New York City Launches Initiative to Eliminate Racial Disparities in Maternal Death

A Central Brooklyn hospital featured in ProPublica and NPR’s “Lost Mothers” series for its high hemorrhage rate will serve as a pilot for quality reforms.

In response to alarming racial disparities, New York City announced a new initiative last week to reduce maternal deaths and complications among women of color. Under the new plan, the city will improve the data collection on maternal deaths and complications, fund implicit bias training for medical staff at private and public hospitals, and launch a public awareness campaign.

Over the next three years, the city will spend $12.8 million on the initiative, with the goal of eliminating the black-white racial disparity in deaths related to pregnancy and childbirth and cutting the number of complications in half within five years.

“We recognize these are ambitious goals, but they are not unrealistic,” said Dr. Herminia Palacio, New York City’s deputy mayor for health and human services. “It’s an explicit recognition of the urgency of this issue and puts the goal posts in front of us.”

The city’s health department is targeting nearly two dozen public and private hospitals over four years, focusing on neighborhoods with the highest complication rates, including the South Bronx, North and Central Brooklyn, and East and Central Harlem. Hospital officials will study data from cases that led to bad outcomes, and staff will participate in drills aimed at helping them recognize and treat those complications.

Health department officials approached SUNY Downstate Medical Center in May to serve as a pilot site for many of the new measures.

 

The Central Brooklyn hospital was featured in the “Lost Mothers” series published by ProPublica and NPR last year as one of the starkest examples of racial disparities among hospitals in three states, according to our analysis of over 1 million births in Florida, Illinois and New York. In the second half of last year, two women, both black, died shortly after delivering at SUNY Downstate from causes that experts have said are preventable. The public, state-run hospital has one of the highest complication rates for hemorrhage in the city.

“We look forward to working with all of our partners to provide quality maternal health care for expectant mothers,” said hospital spokesperson Dawn Skeete-Walker.

“SUNY Downstate serves a unique and diverse population in Brooklyn where many of our expectant mothers are from a variety of different backgrounds, beliefs, and cultures.”

The city will also specifically target its own public hospitals, which are run by NYC Health + Hospitals, training staff on how to better identify and treat hemorrhage and blood clots, two leading causes of maternal death.

The initiative is “aimed at using an approach that encourages folks to have a sense of accountability without finger pointing or blame, and that encourages hospitals to be active participants to identify practices that would benefit from improvement,” said Palacio.

In addition to training, the city’s public hospitals will hire maternal care coordinators who will assist high-risk pregnant women with their appointments, prescriptions and public health benefits. Public hospitals will also work to strengthen prenatal and postpartum care, including conducting hemorrhage assessments, establishing care plans, and providing contraceptive counselling, breastfeeding support and screening for maternal depression.

Starting in 2019, the health department plans to launch a maternal safety public awareness campaign in partnership with grassroots organizations.

“This is a positive first step in really being able to address the concerns of women of color and pregnant women,” said Chanel Porchia-Albert, founder and executive director of Ancient Song Doula Services, which is based in New York City. “There need to be accountability measures that are put in place that stress the community as an active participant and stakeholder.”

The city’s initiative is the latest in a wave of maternal health reforms following the “Lost Mothers” series. Over the past few months, the U.S. Senate has proposed $50 million in funding to reduce maternal deaths, and several states have launched review committees to examine birth outcomes.

As ProPublica and NPR reported, between 700 and 900 women die from causes related to pregnancy and childbirth in the United States every year, and tens of thousands more experience severe complications. The rate of maternal death is substantially higher in the United States than in other affluent nations, and has climbed over the past decade, mostly driven by the outcomes of women of color.

While poverty and inadequate access to health care explain part of the racial disparity in maternal deaths, research has shown that the quality of care at hospitals where black women deliver plays a significant role as well. ProPublica added to research that has found that women who deliver at disproportionately “black-serving” hospitals are more likely to experience serious complications — from emergency hysterectomies to birth-related blood clots — than mothers who deliver at institutions that serve fewer black women.

 

In New York City, the racial disparity in maternal outcomes is among the largest in the nation, and it’s growing. According to a recent report from New York City’s Department of Health and Mental Hygiene, even as the overall maternal mortality rate across the city has decreased, the gap between black and white mothers has widened.

Regardless of their education, obesity or poverty level, black mothers in New York City are at a higher risk of harm than their white counterparts. Black mothers with a college education fare worse than women of all other races who dropped out of high school. Black women of normal weight have higher rates of harm than obese women of all other races. And black women who reside in the wealthiest neighborhoods have worse outcomes than white, Asian and Hispanic mothers in the poorest ones.

“If you are a poor black woman, you don’t have access to quality OBGYN care, and if you are a wealthy black women, like Serena Williams, you get providers who don’t listen to you when you say you can’t breathe,” said Patricia Loftman, a member of the American College of Nurse Midwives Board of Directors who worked for 30 years as a certified nurse-midwife in Harlem. “The components of this initiative are very aggressive and laudable to the extent that they are forcing hospital departments to talk about implicit bias.”

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MOST MOMS AREN’T AWARE OF FREE BREASTFEEDING INSURANCE BENEFITS, SURVEY SHOWS

Progress has been slow, but we’re starting to see the US become a more supportive place for breastfeeding moms. Laws entitle women to nurse in public, pump at work and have access to free products and services designed to give breastfeeding a boost in this country. But surprisingly, 82 percent of moms aren’t aware of all their legal rights and benefits, a new survey shows.

By law, women have the right to a private space to pump (and no, the bathroom doesn’t count), and their employers are required to let them take pumping breaks at work—something 61 percent of women weren’t aware of, according to a recent survey sponsored by Byram Healthcare, a medical supply company that provides no-cost breast pumps through insurance. The fact is, there are a whole host of free health benefits breastfeeding moms are legally entitled to, thanks to the Obama-era Affordable Care Act—but these big money-savers apparently aren’t well known.

Of the 1,000 expectant mothers surveyed, 64 percent didn’t know that sessions with a lactation consultant are covered at no cost to them under most of today’s insurance policies. That’s right—it’s mandatory for most insurance plans to cover lactation support and counseling, as well as equipment for the duration of your breastfeeding period, including before and after you’ve given birth.

That means you’re entitled to a breast pump through your health insurance (and whatever else your doctor deems medically appropriate for you). But 42 percent of women didn’t know you can order a breast pump, usually at no cost (though some policies might require a co-pay). And we’re not just talking a basic manual pump—insurance also covers premium double-electric pumps. Worried you won’t be able to get your pump of choice? You’re not alone, the survey shows, but rest assured plenty of popular name-brand breast pumps, like Medela, Spectra, Lansinoh and others, are available.

 

So how can you go about getting your free pump? First check with your insurance policy to see what’s fully covered and what retailers would be considered in-network. You can place an order as soon as get that positive pregnancy test, if you’d like. The only caveat for many insurance companies is that the pump won’t actually be shipped until 30 days before your due date.

The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months and continuing as long as mom and baby desire—so taking advantage of these benefits could save you big bucks. Breastfeeding isn’t always easy, but at least there are policies in place to help you succeed. If you’re in need of more help, check out these 12 tips for making breastfeeding a little easier.

Science Daily: For women with history of pregnancy loss, walking may aid chance of becoming pregnant

Date: May 8, 2018

Source: University of Massachusetts at Amherst

Summary: Results of a recent study to better understand modifiable factors such as physical activity that may affect a woman’s ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant.

Results of a recent study to better understand modifiable factors such as physical activity that may affect a woman’s ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant.

The study was conducted by recent graduate Lindsey Russo and her advisor Brian Whitcomb, associate professor of biostatistics and epidemiology in the School of Public Health and Health Sciences at the University of Massachusetts Amherst.

Russo and Whitcomb’s findings among healthy women ages 18 to 40 years old with a history of one or two pregnancy losses are based on their secondary analysis of the multi-site Effects of Aspirin in Gestation and Reproduction (EAGeR) study. It is led by Enrique Schisterman of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Results are in the current online issue of Human Reproduction.

Russo says, “One of our main findings is that there was no overall relationship between most types of physical activity and the likelihood of becoming pregnant for women who had already had one or two pregnancy losses, except for walking, which was associated with higher likelihood of becoming pregnant among women who were overweight or obese.”

Whitcomb, whose research on the determinants of fertility and pregnancy outcomes usually involves studying biomarkers at the molecular level, adds, “Lifestyle is definitely relevant to these outcomes because it can have an effect at the molecular level. What we eat and what we do are potential factors we can change to shape our health. So this sort of research is important because it helps provide information on the things people can actually do something about.”

Further, he says, “We were happy to be able to add scientific evidence to general recommendations about physical activity. This is especially true for the results about walking for even limited blocks of time. Walking has great potential as a lifestyle change because of its low cost and availability.”

For the 1,214 women in the study, the association of walking with the ability to become pregnant, known as fecundability, varied significantly by body mass index, the authors report. Among overweight/obese women, walking at least 10 minutes at a time was associated with improvement in fecundability. Further, in statistically adjusted models, women reporting more than four hours a week of vigorous activity had significantly higher pregnancy chances compared to no vigorous activity.

Moderate activity, sitting and other activity categories were not associated with fecundability overall or in BMI-stratified analyses, they add. Russo and Whitcomb say one finding that is still not clear is the different associations related to vigorous compared to moderate and low-intensity activities. Whitcomb says, “We don’t know what to make of the finding that high intensity physical activity may have different biological effects than walking, but our study doesn’t offer enough detail to get at why vigorous activity would work differently than other levels.”

Among a number of cautions the researchers point to in this work is that physical activity is related to other behaviors and lifestyle factors, and women who are more physically active may be different from women who are less active in many ways. Russo says, “We did our best to try to account for the differences and to address them statistically.”

The researchers also note that the overall generalizability of this work is limited because the study population may not be representative of the general population with regard to fecundability, and exercise habits may differ in women with prior miscarriage compared to those without.

Whitcomb says another way in which this study is distinct from other work in this area has to do with who was included in the study. The EAGeR trial focused on women with a history of one or two prior pregnancy losses. However, he adds, “We were happy to be able to conduct research considering women having the most difficulty getting and staying pregnant, and to provide messages about common lifestyle factors they may be able to address.”

The researchers conclude that “these findings provide positive evidence for the benefits of physical activity in women attempting pregnancy, especially for walking among those with higher BMI. Further study is necessary to clarify possible mechanisms through which walking and vigorous activity might affect time-to-pregnancy.”

 

Story Source:

Materials provided by University of Massachusetts at AmherstNote: Content may be edited for style and length.

Rewire.News: Maryland Legalizes Home Births With Midwives (2015)

 Martha Kempner

Maryland Governor Larry Hogan (R) is expected to sign a bill Tuesday that will license direct-entry midwives and make it legal for them to attend to home births.

Maryland Gov. Larry Hogan (R) is expected to sign a bill Tuesday that will license direct-entry midwives and make it legal for them to attend to home births.

Maryland was one of six states that forbid midwives from helping mothers give birth at home unless the midwife is a nurse. Advocates have pushed for legislation to change this law for many years, but opposition from medical groups and concerns about safety had prevented it from gaining traction in the state’s Democratic-majority legislature.

Around the country, the number of births that take place outside of a hospital setting spiked by 60 percent between 2004 and 2012, according to the Centers for Disease Control and Prevention (CDC). Currently, somewhere between 1 and 1.5 percent of all Maryland births occur out of the hospital.

Proponents of changing the state’s law argued that these women and the midwives that help them have few legal protections. They believe that changing the law to allow for licensed certified midwives—as 28 other states have done—could enhance safety through education and regulation and give everyone involved legal protection.

Groups representing doctors, nurse-midwives, and nurses had previously opposed similar laws, as had the state’s health department, but the bill introduced this year included compromises on many issues that had been at the center of legislative disagreement. The bill set specific education requirements for certified midwives, noted which health conditions precluded home birth, and explained when and how midwives would transfer care to another medical professional if they encountered problems during delivery.

The sticking point this year was related to what is known as vaginal birth after cesarean section, or VBAC deliveries. It used to be settled science that once a woman had a c-section section, all future births would be by c-section to reduce the risk of uterine tearing.

New surgical procedures, however, have made this risk much lower and allowed some women to have a vaginal delivery with their next pregnancy or pregnancies. Fear remains that VBACs are more dangerous and many in the medical profession are against VBACs attempted outside of a hospital.

Pam Kasemeyer, a lobbyist for the Maryland State Medical Society and other physicians groups, told the Baltimore Sunin April that VBAC was “the one remaining very contentious issue.”

“We understand that women are going to make that choice and deliver at home, and that’s their right,” she said, adding that medical groups weren’t going to agree to the bill unless VBACs were excluded.

To get the bill to move forward, both sides agreed that VBACs would be prohibited for now. But the bill requires a committee to report on the safety of such deliveries and leaves open the possibility that the law could change.

Delegate Ariana Kelly (D-Montgomery County), who sponsored the bill in the house, was not surprised by the contention. She told the Baltimore Sun: “Medical licensing bills are brutal. They’re turf wars.” Once the last compromise was reached, however, the bill, HB-9, was passed unanimously by both the house and the senate.

Rewire.News: “The Midwives’ Resistance: How Native Women Are Reclaiming Birth on Their Terms”

 Mary Annette Pember

Birth has become dangerously medicalized for them.

Aboriginal or indigenous midwifery is seeing a resurgence as conventional health-care policies in hospital and clinics perpetuate an environment in which most contemporary pregnant Native women are considered pathologically unhealthy.

“The mainstream medical narratives surrounding Native women depict moms who don’t breastfeed and don’t have partners. According to this portrayal, Native women don’t exercise, eat poorly, and have diabetes. We are seen as hopeless,” said Marinah Farrell, an indigenous Chicana certified professional midwife based in Phoenix.

“When I worked in the hospital, I saw so many Native mothers who would hemorrhage and have terrible outcomes during their births. It seemed so abusive; they were treated like they were sick already when they entered the hospital doors,” said Rebekah Dunlap, a member of the Fond du Lac Band of Ojibwe who works as a doula and is a registered nurse, bachelor of science nurse, and public health nurse in Minnesota.

What began quietly as the efforts of a few dedicated women has in recent years grown in size, scope, and agility. Today, Native women across the United States and Canada are putting their skills to work in challenging the status quo of mainstream medicine.

Birth has become dangerously medicalized for them. Cut off from traditional diets, support networks, and community midwives due to colonization and assimilation, many Native women have chronic health conditions that mean giving birth is a high-risk activity—and one that requires travel to well-equipped hospitals.

Many indigenous women in the United States and Canada give birth in governmental health facilities overseen by Indian Health Service (IHS) in the United States, and First Nations and Inuit Health Branch in Canada.

Health-care policies at IHS and First Nations and Inuit Health are comparable to those at conventional health-care facilities in both countries.

Aboriginal or indigenous women, especially those in the United States, are overwhelmingly classified as high-risk. In Canada, according to Statistics Canada, birth outcomes among indigenous peoples are consistently less favorable than among the non-indigenous population. Native American and Alaska Native women have higher rates of maternal morbidity or injury compared to the general population, according to the Centers for Disease Control and Prevention (CDC). The risk of maternal death for Native women is twice that of white women in the United States.

The infant mortality rate for Native American and Alaska Native babies is .83 percent, second only to rates for non-Hispanic Black American babies of 1.13 percent.

The practice of forcing Native women to travel to hospitals because their traditional ways of caring for pregnant people were outlawed contributes to an endless cycle of poor outcomes. Despite the public health industry’s best attempts at addressing Native women’s high-risk status, this cycle can’t be addressed by the same Western-style institutions that are complicit in perpetuating the problems in the first place, according to indigenous midwives including Katsi Cook of the Mohawk Nation.

For instance, governmental policies such as forced attendance at Indian residential schools in Canada and Indian boarding school in the United States were explicitly intended to eradicate and denigrate indigenous cultures, languages, and ways of healing and birthing. Many children in these schools were subjected to sexual and physical abuse and denied access to their families, thus creating generations of untreated post-traumatic stress disorder or historical trauma. After being cut off from families and traditional lifestyles and foods, which some suggest offer nutritional benefits, indigenous peoples began developing high rates of diabetes and poor health outcomes, such as high rates of lung, chest, and intestinal disorders.

Forcing Native women to birth in hospitals is another in a long line of colonial acts of violence, explained Kanahus Manuel, a member of the Neskonlith Indian Band of Secwepemc Nation in British Columbia, Canada. “Birth is the ultimate act of decolonization and resistance,” she said.

Reclaiming Tradition

The efforts of indigenous midwives in Canada and the United States run a wide spectrum of styles and practices. However, according to Nicolle Gonzales, Navajo nurse-midwife, “Indigenous peoples share a worldview of connection to the land. We view birth and motherhood as ceremony,” she said.

“Traditional midwives took time to sit and talk with the mothers about their lives, families and challenges,” Dunlap noted.

“Our women were given time and support to have their babies; there was no agenda dictating the various stages of labor,” she said, drawing a clear distinction between birthing experiences at hospitals versus in Ojibwe communities. According to the American Pregnancy Association, there are three stages of childbirth including early labor when the cervix moves toward complete dilation of 10 centimeters, active labor when the baby is delivered through the fully dilated cervix, and third stage which includes delivery of the placenta. The first stage of labor is usually the longest period and can last from a few minutes to many hours.

Among indigenous peoples, as birthing women moved through the stages of labor, they were fed certain foods to provide physical, emotional, and spiritual strength.

When the baby was born, its feet touched the earth even before it was given to the mother.

“All of these ways had important meanings that are not yet completely lost,” she said.

“Woman is the first environment,” Cook said, echoing Dunlap’s sentiments. “With our bodies we nourish, sustain, and create connected relationships and interdependence. In this way the Earth is our mother, our ancestors said. In this way, we as women are earth.”

Cook has influenced and inspired generations of midwives to embrace their traditional Native ways. “I have a long tail in championing indigenous midwifery extending back to when I was first pregnant in 1973,” Cook said.

Cook has worked as an indigenous women’s health and midwifery advocate for many years. In 1983, she helped create a “Birthing Crew” of local elders and midwives on her home reservation of Akwesasne in New York and Canada. The crew provided midwifery services and health education to tribal members. In 1985, after the nearby St. Lawrence River was polluted by polychlorinated biphenyls (PCBs) from General Motors, Cook established the Mother’s Milk Project. A study found PCB contamination of breast milk of Mohawk women who ate fish from the St. Lawrence River.

Today, Cook’s many devotees and students continue taking up the challenge to revitalize indigenous midwifery.

Aboriginal midwife Kanahus Manuel is a self-proclaimed warrior, freedom fighter, and well-known indigenous land and water protector.

Manuel was pregnant with her first child while opposing the Canadian government’s plan to build facilities for the 2010 Winter Olympics on Secwepemc lands. When she learned that authorities had issued a warrant for her arrest for these activities, she fled to the Marble Mountain range deep in Secwepemc territory when her time came. “I knew I wanted an unassisted birth as my ancestors have done for centuries; I didn’t want to have my baby in a prison cell,” she said.

She educated herself in both mainstream and traditional birth practices and has since birthed all four of her children in the Secwepemc way, at home attended by family and/or midwives.

For Manuel, revitalizing indigenous midwifery is a declaration of sovereignty over women’s bodies and autonomy from colonial governmental systems.

Other advocates are finding ways to work within the systems to revive Native birth ways.

Gonzales is working within U.S. medical laws and regulations to create what will be what she describes as the first Native culturally focused birth center on tribal lands. Founder and executive director of the New Mexico-based Changing Woman Initiative, Gonzales received her bachelor’s of science in nursing and master’s degree in nurse-midwifery from the University of New Mexico and is a member of the American College of Nurse-Midwives and certified with the American Midwifery Certification Board. Although eligible to practice in a conventional hospital, Gonzales envisions creating a birthing environment that is friendly and welcoming and where Native women can have ceremony, eat traditional foods surrounded by family, and reclaim their traditional ways of birthing and healing.

According to the CDC, in 2015, 98.5 percent of births in the United States occur in hospitals. Out-of-hospital deliveries represented 1.5 percent of births in 2015. Of the more than 61,000 out-of-hospital births, 63 percent occurred at a home and 31 percent at free standing birthing centers. However, most insurance companies don’t cover home births and may only offer limited coverage at birthing centers.

Gonzales hopes she can establish Medicaid certification for the birthing center they are building and establish other ongoing funding in order to offer services for women who may lack other health insurance.

She and her supporters and co-workers at Changing Woman Initiative equate Native women’s rights to birth in their own ways as inherent and inalienable rights affirmed by the United Nations Declaration on the Rights of Indigenous Peoples.

They hope to complete the birthing center, on the Pojoaque Pueblo, north of Albuquerque, this year.

Providing Truly Culturally Sensitive Care

Gonzales and her colleagues argue that although the Indian Health Service is tasked with providing health care to Native Americans, it is unable to effectively meet its mission. IHS is the federal agency within the federal Department of Health and Human Services that is charged with meeting treaty agreements between federally recognized tribes and the U.S. government, which promises to provide tribal members with health care. These promises have their base in Article I, Section 8 of the U.S. Constitution governing duties and powers of the Congress.

Criticism of the type of health care offered by IHS, however, could be lodged against other conventional health-care facilities in the United States that are also subject to the same limitations and laws regarding types of services that can be offered.

A statement provided by the Phoenix Indian Medical Center indicated that it employs ten certified nurse-midwives who provide culturally sensitive and relationship-based services. According to the statement, the health center provides pregnant people with therapeutic massage, hydrotherapy, and lactation support. Gonzales, however, argues that although IHS insists it offers culturally sensitive birthing practices, most of the midwives are non-Native and the facilities are still governed by the same strict hospital-style protocols as its mainstream counterparts. So no matter where a Native pregnant person might reside, their access to culturally sensitive care will be limited, if nonexistent. Birthing mothers are restricted regarding food consumption and the use of open fires, and ceremonial food preparation is restricted.

Aboriginal midwifery in Canada, however, has long been recognized by mainstream organizations such as the College of Midwives of Ontario. The college, responsible for registering midwives in the province, declared in a 2001 vision statement that midwifery care in Ontario, including aboriginal midwives, was defined by ongoing support for community-based midwives working in partnership with childbearing women. Aboriginal midwifery is seen as a valuable way not only to improve patient and infant health outcomes, but also as a means to help reverse overall health disparities among Native peoples.

In 1994, many Canadian provinces added a special exemption to the Canadian Midwifery Act. It allows aboriginal midwives who provide traditional midwifery services to tribal communities to practice without registering with the Regulated Health Professions Act. The act varies by province but requires midwives to complete a set of mandatory courses and abide by the rules of the act. Aboriginal midwives can practice legally without accreditation under the often-rigorous demands imposed by the act.

“Indigenous midwifery and healing practices are keystones in addressing reproductive health and longstanding problems in communities such as addiction, disease, shame and trauma,” said Cook, who helped create the 1994 exemption.

Preliminary data and evaluations indicate that birth outcomes have improved since the exemption was added. For instance, Inuulitsivik Health Centre’s Midwifery Service in Nunavut territory has provided care by traditional Inuit midwives to clients since 1986. According to research funded by Health Canada and published in Birth Issues in Perinatal Carefindings indicated low rates of intervention for births despite the high-risk designation of many Inuit mothers. Ninety-seven percent of births were documented as spontaneous vaginal deliveries; Inuit midwives attended 85 percent.

Midwifery in the United States, however, is not as accepted as in Canada. Laws governing its practice vary greatly from state-to-state. Only certified nurse midwives (CNMs), not other midwives, can practice legally in all 50 states. They are afforded hospital privileges in 30 states. After earning a bachelor’s degree in certified nursing, most CNM candidates also complete graduate studies in programs certified by the American College of Nurse-Midwives.

Some midwives may practice under other designations, including direct-entry midwives, certified midwives, or certified professional midwives, who may work in birthing centers and/or help with home births. Training for and attainment of these titles varies from state to state. In some states, many midwives run the risk of arrest for practicing medicine or nursing without a license.

For most women in the United States, the path to childbirth begins with a trip to a traditional hospital. Native mothers frequently must travel great distances from rural home communities and frequently can’t afford to bring along family or other support people. More insidious, however, according to indigenous midwives, is the impact of ongoing trauma from sexual assault as well as unresolved historical trauma created by U.S. federal policies designed to separate Native peoples from their lands, cultures, and languages. According to the Department of Justice, Native Americans are 2.5 times more likely to experience sexual assault compared to other ethnicities. One in three Native women reports having been raped in her lifetime.

The hospital environment with its rigorous, sterile protocols forbidding food; regulations regarding the number of visitors; agendas dictating when to induce birth or perform cesarean sections seem like another in long line of traumatic events.

According to Cook, Native peoples won’t be healthy and whole until Indigenous midwifery, which helps to combat trauma affecting poly-victimized people, is restored to their communities.

In that vein, Dunlap and a handful of other Native women in her area are creating a local effort to spend time with traditional midwives and healers and encourage expectant people to learn more about their Ojibwe birthing ways.

“Our Ojibwe stories describe how the fathers would keep a fire burning while the woman birthed so the baby’s spirit could find its way.” Having a prescribed role for the father provides him with a sense of connection and purpose with the birth.

“For Ojibwe, birth is a ceremony; baby is on a spiritual journey before they actually arrive,” Dunlap said.

“We have ancestral knowledge that Ojibwe women can share with each other,” she added.

The reclamation of indigenous women’s medicine is a true grassroots endeavor, Cook pointed out.

“In indigenous communities, health begins at home, at the kitchen table, using the everyday language of everyday people,” she said.

CORRECTION: This piece has been updated to clarify Kanahus Manuel is a member of the Neskonlith Indian Band. A previous version of the piece also listed Rebekah Dunlap as her online pseudonym R.A. Mackelberry.

Evidence-based journalism is the foundation of democracy. Rewire.News, is devoted to evidence-based reporting on reproductive and sexual health, rights and justice and the intersections of race, environmental, immigration, and economic justice.

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Birth Statistics ~ The need for more Midwives

Demetra Seriki is a NARM registered Midwife and owner of A Mother’s Choice – Birth Options and Beyond

She is also a Midwife who serves the community of Colorado Springs, Colorado and is currently seeking Student midwives of Color who are interested in training to complete their education as midwives. With so many hospitals closing in many states across the country, the necessity for properly trained Midwives are seemingly increasing.

She recently shared some disturbing but much needed statistics about birth:

 

It is with a very HEAVY heart that I will report the 2016 birth statistics in El Paso County (Colorado Springs) for families of color. They do not separate the stats by birth location so these numbers represent total births and all birth locations.

Total births (all races) 9,499
1. Hispanic – 1,517
2. Black – 814
3. Asian – 468
4. Native – 92

Low Birth Weight (<2,500):
1. Hispanic – 8.8
2. Black – 14.1
3. Asian – 9.0
4. Native – 13.0

Very Low Birth Weight (<1,500)
1. Hispanic – 1.5
2. Black – 2.5
3. Asian -0.9
4. Native – 6.5

Preterm
1. Hispanic – 10.4
2. Black – 13.5
3. Asian – 9.8
4. Native – 19.6

52 infant deaths
34 neonatal deaths

Unfortunately the data that I can see does not identify these babies (angles babies) by race. (I can’t imagine why)

 

If you are a student midwife or a women seeking health services in the Colorado Springs, Colorado area please feel free to contact her.

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Taji Mag|YtheDoula introduces the IbiOp App for Birth Options & OBGyn

ibiopFinally an app that lists all Doulas, Midwives, OB-GYNs and more of Color: the IbiOp app. Yasmintheresa Garcia is 24 year old Afro-Dominican from East New York, Brooklyn. This Midwife in training, Doula, and Childbirth educator is recently the creator and developer of the IbiOp App.

Yasmintheresa recalls practicing being a Doula when she was 12 years old, before she even know it was a career. She began to focus on her career as a Doula to gain experience to become a midwife 3 years ago after watching the “Business of being born” documentary.

What made her interested in this field of expertise was the want to make women feel empowered by supporting them during the moment when they become super humans but may also feel the most vulnerable.

ibiopDuring her extensive research to find a Midwife to be her preceptor as Midwife in training, she realized the lack of accessibility there is to different medical providers. Many Midwives who have their own private practice don’t have time to update their facebook page or twitter let alone have a website. Roughly only 27 states allow Certified Professional Midwives to have their own practice outside of hospital institutions, therefore she made it her mission after training with the Farm Midwives of Summertown, TN to create a directory where not only clients can find these birth workers who specialize in natural birth, but students interested in the field also.

Since her freshmen year in college, Yasmintheresa knew that as a millennial she would have to create something in the tech world or else regret not using her knowledge of advance technology that she acquired while growing up. She came up with the idea in January of 2016 when she created a virtual vision board for the spring season and added a photo of the app store logo to remind herself everyday to research and create an app to serve the industry she works in. After intensive research and creative surges she drew up her app, gathered data, and began to work on hers. Yasmintheresa wants people to know that not all millennials are lazy. That even though she has had many doors closed in her face, she still manages to create what she wished existed, including her own opportunities.

IbiOp was created to allow women all over the world access to health care focusing on gynecology. With the IbiOp app, women can now access a directory of medical providers or labor and birth support persons anywhere in the world. This app will allow women who travel the touch of a button access to options available in their community for gynecology services or antenatal, prenatal, and postnatal support.

Women who are expecting or just concerned with their health will now have an app where they can find anything from a Midwife who does regular check ups and all well women care, to OB-GYNs who focus on high risk patients, or expecting mothers who are simply looking for labor and birth support from Doulas. The app also includes events happening worldwide that focus on women’s health, expectant mothers, and family planning.

Their goal with IbiOp is to have as many options for women to choose from when selecting a labor support person or medical provider. IbiOp will benefit every woman who has access to apps worldwide. Now an 18 year old in college who just had her first experience with a guy and wants to get checked but is to shy to walk into a clinic can find someone on the app that looks like her and who she feels comfortable with. They have even considered the woman who is pregnant and travelling who needs to see a midwife for a sudden check up in a foreign country.

Yasmintheresa is an ambitious young woman thriving in an industry that was once known for having mainly elder midwives as birth attendants and gate keepers of life and death. Today the maternity industry has women of all ages catering to mothers across the board while jumping through loopholes and creating new rights for women to be able to birth freely. She works tirelessly to fund her own Midwifery education and career and hopes that others see the necessity in support for women of color.

IbiOp is now available for download in both Apple & Google app store for FREE.

The Willow Breast Pump

There is no question that best way to feed a newborn is to breastfeed. When a baby is born they constantly seek the comfort of mum because that is now their life force. Mum provides love, protection, nurture, and food of course!

Breast feeding is imperative for a babies’ development and creating the very important bond between mum and baby however many mums find themselves still in need of a comfortable breast pump to use while breastfeeding or when they have to be away from their babe.

Whether it is because you have to return back to work or school and want to insure your baby still feeds from your milk exclusively or if you are experiencing large amounts of milk being produced by your breast, you will need a comfortable, easy to use and to hide breast pump!

Well how about a breast pump that fits in your bra and no one even notices your pumping. Sounds PERFECT!

How about a breast pump that doesn’t hurt because it can fit any boob of any size?

Check out what I found. One of my new favorite products!

http://www.willowpump.com/

 

 

Article from    http://mashable.com/2017/01/05/willow-breast-pump/#YxMJmoLP8ZqY

“A new breast pump startup wants to help new moms take a literal hands-off approach to pumping. 

Willow is a set of two breast pump wearables that are meant to be worn inside a woman’s bra. An app on the wearer’s smartphone tracks volume of breast milk and time spent pumping and logs that date for later use. 

Women don’t need the app to pump, however– the product works entirely on its own to encourage the let-down reflex and then adjusts pumping based on the wearer’s flow. When the bag is full, the pump stops automatically. One charge gets wearers at least five pumping sessions, and in a pinch, can do a single session on 20 minutes of charging.

The idea behind Willow is to allow women to pump while still going about daily activities. But is it discreet enough to be worn out of the house?

Willow Co-founder and CTO John Chang tells Mashable that women who’ve tested the pump can testify that it’s quiet enough for public use. 

“Moms have come back to us and, instead of having to hit the mute button on a conference call, they’re having a conference call and nobody knows that they’re pumping,” he said. Indeed, the pump made little noise as we spoke at Willow’s International CES booth.

Chang admitted that because of their larger size, users have said that spouses and coworkers can tell when they’re wearing the pumps. Strangers, however, don’t seem to take notice. 

“What we’re hoping is that this is transformative for moms, so that they don’t have to stop or pause their life. They can plug into life, not plug into the wall,” Chang said.

 

SO JUST A HEADS UP AS SOON AS IT HITS THE MARKET! I’LL BE SHARING THE NEWS!

 

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THINGS TO REMEMBER:::

How breastfeeding BENEFITS BABY

  • Breastfeeding protects your baby from a long list of illnesses
  • Breastfeeding can protect your baby from developing allergies
  • Breastfeeding may boost your child’s intelligence
  • Breastfeeding may protect your child from obesity
  • Breastfeeding may lower your baby’s risk of SIDS
  • Breastfeeding can reduce your stress level and your risk of postpartum depression
  • Breastfeeding may reduce your risk of some types of cancer

 

How Breastfeeding BENEFITS MOTHER

  • Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster.
  • Releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and reduce uterine bleeding after birth
  • Lowers mother’s risk of breast and ovarian cancer
  • May lower risk of osteoporosis

 

*For breastfeeding support and education click for Doula services*

 

 

 

 

YtheDoula Diary: Baby Charley the Warrior’s Princess

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 -A YtheDoula Story-

At 2:33am her labor intensified and she was now in Trans. The look on her face was psychedelic. It was as if all of her fears had whispered away as she began to surrender to her godliness. In that moment she began her transformation into this fearless warrior  whose body was no longer hers but belonged to all the women who once walked in her footsteps, crouched down on their knees, and birthed nations across the oceans.

THE DIVINE INTERVENTION

I met Arlene and Charlie through divine intervention is what I like to believe. Just days before Arlene’s predicted due date, her original Birth Doula, my former classmate who trained as a Doula with me; had to leave for Africa to embark on her 6 week journey of nursing and midwifery studies. Like any responsible Doula does; Ashlie decided to contact me and refer me to the couple as their back up Doula just in case the baby came after Ashlie boarded her flight. Ashlie and I did our Birth Doula workshop together and she believed that my philosophies of birth were parallel to hers and I would be a great stand in for her if the unfortunate situation happened where she would miss the birth of the Baby. In the beginning of the week Ashlie had us get acquainted via Group chat and email. I was briefly educated on the journey that the soon to be mum and dad had been through with Ashlie. I began to feel as though I was called into this birth for a reason. My spirit guides told me that I should meet with the couple as soon as possible because I would soon be the chosen Doula for their birth.

On a Friday night after a long week, Arlene and Charlie arrived at my Harlem office with Poppa Charlie’s mother and loads of questions and apprehension up their sleeves. I was so excited to meet them but felt a weight of responsibility to be ready at any given moment to support this couple as a Doula with knowing little to nothing about who they were, how they loved, and what I could possibly pull out of their souls to provide them with the strength they needed to get through this miraculous experience. I literally had 24hrs to meet them; their souls, their spirit, and the spirit of their unborn baby through the love they expressed towards each other.

THE INITIAL CONSULTATION

I left that consultation feeling inspired by Arlene, after conversations with her and husband about her fears and joys, anticipations and expectations. I learned that there were so many warrior spirits that surrounded and raised Arlene to be the woman she is today. I wondered to myself how I would gather all this power to assist her through what I knew would be the biggest transformation in her life. With much privilege I took on the responsibility of being chosen to be her gate keeper of life and death as she welcomed the new life of her baby onto this earth and departed from herself as a woman who was not yet a mother. I gave Arlene and her husband Charlie a few days to consider hiring me as a Doula, because after all; my belief is that the baby chooses the birth Doula not the parents. They went home that night, meditated on it and emailed me way before the 24 hours to inform me that I should be ready because the baby had chosen me.

THE CASUAL YET NECESSARY CONVERSATION

My practice as a Doula is based on how I can be this woman’s keeper. My goal is to dive deep into her psyche and learn her in depth feelings about the journey she is on as a woman. I often find myself asking mum’s who are fearful of labor if, “They are ready to be a mother to this specific child.” Through my observations I have gathered that all births are different for mums and that often times when a momma is worried about her delivery it is based on a fear of what life would now be like after the baby becomes a little human right before their eyes. Therefore, I tap into my client’s emotions with genuine curiosity in search for guidance on what will be needed of me as a Doula toensure this woman is empowered by this experience. I remember asking Arlene if she was ready to be a mum. This was Arlene and Charlie’s first baby.  After our in person consultation, I went home concerned by Arlene’s fear of not living long enough to see past the birth of her baby girl. She expressed that one of her fears was not being able to see far enough into her future to witness her baby grow up. I wondered if her mentality sprung from a societal repression of the Generation Y2k, whom see the world for the scary place that the media makes it out to be.  I wondered what made this strong, vibrant, and joyful woman hinder her own ability to believe in the hope she had for a wonderful future with her new family. As a Libra myself, I decided there were so many layers apart from strength and perseverance that made up Arlene’s character. I learned she was a Libra who was in the process of working tirelessly to bring both sides of her family together in love and unison before the arrival of her baby. Arlene was joyful about meeting her baby but was anxious about welcoming her baby into a safe and loving environment. I assured her that nothing happens as a coincidence and that baby would be what would remind her, her family, and all who are a witness of what love, life, and adventure is truly about; the unexpected and the inevitable.

FROM CONCEPTION TO CONTEMPLATION

Around 9:00am Arlene began to update me with what her body was undergoing. Charlie was more excited with letting me know every new phase Arlene went through in the beginning of labor. I asked Charlie to keep me updated. But also to go about their day as normal as possible. The two of them began their Saturday morning with loving vibes, a stroll in the city, grocery shopping, and even having a good ole slice of pizza at a local pizza parlor. As a Doula, I was 40 minutes away with my phone attached to my hand going along with my day working my 9-5 with the readiness to come up with an excuse for my supervisor if at any given moment I had to leave for the birth of the baby. I asked Charlie to track Arlene’s labor moods, and contractions as the hours went on in order for me to know exactly when I would have to leave for Harlem from White Plains NY. It is always better to be near the laboring mum. Not necessarily with her all day, but nearby just in case the baby wants to rush into this world without notice. By 1:00pm I decided to take the train ride into the city and hang out at a local coffee shop since the text messages from Poppa Charlie were getting more dramatic by the hour. Just as new parents would react in a situation not knowing what to expect; I wanted to assure them that I would be near them for whenever they needed the in person support. By 6:00pm, Arlene’s contractions were going at every 5 minutes, 30-40 seconds long. At 7:30pm I arrived to their home. My favorite part of my Doula career is the reaction of the parents, especially the mum the moment I arrive at their door. Like most mums in their homes during labor, I walked in to Arlene cleaning. It is almost an innate reaction that a woman has while laboring at home to begin cleaning to get her mind off labor and keep distracted from the process. However from a birth worker’s perspective; I know too well that this kind of behavior is anxiety manifesting its form of cleansing out the old energies in preparation for the new energies and new life coming into the home. Then again Arlene is Colombian; historically many Hispanic and African cultures the woman always cleans when they have a lot on their mind. Can you blame us? It is extremely therapeutic. A clean space equals a clear mind.

Upon Charlie opening the door, Arlene saw me and my bright cheesy smile that followed with a joke, “What are you doing? Cleaning? Why? Wheres the party? I asked. She smiled with joy.  A spirit of peace came over her.  It was such a privilege seeing her sweep the broom across the living room so calmly as if she had no care in the world because now her Doula was there. Little did she know she was going to be the one doing all the work; the cleaning included. It helps for a mum to be active during contractions and I wasn’t going to be the one to take that away from her. I made this very clear to her through many jokes. The night progressed smoothly as both mum and dad insisted in catering to me as if I was a guest of honor. I had to remind them that I did not need anything to drink or eat but that I was there to serve them and make sure they had everything they needed to be comfortable and Zen. During Arlene’s contractions, Charlie would tend to her like a Lion romancing his lioness, gallantly protecting and nurturing her yet secretly adoring her with all his gratitude as she labored their unborn baby.

THE EFFECTS OF AN UNEXPECTED GUEST

At around 9:40pm unbeknownst to me the unexpected happened. As a birth Doula and future midwife I have strong beliefs about who should be present at a woman’s birth. Most pregnant women don’t usually conceptualize how spiritual the birthing journey can be. Nor do they consider how powerful each individual presence involved during the labor can be. It is highly important for all of those who are in the presence of the laboring mum to be invited and to only be there to serve the situation with physical, spiritual, and emotional support. That being said, no one who is fearful of the processes of labor should ever be in the presence of a birthing woman. Energy is very real and while a woman is laboring she is literally in between two realms; the realm of life and of death and as she travels spiritually in and out of this dimension she gathers strength and purpose from all her ancestors and all her predecessors in order to birth her child.Therefore it is my duty as her Doula to protect the space for her to travel freely and peacefully.

 

Suddenly I heard a key turning in the door of the apartment and my heart dropped. I didn’t want to believe what I knew was already manifesting. After all, Charlie and Arlene made it very clear to me that Arlene’s mother in law; Charlie’s mother was not going to be in attendance during the laboring process of their baby. That she would only be allowed in the waiting room during the delivery as she expected her first grandchild. Arlene was doing so well during her contractions that we all found it so comical how she would be telling a story and sharing jokes but then in a split second she would close her eyes and disappear into a wave of energy that both Charlie and I could only imagine what kind of roller coaster ride it felt like. Like clockwork, Arlene was at a steady pace of 40 second contractions every 3 minutes by now but then the door opened.

It was Charlie’s mother. All of my attention was glued to Arlene when I noticed her shift in energy the moment she saw her mother in law come into the house. I quickly accessed the situation and realized that the couple was not expecting her arrival to the home before they went to the hospital. As I continued to look at my watch in monitoring Arlene’s contractions I became worried when I noticed that she was no longer contracting every three minutes. She had stopped contracting for 10 whole minutes now and I quickly decided she needed a change of environment away from her mother in law. I asked her to come with me to her bedroom and I brought it to her attention; how her energy became bothered and unsteady the moment her mother in law walked in. She shared with me how she loved her mother in law but that her cigarette smoke scent and the past week full of horrifying birth stories from her was what she feared having to experience at that moment.

FROM A WARRIORS BELIEF CAME BABY CHARLIE

It  was in this defining moment that I realized how much value my work as a Doula truly has. As I paint this picture I wish for all to imagine for just a moment this beautiful yet chaotic energetic chain of events that led to the minutes that introduced baby girl Charley into this earth.

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By 10:30pm mum had progressed in labor and the energies of the home felt a bit more peaceful. Mother in law was staying out the way by suddenly picking up the responsibility that every Afro-latina woman is graced with during any moment of anxiety and she began cleaning every inch of her son’s apartment. As I monitored Arlene, she began to not be able to voice her labor progression and the jokes were now one sided. It was then that I prepared mentally to schedule our next moves. My duty was to keep calm, and get poppa to order this Uber, make sure mom in law continued to scrub the floor somewhere in the back, and help Arlene feel safe every time she transitioned further and further away from her natural state of consciousness in order to bare the labor pains.

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No surprise at all when I was approached with the duties of ensuring mum would stay mentally in the birthing zone. It almost became a game every time Arlene will have a 3 minute break between contractions and start asking everyone if they had everything they needed. She asked if we had her IDs, did we have the suitcase, did I have everything I needed. I was like, “Arlene, focus on birthing this baby and let us handle everything.”She even suggested we all take a selfie in the elevator on our way to meet the Uber. I couldn’t wait to tell the Uber driver about how important this ride was for him as much as it was for us. Shout out to that Handsome African Uber driver who was so impressed by Arlene’s powerful handle on the situation she was dealt. It made me so happy to be apart of a man from Africa witnessing an American woman labor so gracefully with no complaints. The whole ride to the hospital he kept affirming her ability to do it. We all became Doulas in that car ride!

 

 

Upon arriving to the hospital I had to mentally prepare myself for the worst. Being a birth Doula in hospitals can be very challenging when working to keep mum at peace in a very chaotic and stoic environment. Arlene was 4 centimeters when we arrived and the nurses suggested that she leave for two hours and come back when her labor had progressed. Imagine the disappointment when we hear this after thinking we did most of the work at home. It was game time for me.

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My job was to make the best of the situation at hand which was the reality that Arlene and her husband would have to labor in this hallway waiting room with other expecting families staring. I quickly positioned her crouched over a big medicine ball, pulled out my headphones from my bag and activated her prepared playlist. She was officially gone. By 1am she had advance a few centimeters and her contractions were getting stronger. There were moments where I had to coach her like a sports player to get up off the floor or switch positions in order for her to keep her blood circulating and get the baby to move downward. I had to make sure she was comfortable and not cramping her legs by being on her knees for too long.

 

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Charlie was so loving throughout the whole process and only wanted to ensure that she wasn’t in too much pain. Charlie kept Arlene comfortable the whole time and would kiss her and keep his hand on her to remind her that he will never leaver her side especially in their toughest moments. It was magical to bare witness to a poetic love story I was just beginning to read. Many moments occurred when I would look away from Arlene and see her mother in law right behind her rubbing her back the whole time, while we were on the floor, when we moved to the middle of the hallway against the wall. I realized that mother in law understood why I was there. Here was this 60 something year old lady whose had traumatizing births in the same city was now witnessing her daughter in law have an empowering experience with a dream team who was supporting her every time she moved, had to pee, or needed us to hold a cubby for her to throw up in while we stood in the middle of the hallway. It was in that moment that I knew my job was to be the Doula for this whole family who was learning the true beauty of natural labor.

By 2am Arlene’s moans made a roaring entrance into a very quiet scene. It was time. Charlie had Arlene come off the elevator after a walk alone together around the floor below us and as they stood in the elevator she had to step out because baby was coming. In the elevator hall way they stood and Arlene let out a roar like a warrior who had led all her people to the promise land but was tired as heck. Her body collapsed over the arms of her husband and her water broke. I stood watching everything from the glass doors confident that this was my place just making sure they knew I was close enough to assure them that all of what was happening was completely normal.

It took only 2 seconds after her roar for Mother in law to flee to the scene while asking me if she was okay. I explained that she was fine. Her water just broke and there is amniotic fluid on the floor and its time; but she’s doing great! Mother in law rushed to get through the door just like a momma bear wanting to protect and save all and anyone in distress. I almost had to box out mother in law from the energetic bubble the couple was in to make sure that her fears wouldn’t freak out Arlene or Charlie. I knew I had to watch out for mother in law the moment she rushed in asking if everything was okay which transmuted into Charlie taking all the napkins he had in his pocket and started cleaning the wet floor while trying to hold up his wife. I laughed. And quickly gave everyone a small speech in our hallway huddle, “Charlie leave that there, I am sure they are use to having women’s fluids everywhere around here. Mother in law, this is normal. She is now ready to deliver baby. Arlene, you did it! You are at the end of your marathon and your so close to meeting your baby.” Within minutes we get her admitted into her room and Arlene delivers a beautiful baby girl in which no one knew the sex of before meeting her.

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They named her Charley in honor of her daddy. I never seen a love so quiet yet powerful between two people the way I have witnessed between Arlene and Charlie. That morning I had battled more negative spirits and transmuted negative energy into positive than I ever had in such a short period of almost 12 hours. I wrestled with mother in laws negative experiences and fears and watched her transform her birthing beliefs by watching how calm and graceful her daughter in law was during her whole labor. I then had to tame the energy in the room while comments of a prejudice P.A. insisted in telling us how well women of color delivery babies because “Our bodies were meant to reproduce.” I, as a Doula have been honored to be asked to create a sacred space for this family to welcome their baby girl no matter what was happening around them.

After two hours and smiling faces and a now topless Father Charlie, I knew my job that morning was done. After a twelve hour shift I was ready to go home, rest, and regroup. Baby was beautiful and healthy and grandma was overjoyed and impressed beyond belief of how well her daughter in law and son went through the journey of childbirth.

 

A week later I visited Arlene, Charlie, and Baby girl Charlie at home. Mother in law had gone back home to puerto rico and the home smelled like love and new born baby. The couple remembered everything except some of the funnier moments I would have to keep out of this story because I can easily make this into a novel. We shared pictures and drooled over how adorable baby Charley was. After making sure the couple was in high spirits and in love I was overjoyed especially when they confirmed their gratitude for my Doula services. To make a long story short, we are good friends now and I can’t wait to see Baby Charley the warrior princess grow into a Queen like her mum one day.

 

~ YtheGarcia  Q1-2017

Dami Akinnusi (Darkling) ~ Client Testimony

Yasmintheresa was a wonderful doula to me and my family. During what is a really intimate time and life changing event you need someone in your corner who understands the transition into motherhood as well as the hospital procedures that you may or may not be aware of and Yasmintheresa was on point in this regard. Her warmth and energy is what made me choose her from the others that I interviewed and she instantly had a good rapor with my family during our first meeting.

I initially decided on going with a doula due to being unfamiliar with the American health care system, having moved here from abroad. She was able to give me sound advice about  the best ways to advocate for the type of birth suited to our needs and was then also on hand to facilitate our requests during labour when my focus was obviously elsewhere. This is no way interfered with my partner’s role allowing him to be as involved as he wanted whilst alleviating some of the anxiety that comes with bringing a new being into this world.

I can honestly say it felt like she was a member of the family or that best friend who holds your hand in times of need. She even showed up to the hospital with healthy snacks and drinks and just surprised us with her generosity and kindness. She also captured our moments on camera for us which ca easily be forgotten in those minutes after giving birth.

When finding a doula you want a person who you feel comfortable with in your space from the get go and Yasmintheresa was that person. In her post natal visit to check up on us her concern for not only our newborns well being but also mine was heart warming beacuse most visitors naturally are so excited to meet the newborn they forget about the new mother and how she might be coping. All was well but it was nice to be reminded that you did a good job. Looking back we are so grateful to have had her as part of this life changing experience. Good luck ladies! ~Dami Akinnusi