part of the reason why we do everything that we do is to educate not just the birthing people now, but the ones in the future.

Right.

So the doulas, or moms who are working with doulas, they then go on and tell a family member who's pregnant, hey, reach out and get yourself a doula.

so we are definitely changing.

we are changing.

Or I would say having a positive impact on our future babies who are even thought of right now.

Because when you're educated and you have such a great experience, you want to share, and that's part of that community, part is making sure we're taking a taking part of the community as far as each one is, each one right from the experience.

Yeah.

And Stephanie, I know, Jasmine just said they're going to a lot of medical referrals, right?

Stephanie, are you are you, referring your clients to doulas more often now than before?

So, I think overall we're really trying to increase that, kind of communication there and make sure that our patients are aware of the resources, that are in support of being able to access, doula care and other, kind of support strategies with the community, and then kind of in tandem with that, because we've been able to kind of increase this collaborative work.

We've also been doing a lot in our hospital system as well to be able to invite doors into the conversation on, how we kind of work together on the labor floor, including things like, you know, doing simulations, for our care together with our doors, to be able to further streamline the process of that, that collaborative care in the hospital.

And I'm pretty sure there are some boundaries that are set right, because if you're both if you're in the hospital with medical professional, ObGyn and you're a doula and you're trying to advocate for your client, there's a point where you're trying to like, hey, wait, no, I know what's best.

And is there some, you know, tussle back and forth?

What what does that look like?

You know, I think everyone, you know, everyone's there for the same purpose to make sure that mom and mom mom is safe, and that a healthy baby is born into a, safe environment.

So as doing as we know our roles and we respect the other roles in the room and our, our part of our role is not to really directly speak up to medical providers.

Right.

It's more so that we can help, inform and advocate with mom by supporting her while about lifting her voice.

Right.

we never want to take her voice away from her.

So, you know, sometimes mom may say, well, can you say that?

And you say, no, let me tell you how you can, get that message across.

let me help you in that area so the support looks different.

but what I will say is what I find in the rooms, because I, I go out and I assess clients as well.

I'm a doula as well.

I find, and we have come a long way as far as, like, nurses, medical providers and doulas in the room, I find that everyone works in harmony.

We really do.

For a majority of the part.

I will not say there are some, situations where you kind of feel uncomfortable or, maybe someone else there energy.

It seems like they're uncomfortable, but but for the most part, we are there for mom.

So at the end of the day, the doula is going to come in here and support exactly how we need so, and we will not, you know, we're mindful of making sure that, mom, we don't get in the way of mom having a great experience with her care team as well.

Ayanna, please chime in, because you're in a birth in space as well.

Yes.

Oh.

Go ahead.

Yeah.

Go ahead.

You can go ahead.

what was the what was the question?

The question is like in the, in the, in the labor room, right.

There's that dynamic, those boundaries.

Yeah.

There's boundaries that.

Yeah I know Jasmine that I, I also agree with like if not more often than not at the very welcoming environment.

the providers are.

Oh, what are you asking me my opinion.

What do you think about this position?

Should we try to get her into.

so they're very, open and open and welcoming and fostering a great environment most times.

And then me as well.

Like, I know that I'm not medical, so I'm not going to be like, giving advice.

And I don't have the scope of, like, it's beyond my scope of practice.

So I stay in my lane.

But I also have my client.

Like I said, I'm helping them amplify their voice, making sure that they know that their voice is the most important one in the room.

And you can tell say what you feel, say how, say what you need to say.

And like I said, sometimes it takes that time that you need to ask the doctor provider, hey, can I just get a few moments to think about this so that you can figure out what what is your voice?

What do you have to say?

And then you can say that, and communicate that clearly.

But I'm not like, you should do this and don't let like it's really because I don't know what's best for you.

You know what's best for you.

I can give you the information that I know.

and then based on what the doctor has also said, you make an informed decision for yourself.

I don't want to, like, persuade you and point you in any one direction, because you know what's best for you.

Okay.

Yeah.

And, Stephanie, I just want to piggyback off of that.

From your perspective, do you see the medical field becoming more open to working with with doulas alongside doulas?

do you think so?

I think both because it's becoming more of a practice, which then means that the more opportunities that we have to collaborate together, the more we get to know each other and get to know everyone's contribution.

which always just makes that that collaboration and teamwork work better.

but also because, you know, we each provide a different lens to the the birth experience that this person is having.

So.

Well, I had, you know, my team may have the medical background.

We haven't had the opportunity to visit with this patient in their home and, and learn about, you know, their risk tolerance and their, you know, goals and values for their birth experience and so we each kind of have a different lens to what's happening for the birth, and makes it very collaborative when we can work together.

And the more we can do that, the more, kind of streamline that process becomes.

Yeah, I, I can say that, doulas become besties, right?

What's your what's your clients at some point, right.

you know, everything about them.

so that's always great to have, like, a best friend in, in the room with you.

so we're going to just take a quick short break, and then when we get back, we'll have more with our guest.

We're talking about black maternal health and the role of doulas right here on connections.

Coming up in our second hour, Rachel, Steven host a conversation about prom season and in particular in many black communities, how prom has become a kind of teen Met Gala shaped by tradition and TikTok.

But it also raises deeper questions about identity and performance and pressure and social media, and explores all of that and more.

Next, our.

Support for your public radio station comes from our members and from Lakeview Organic Grain, supplying certified organic feed grains and crop seeds to northeast organic farmers.

More online at Lakeview Organic grain.com.

This is connections.

I'm Rachel Stevens, filling in for Evan Dawson this hour.

We're talking about the role of dual, that role that doulas play in black maternal health.

From the delivery room to the wider fight for reproductive justice.

My guest this hour, our Jasmine Brewer, program manager of the Black Doula Collaborative at the Healthy Baby Network.

I also have Ayanna Alexander, a community based doula and doctor.

Stephanie Hollenbeck is an assistant professor of obstetrics and gynecology and biomedical engineering at the University of Rochester Medical Center.

Thank you, ladies for joining us.

We actually did receive an email from a listener.

and his name is Alex and he's a Rochester.

And he says as a new dad, having a doula support, my wife and I was invaluable.

Can't recommend it enough.

While Rochester's own senator, Samra Brouk, led the fight in getting doulas covered by Medicaid, this Lee's parents with employee health plans to say something to to pay nothing of Medicaid and rope to say nothing of Medicaid enrollees in other states.

Georgia, Louisiana and Texas have some of the highest maternal mortality in the country, and not coincidentally, some of the highest number of black adults enrolled in Medicaid.

40% of Georgians are roughly half of black Louisianans and one quarter of black Texans.

These are states whose majority vote conservatively.

And for candidates who cut Medicaid discriminatory.

Statistically speaking, black adults in these states do not vote conservatively.

How can federal legislators more effectively fight to expand Medicaid when the data overwhelmingly shows whose lives are lost by a lack of doula coverage?

He said.

I'm sorry for the rant.

I'm not.

Thank you.

Alex.

and we know.

Yeah.

And big shout out to my girl Sam or Senator Sam or Brooke and her fight for black maternal health, and Medicaid coverage.

Right.

Big congratulations for for having, doulas being covered on Medicaid.

is that why we're seeing such an increase in people wanting tools and and what can you tell me about that coverage?

Any of you, So, Healthy, baby.

Now we're we're really, separate from, you know, we are definitely in support of everything that's going on right now.

We actually were tabling at her baby shower recently.

but healthy baby network.

We are, non-for-profit in all of our doula services, our cover.

So we actually do, you know, our free of charge.

Oh, yeah.

And, Doctor Hollenbeck, over at, UMC, are we are patients now with this Medicaid being being covered by Medicaid, are you seeing that patients are requesting doulas more often?

What are we seeing here as far as a dynamic between Medicaid and doulas?

I definitely think that there's such a critical piece that that access plays to helping people, access the services that they want and can benefit from.

And so it's so great to be in New York, where we have been able to have all of our, Medicaid enrollees, be able to be covered for doula services at no cost since, just about this time last year.

and I think that's one of the, the pieces that really helps us driver access to this.

And I agree with, those kind of very strikingly poignant statements brought together, by by the person writing in that we are so lucky here to have this resource, but it's something I would love for us to see advocacy for, to really make sure that that access can become more universal.

Okay, we know having a doula care black maternal health is somewhat of a is a public health issue, right?

But it's also like a justice issue.

How do we make room for both?

so I think when we're, speaking of justice or addressing issues, about about black maternal health, one thing that we value as a healthy baby network is hearing directly from the community that is served, and that's how we go about, addressing, injustice or like any barriers that are going on in the birthing space, you have to listen to the body of people.

It's happening to.

Right.

we cannot you cannot, think you're going to get, correction from people who do not, fill those, disparities.

Yes.

Or have those experiences, those lived experiences or connect it to it.

you cannot be so far removed from it or do not know about it and, provide correct corrective action, you know, so we do value with all of our services that we provide, with listening to parents first.

That's why we do surveys.

That's why we go back to the drawing board and say, how can we make this better?

That's why we had those conversations.

so that's invaluable to us.

Teach us, tell us, show us so we can help make those corrections or, you know, dismantle, help dismantle some of those issues.

And I, Stephanie, I wanted to ask you, you know, with the, you know, federal cuts, a lot of times, you know, a lot of cuts, federal grants are being cut.

are we concerned at all that something can happen to health care and how the grants can affect black maternal health?

Absolutely.

We are already at a place, even before the kind of most recent round of of federal changes to coverage, may start to be making an impact where we already knew that our rates of maternal mortality and mortality were too high.

And then when we, on top of that, start to dismantle our ability to do research into how we can, dismantle inequity when we start to take away our ability to improve universal care so that people can take great care of their health prior to a pregnancy, and enter as safely and healthy as possible to improve the chance of having good outcomes.

So understand how we can best care for patients and get them good access during their pregnancies and beyond.

all of those things were places we already, had so much work still left to do.

And now when all of these, these grants and other kind of universal strategies of coverage are starting to be stripped away, it worries me that we're only going to see those disparities becoming worse now, when we've been working so diligently to try to start to kind of reverse that tide.

People were looking at some big barriers here.

Oh, there's a whole show on.

It's on its own.

I know we have a someone on the line.

We have Lisa, from Rochester on the line of caller.

She would like to, make a comment or talk to our doulas.

Yes.

Hi.

I'm really enjoying the show.

Thank you so much.

I, I'm so concerned because, you know.

Well, first a comment, then a question to see if we could do something about it.

But Rachel Barnhart, the legislator, just published, a pretty comprehensive study showing pretty inconclusively that Monroe County DHS is slow walking benefits to people, and it's really hurting people.

And particularly now, I wonder if there's anything that, this group can do to try to get them to do better by the people in need around here who often pay for these benefits.

Oh, thank you, thank you, Lisa.

And and the benefits that you're, you're referring to.

Can you, can you elaborate on that?

These benefits.

The Rachel Barnhart just published, it's a pretty, elaborate study that shows pretty inconclusively that, pretty conclusively rather that, Monroe County's DHS is slow walking, all kinds of benefits.

you know, if a senior gets too much pulled out of their Social Security check in advance of, from paying for Medicare for the Medicaid part of their Medicare that they already bought.

if you try to get that money back, it's almost impossible.

You end up waiting over a year to get any overpayments back.

And most seniors are kind of stable.

But this is going on across the board with DHS of Monroe County, slow walking payouts to people, and it's hurting people.

And I think it's accelerating the homeless crisis.

Thank you.

Thank you.

Lisa.

ladies, you have you had an experience with DHS in in the work that you do as as Douglas, the only part of DHS, we do not work directly.

we support moms if they have to maybe fill the application out.

Right.

but as far as the barriers or, the things that are taking place at DHS, we are not part of, you know, those meetings and things like that.

the doula from our space, we're here to support, mom, you know, and if support around DHS in our agency, it would be letting her know what's available and maybe supporting her while filling out a application or doing some follow ups or fighting, finding, you know, who's your caseworker or things like that.

But as far as the bigger part of that, like decision making and, that, you know, on that level we do not sorry.

Anything you want to add, Ayanna?

No.

Oh, I know, so I, I want to ask, very broad question.

What what changes do you think we would see in our community if every black birth and person had access to a doula?

I know it's a good question when they say oh yeah.

It's a great question because you know, so when you say you know what changes we have seen changes in our community.

We've seen lower C-section rates.

We've seen, higher breastfeed initiation rates, our program, all the women who are out of all the women, almost 500 women who have came through our program in birth, we have a 98% breastfeeding initiation rate.

And that's from education support from the doulas and the services that they are providing.

That's from going into the homes and saying, hey, let's do that birth plan.

Have you breastfed before?

And sometimes we hear those stories like, no, no, I, I've never seen anybody growing up, you know, breastfeeding.

So it's not the norm.

Okay.

But we were doing this, you know, let's, you know, a whole nother segment could be our history of breastfeeding, but I won't go there.

But I'll just say that as far as changes, we are seeing lower C-section rates, less medical interventions.

and that speaks directly to the education.

that is an informed care and support that that's being provided through the doula services.

So, what I project, you know, I'll give a little quick story, just my own success.

My mother breastfed, right?

She breastfed me.

I breastfed my son.

I did not breastfeed my daughter, but just from breastfeeding my son.

And then, you know, becoming, certified lactation counselor.

before Covid, during Covid, I was doing zoom meetings with moms that I would be meeting with and from my son's 17.

But at the time he was like, you know, well, when I get married, I want my wife to breastfeed my baby.

That's from hearing about the facts, you know.

So just given that example, because when you educate and then you model, it makes a different trend in the community.

So that's what we're projecting to see.

We're going to continue hitting the ground and our bolts and doing the work we're doing.

No matter what's going on, support is always going to come from us.

Education is going to come from us.

that's the space we're speaking from.

So we're definitely looking forward to seeing less medical interventions, less C-sections, healthier birth, birth weights, and more of a, you know, it's totally up to moms choice.

But if you want to breastfeed or you don't know about breastfeeding, we are here to support.

And we know that it's the best option for baby.

I want to talk more about the relationship after birth.

Right.

With your with your client.

because it doesn't end in labor and delivery, right?

I can still call you up a girl.

Can you come help me breastfeed?

Yeah.

Can we talk about this relationship after after birth?

And when does this end?

Can I do?

My doula is always going to be there for our program, the home visiting aspect of it.

And that three month, 12 weeks postpartum, and I have my clients, they call me for everything.

Like they're like, hey, because like you said, a friendship is formed.

there's trust there.

They're like, hey, this is happening.

what should I do?

Or, like, is this okay?

And sometimes I say, well, call your provider and tell them that.

And they're like, oh, okay.

Like, if I'm just telling you the cloud provider, but they're like, oh, thank you.

Or sometimes it's just they're calling me to tell me how they're feeling right now, and I'm just a listening ear that they trust and they know I'm going to just listen to them, and that's all they really need.

Postpartum.

but yeah, we go into the homes, we help them with breastfeeding.

Sometimes I'm holding your baby for so you can have your hands free for a second because you're just sitting there with baby all the time, and you just want to have your hands free, to do whatever.

But our home visit my consists of me holding baby and, you know, talking to you.

Or it can look like a wide variety of things, but just having someone come and lay eyes on you postpartum can be life saving within itself.

and that can be like, medically like, oh, these are the red flags that you should look for postpartum and that might be something that comes up or just so that they can hear how you're feeling and look at you and say, you get you got this.

Yeah.

Or here's a referral to someone that can help you.

get them extra help if you need it.

So it can look like a wide variety of things depending on what that particular parent is going through.

Yeah.

So you're not babysitting so I can call you to babysit when I if I want to take.

I have, you know, mom and dad wants to go out.

and I call my doula and I do that, do that.

Our program doesn't do that.

But there are if do like, overnight postpartum doula care.

and things like that.

So it depends on where you live.

And I want to add that, you know, that I'm so happy that the father came in, caught in or emailed in.

I'm sorry.

Because the community based a little part.

We are definitely in support of that as well.

Yeah.

So sometimes, during those visits, you know, the prenatal visit or postpartum dad is like, hey, where do I fit in?

You know, in the birth in space.

So it's really cool.

to really get that relationship with the partner before labor and delivery as well, because you can show him some comfort measures, some things that he can do to really relax and help support mom, because dads do not not always know what to do in that space.

Or sometimes, you know, during that postpartum period that is like, okay, I don't want to aggravate her or annoy her, but what can I do to support her?

Okay, she's breastfeeding.

So, you know, I don't have to breastfeed a baby, so how can I support her?

Dad?

You can go.

You can rubber feet.

You can, you know, just be there while she's breastfeeding or, you know, sometimes just adding that extra pillow.

Hey, baby, need a pillow?

I'm giving her a glass of water, some snacks.

Dads definitely our value in that space.

so I'm so thankful for her, email and, and just speaking of his experience, because we definitely in our program encourage dads to come on and hey, we we need to educate you tool or ask questions as well because we want to inform you too.

Yeah.

That's I mean that's that's a great topic in itself having that support for, for fathers because I know when my pregnancy experience, my son's father was having all the symptoms, pregnancy symptoms, he was eating everything.

And I was pregnant here.

Right.

So dads go through postpartum as well.

Yes, right.

Postpartum experience like they do go through there.

So having that support for dads are great.

And I want to ask you ladies, is there a moment, in your career where being a doula, you just like, wow, this is why I do what I do.

Every birth, every person.

That's my that's that's my daughter.

That's not fair to everybody.

It's because of, like, us.

So, like, you're in the room for a while with the mother laboring, so you have the continuous support.

So, when the mom's going through each contraction, I feel like I'm.

I'm there with her.

With each contraction, I'm making sure she's okay.

I'm fanning her.

I'm offering her something to drink.

Do you need some chapstick?

I'm there by her side.

and then as we're getting closer and I can, like, feel that baby's almost here, I'm like, oh, it's happening again.

Like, I get excited all over again.

As if I didn't do this five days ago or two weeks ago, or whenever the last birth was.

It's like all over again.

I'm getting excited.

I'm like in the room, like doing like my little labor dance.

I call it.

Like I get excited and, yes, I'm grateful every time it's the same experience for me.

It's brand new all over again.

So how many families do you do you work with on a monthly basis, a yearly basis?

I do approximately two birth a month.

Wow.

and that can always be more or less because the woman goes late, another one goes early.

It might be three birth or less, depending on what it is, but I get to two people that are doing each month.

and sometimes they're back to back and sometimes they're spaced out.

But depending on, like I said, when the birth happens, okay, I was just going to say an intentional the way our program is framed because burnout Israel.

Right.

it's definitely quality over quantity.

We're not trying to do, you know, overload any of our birth workers.

Right.

because quality and that support.

And like she said, sometimes someone can go early.

So you might be birthing three times.

It's an experience, you know, so quality over quantity so you can get their phone call any time of the night.

Yeah.

They like to come in the middle of the night for me.

Me too.

Wow.

Wow.

Okay.

That's I mean, ladies, I commend the work you do because I, a lot of people don't understand how vital.

Right.

Having that role is, especially for black moms.

Right.

Having that support in that labor delivery room.

is is critical.

especially now, when you, when you do enter that that labor delivery room space is there, do you do any some type of routine to get ready or how you know what, for the most part, you know, if there's no emergency or alarming things going on, my first thing is, mom, get your rest now, honey, you know, get your rest now.

You want to rest as much as possible?

just making sure that she's comfortable and whatever we've talked about beforehand, it's all on a birth plan, so some might.

Somebody may like music playing.

She may be like, you know what, I want to jam.

So babies come.

Coming.

You know, we might be having a little birth party in there and then some.

Mom, she's like, turn the lights off, put some rain music on rain sounds and let me relax.

every birthing space is different.

but that birth plan is definitely important, and it's one of the reasons why we do them to really, help mom know when she's dreaming about her ideal birth.

Yes.

You know, so, you know, mom leads the way.

so if there's anyone interested right now, that's that's listening and interested in becoming a doula or having a doula.

how can they reach you or what steps should they take?

Yeah.

So, you can always reach out to us at the Healthy Baby Network at info, at Healthy Baby Dot net or, email me Jasmine at healthy dash baby dot net.

as far as, doula training, community based doula training we are planning now, we do not have specific dates, but we are planning now, to, run two trainings by the end of this year.

our trainings are a little lengthier than most doula training because of that community aspect, that home visiting aspect, you know, safety and all of that.

but we are, you know, keep in contact with us, reach out, because we do have some trainings coming up for sure.

And what would you say on is the best part about being a doula?

witnessing like a baby coming to the world like it's just a beautiful experience.

And then standing next to that woman as she's transitioning into a mother is a it's a something I just can't even put into words.

and and Jasmine, what would you say is the best part about being a doula?

I would say the same.

You know, that, all that hard work when mom gets that beautiful reward, that bundle and you see Dad and mom drop its hair and you see their baby take their first breath, it's like the first time.

Every time.

It truly is.

Well, ladies, we want to commend you for the great work you do for our community and and for our black birthing, people.

Thank you so much for joining us on this hour of connections.

Jasmine Brewer, Aiyana Alexander and Doctor Stephanie Hollenbeck on the phone.

Ladies, thank you so much for being for having us.

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