Birth Journeys: Lifting the veil on the birth experience
Did your childbirth experience go as planned? Then The Birth Journeys Podcast® is for you! We share powerful and transformative birth stories that illuminate the realities of childbirth. Hosted by a labor nurse and prenatal coach who specializes in transformational coaching techniques, this podcast goes beyond traditional birth narratives to foster healing, build trust, and create transparency between birthing individuals and healthcare providers.
In each episode, we dive into essential topics like birth preparation, debunking common misconceptions, understanding hospital procedures, and promoting autonomy in the birthing process. We also bring you the wisdom and insights of experienced birth workers and medical professionals.
This is a safe and inclusive space where every birth story is valued, honored, and deserves to be heard. Join us in exploring the diverse and unique experiences of birth givers, and discover how transformational coaching can empower your own birth journey.
Contact Kelly Hof at: birthjourneysRN@gmail.com
Birth Journeys: Lifting the veil on the birth experience
Suzzie Vehrs Shares Insights on Doula Support and Maternal Care
Unlock the secrets to a more empowering childbirth experience! Join me as I sit down with Suzzie Vehrs, a dedicated doula and mother of two, who made a remarkable transition from finance to birth advocacy. Suzzie opens up about her personal journey through pregnancy, loss, and the incredible power of support during childbirth. You'll gain insight into the vital role doulas play in helping mothers make informed decisions and letting their voices be heard in the delivery room. Plus, we dive into the recent legislative changes that have made insurance coverage for doula care more accessible than ever.
Navigate the complexities of hospital births as Suzzie shares strategies for ensuring informed decision-making and effective communication with medical staff. We discuss the varied policies of different hospitals, especially concerning interventions such as inductions and the use of drugs like Pitocin and Cytotec. Suzzie emphasizes the importance of having birth preferences that accommodate both an ideal vision and potential complications. Learn how doulas and labor nurses can collaborate to advocate for the mother's choices, fostering a supportive and understanding environment.
In our final chapter, we delve into practical tips for hiring the right doula and the nuances of creating a positive birth experience. Suzzie offers guidance on financial considerations, conducting thorough interviews, and the benefits of prenatal planning with techniques like hypnobirthing. We also explore how to maintain a calming environment in a bustling hospital setting. Wrapping up, we highlight the collaborative relationship between nurses and doulas and the incredible resources available on shebirthsbravely.com to further support expectant mothers. This episode is packed with valuable insights to help you feel confident and empowered as you prepare for childbirth.
Connect with Suzzie Vehrs: https://shebirthsbravely.com/
Join the Bump & Beyond Online Community for moms & moms-to-be!
Coaching offer
Kelly Hof: Labor Nurse + Birth Coach
Basically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!
Connect with Kelly Hof at kellyhof.com
Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.
Hello, Today I have with me Susie Veers. Susie is a doula and a mother of two. She is here today to share with us about the importance of birth prep, becoming confident about birth and finding your voice and learning to advocate for yourself in the delivery room. Susie also has insight on how to find insurance coverage for doula care after recent legislation has been passed to allow birth support. Susie, welcome and thank you for joining me. Hi, thank you so much for having me. I'm really excited to hear about all your insight because birth prep was one of my passions. I would love to hear about your take on birth prep and how you came to be a birth doula and how we can all have doulas at the bedside.
Speaker 2:Well, I came here in not a street or linear fashion at all. I started my career. I studied economics, I worked in finance. My experiences becoming a mother was not necessarily an easy route. I experienced loss at 14 weeks with my first pregnancy, a year's worth of medical complications due to that, and then my pregnancy with my first daughter. But second pregnancy was like so easy, so great in comparison to what I had been through.
Speaker 2:But her birth was wild and not what I expected at all and I realized that there had been so many things that I wish I had known before and after her birth I was like, okay, like I just wanted to close the chapter on birth pregnancy. It was not for me, but I knew I wanted to have another child and luckily I met a friend who was a student midwife and as we would spend time together and I'd hear the stories from her clients, I started to think I missed out on so much. Like there was so much joy and closeness and bonding and love and excitement in all of this. I always say it like the way I went through pregnancy and birth with my first child is if you're on a hike in a beautiful area and all you do is you stare down at your feet and think, what if I fall off the cliff? What if I fall off the cliff? What if I fall off the cliff? And then you fall off the cliff right.
Speaker 2:And so when I had Hazel, I had somebody to kind of guide me, help me understand like a broader perspective, a more holistic perspective, helped me understand what my needs were, helped me know how I could actually meet those needs.
Speaker 2:And I had an incredible experience with Hazel's birth and I had both a midwife and a doula that I was very close to and they took very good care of this younger version of myself who was coming into the experience with quite a lot of trauma to process, and it was just such an empowering experience. So after Hazel was born, when she was a year, I went and did my certification as a doula and I've been a doula for about five years. I've been a childbirth educator for about three of those and I just really, really love helping moms gain that knowledge, gain that confidence, gain that trust in themselves and in their teen. Before birth instead of after, we can heal from the difficult experiences and sometimes birth throws curveballs that we can't plan for. I don't want to paint too rosy of a picture, in the sense that if you prepare, it will always be perfect. It won't, but if you know that you're capable of meeting the challenges as they come, there's a lot less fear and a lot more joy in the process.
Speaker 1:Yeah, I couldn't agree more. There's so much flexibility and mental preparedness that is needed to be able to feel successful and powerful and joyful during the birth experience, because it is a challenge, it is a very physical experience, it's very intense. It's like for lack of a better metaphor it is like running a marathon, and it's something that you do need to prepare for. So, especially if you've never done it before, if you have no idea what you're in for, you need to figure out how you're going to rise to the challenge, no matter what comes. And it's such a good preparation for parenthood, I think, because you're going to continue to have those opportunities to rise to the occasion throughout your parenthood journey, and birth is just the gateway to that whole parenting experience.
Speaker 1:I like how you word your mission. I like that you put the power onto the birthing person, versus when I go to a doula website or when I talk to doulas, they talk about being the advocate versus helping the mom become their own advocate, and I think that is such a fine line. But it's a very important distinction, because when you're advocating for someone and they don't have a voice themselves, then are you really advocating for them, and that's something that I've wrestled with for a long time, but I wonder if you could speak to the distinction between helping someone finding their voice and learning to advocate for themselves and when to step in and advocate for them and how to make that distinction.
Speaker 2:Yeah, I think for me a lot of that comes down to I always have the goal of protecting a mom's right to informed consent. The longer I've been a doula, the more that I try to make sure that that's covered before you go into labor, because once you're in labor you should have the freedom to be able to go into labor land and to kind of disconnect from the way that we think and process so that you can be present with your contractions, so that you can be present with your breath, so that you can be present with the moment. But there are decisions that have to be made sometimes during labor. I know I was just working with a mom. I was talking to her this morning and here in Seattle where I live, we fortunately have many, many different hospitals around us. So when I go to the hospital as a doula there's like seven or eight different hospitals that I go to pretty regularly. This mom is at a hospital where the C-section rate for first-time low-risk moms is close to 40%. I know it's a very high number. I was trying to get people to drive the extra 20 minutes because there's a hospital where that number is like 20%. But the care that is common there is very much like your labor is not going to work. Let me help you, let me fix it Right. And so it's like let's intervene early, let's intervene before there's a problem, let's induce everybody, let's use as much Pitocin as we can, and if there's fetal distress, well it's just. Labor is so unpredictable. Good thing you were here. And it's this weird cycle. Medical help is so important in some cases, but some of the drugs commonly used in labor, like mesoprostol, also goes by Cytotec. It's not even FDA approved to use in labor. It's FDA approved to use in stomach ulcers and it says on the label not approved for labor. No safety data has ever been given on this, and Pitocin is on this high risk list of only six drugs for drugs that can cause harm to a mother and baby, even when used correctly.
Speaker 2:And so, with my clients, I try to help them think through like, okay, what does an ideal birth look like to you? If everything goes perfectly like you don't have any medical complications, you're just sailing through this experience, what does that look like? And we create that vision. But then we also have conversations about like okay, if something goes wrong, when would you be open to these? And let's get you a little bit of knowledge about what does it look like when you might need help and what are those situations, so you can have a logical choice. But you don't have to necessarily be thinking about everything all the way through your labor because you can let go and just be focused on that really, really perfect plan, which very often does go that way when you've planned and you're ready for the contractions.
Speaker 2:But also then, when someone is equipped with a little bit of knowledge, then they can truly make their own decisions right. Then they can truly make their own decisions right, and so I try not to ever make decisions where people only provide information and context and then, when a person has made their decision, I let them state their decision and then, if they're getting pushed back, I'll typically come in and support their voice. For example, sometimes when water breaks, moms are like I'm open to doing an induction, but I want to wait 12 or 24 hours before I start medication, knowing that most women will start labor on their own by then goes depending on the hospital we're at. Sometimes it's like great, we'll see you in 12 hours, we'll see you in 24 hours, and other hospitals it's like no, we see right away. That's what we do here.
Speaker 2:There is no choice unless you ask more questions. My strategy is to provide the information and then, once somebody has made their choice and vocalized their choice, if they're getting pushback which they typically don't, but if they do just being the one to step in and say this is what she said. Do you have concerns about that? What are your concerns? Okay, this is what she has said about that. This is what she's already vocalized to you.
Speaker 1:I like the way you word that, because I always try to encourage my clients to use the words concerned or what are your concerns. I feel like that is such a disarming way to ask questions, and I also feel like the best way to get to the bottom of what people's thought processes are is to continue to ask questions like what are your concerns? Can you help me understand what your thought process is, or what your plan of action is or what your goals are with this? And then, if we don't get to the point where we can come to a common understanding, then we can start saying things like well, am I safe right now? Is my baby safe right now? Do we have time to think about the decision? Or how long can we go without doing anything right now? Because I agree, I feel like hospitals are getting better in general. As more evidence comes about.
Speaker 1:I feel like we are starting to kind of relax and understand that not all birth is pathological, and that's something that midwives and doulas have known for a long time, because midwives and doulas specialize in low-risk, physiologically straightforward birth. I don't want to say normal, because what is normal?
Speaker 2:Right, and there's such a wide variation of what a labor can look like and still result in a healthy mom, healthy baby the baby and I just I really think that we are coming from two different sides of the spectrum because me as a, I come from the labor nurse medical side, but as a nurse I've been a part of enough physiologically straightforward deliveries or inductions.
Speaker 1:even that become straightforward because I know how to help someone move through labor and I think it's important to be able to recognize normal in all of its stages and then be able to move towards. Okay, I'm starting to see some things that may not be normal. Let's evaluate our options instead of coming from this place of all, birth is medical and then going back and trying to look for the arguments that this birth needs help, and so it's so important for moms to be able to make decisions that meet their needs, as their needs evolve and change.
Speaker 2:Nobody asks to have really high blood pressure and nobody asks for their water to break at 35 weeks or 34 weeks, like sometimes. Life throws us into these situations where we do need the medical help and we need to know how to ask for it and say like, hey, this is what happened to me. I think my water broke, but it seems too early. Do I still call? I once had a mom that had that happen and she didn't know. She was too scared. She was like I didn't want to seem like I didn't know what was going on, so I didn't call my doctor and I was like wait, wait, wait, wait, wait. I love you and I'm your doula, but let's call together and if that means your birth plan changes, then I'll still be by your side and you can have a beautiful birth. It just might take a different shape than you anticipated.
Speaker 1:Yeah, and you can still have autonomy during birth. That wasn't exactly the way that you planned, just like if the road is closed on your way to work, you can still get to work by going another route. It may be a longer route, it may not be your favorite view, but you'll still get there, right? I think probably the most unhealthy thing that I see is this attempt to avoid dealing with the fear in the hopes that it makes it go away. I think we kind of go into fight or flight in our mind. I disagree. I think it's important to mentally confront the possibility and the options and ask yourself at what point, like you said, when would that be something that I would accept in my labor? When would that tool become important for me, and then go from there and figure out how to cope with needing that tool.
Speaker 2:Yeah, I worked with a mom once who had done exactly what you said in her first birth, where she had really high blood pressure and she ignored it. Her doctor had said I really want you to come in. You need to have your baby. This is unsafe now. And she was like no birth is so natural and she ended up in this crazy emergent situation. When she reached out to me for her second birth she was like I've always wanted a natural labor but I have to make the choice for an induction. I know that's.
Speaker 2:My biggest regret was that I didn't make that choice the first time, but I don't know how to protect my sovereignty in this situation. And so it wasn't that having a doula or having somebody by her side meant that we were avoiding things. A lot of it was supporting her in, like I'm very afraid. And she did a very brave thing, which was to recognize. The same thing I've recognized in my first birth was I didn't have the knowledge to ask the questions. I knew I had questions. I didn't know what they were. I knew I had big emotions, but I couldn't verbalize what those were yet I think my midwife friend was the one that helped me kind of develop the vocabulary around that and I truly didn't have the communication skills Same with her to say, like you're telling me this, skills Same with her to say, like you're telling me this. But I believe this there's a gap.
Speaker 2:Where's the bridge?
Speaker 2:I truly don't have judgment on this for medical staff, because I look at how busy they are and, like I was one time with a mom, it was like pushing her baby and the doctor, as she was sitting there waiting to catch the baby, prescribed medication to a mom in another room, remembering her allergies, advocated for a mom that came in through the emergency room that they were trying to send home and she was like no, if my patient came here, I am going to see her.
Speaker 2:Sometimes there's just a lot going on. If a provider is not giving you the information that you need, it's not because they don't care. They just might not know you well enough to know that you're not speaking up or you're still kind of sitting in the anxiety and you haven't found the words for it yet. Those doulas. It's often like building that bridge and that communication and asking the provider can you stay a few more minutes? We have more questions, we need more information, we need to get to a place of feeling more security and safety before we can go forwards with your recommendation, which is ultimately, in this situation, what needs to happen.
Speaker 1:I agree it's an unfortunate downside.
Speaker 1:If you are wanting a hospital birth or if you're required to have a hospital birth because of any kind of illness or complication to the pregnancy, that is the downside that you're going to be sharing your doctor, or even if it's a midwife our midwives one of the hospitals I work at are the busiest ones on the floor because they have all the patients.
Speaker 1:It's a huge practice and you get one midwife and they can be delivering 10 babies on the floor at one time, like they'll just be bouncing room to room to room. And unfortunately, the downside of being in the hospital is you have the potential to become someone described at one time as like a cog in the machine and if you are requiring more attention it may slow down the whole machine and then we have to prioritize that attention. So if you are physiologically normal and safe and someone else isn't and our need to put more attention on you means that we can't put attention to this other emergency that's going on, unfortunately we're not going to be able to put that attention on to you. We're going to have to prioritize, which is sad but it is the truth and it is very frustrating for a patient that is, wanting the care that all patients deserve.
Speaker 2:They deserve right, yeah, and it's not the people in the system's fault, because if you're a midwife with 10 patients, you can only do so much and your heart can be with every single person, and yet your time and attention can only be in one place.
Speaker 1:Yeah, something that I encounter, and I'm starting to notice a shift, or maybe I'm just trying to find the birth workers who have already made this shift. I notice more doulas that are becoming more comfortable with the realities of hospital birth and I'm seeing less of what I used to see in what I guess, gave the conflict we all know can exist between hospital and doula. Was this everybody in their own corner situation? Right? So the medical aspect of birth and the natural aspect of birth, and everybody is just trying to fight their own logic. But now what I'm seeing is a lot more ability for the doula to support someone through a birth, given the resources that are in the hospital or given the obstacles that are in the hospital. Right? So if you were having a home birth, for instance, you are less likely to be monitored continuously. In fact, you probably can't be monitored continuously, right?
Speaker 2:Right, I mean I'm going to sit there and listen with the Doppler, and I have seen that at home births, where it's like I need to pay extra attention but it's not going to be the continuous, or like I wasn't sure what I heard. I need to listen in the two contractions in a row, but it's still not like wearing the monitors. You go for a walk and they fall on your foot and so then you stop walking.
Speaker 1:Yeah, and there's a give and take and it would be lovely if the midwives could do the monitoring for one or two contractions on everyone. But once you start, like you said, the cytotec we have to monitor because we don't know how the baby's going to react, the pitocin we have to monitor because we don't know how the baby's going to react.
Speaker 1:The Pitocin we have to monitor because we don't know how the babies react. We're moving away and at least the hospitals that I'm working at and the guidelines from ACOG and AWAN and all of the governing bodies are now saying that we can do the pre-induction with intermittent monitoring because it's safe and because moms are pushed back because they don't want to be unnecessarily monitored. But how do we work with when we're in a hospital having a natural, physiologically straightforward birth and still having to have the IV port not necessarily hooked up, or having the intermittent monitoring and all of that stuff? I feel like it takes a special skill set from a doula to be able to support a mom through a hospital birth versus through a home birth. If there were new people starting out that wanted to be doulas, what would you tell them about how to support somebody through that?
Speaker 2:Yeah, I don't know if my answers are perfect, but I can share what I do. Most of my births are in the hospital. I had a home birth. I loved my home birth. I occasionally go to home births super special experiences when they go well, super easy comparatively to being in the hospital. Sometimes I'm like, oh, I'm just a photographer. It's a completely different feeling.
Speaker 2:But for me, for all my clients home birth, hospital births what I do is before labor, we meet twice, and the first time we're very focused on the birth plan and we go through a checklist of every single thing that's going to happen or every choice that they have. So we will talk through okay, when you're dilatingating, when you're pushing it in the golden hour, and that's our chance to talk about, like, okay, when we get to the hospital, this is what's going to happen in triage. You're going to get an IV. You're going to typically get a cervical check. You're going to be monitored continuously, at least for the first 15 minutes to a half hour. That is part of triage. And now let's talk about what your needs are, knowing that this is what it is. Sometimes I've worked with a few moms that have been victims of sexual assault, who are like I am very worried about that cervical check, I cannot do it. And so it's at that point, before they're in labor, where we're saying, okay, a cervical check is part of triage. Now we need to come up with a plan, and I have on occasion asked people have you talked to your doctor about your abuse? Do they know that this is more triggering to you than someone else? And their doctors have noted we will not do a cervical check in their official medical documentation. So when we get to triage and we say we were not do a cervical check in their official medical documentation. So when we get to triage and we say we were hoping to delay the cervical check and often there's an agreement here, if all is going well, either until after an epidural or until starting to feel an urge to push, or somewhere later in labor, where a lot of times clients can kind of have some choice about when it would be okay for them and then having that choice it makes it so that intervention isn't as difficult, or after an epidural it won't feel the same, it won't bring them the same trauma and same.
Speaker 2:With the IV port we talk about how do you do with needles, what are the things that go through your minds. What do you do when you're in stressful situations? How can I help you through this? Is it going to be distracting you? Do you need to know everything that's going on? A lot of hospitals have like special IV teams that can come in with a little ultrasound machine and that can get it right on the first time. Is there something that we can do to make this easier for you? And so sometimes the conversation isn't necessarily.
Speaker 2:You know a lot of home births.
Speaker 2:Moms are opting out of a lot of things, and that's fine.
Speaker 2:I want to opt out as much as I can, but I can't opt out of everything, either because of the location they're at or because of the life situation that their pregnancy and birth is happening within.
Speaker 2:And in those cases, when we talk about it before and we've gone through literally everything from start to finish, then it's like this weight off of their shoulders and then they can get practice talking with their doctor about it.
Speaker 2:Sometimes I will go with them in very special cases and have that conversation with them and say, like we're trying to meet you halfway. These are her needs, how can you help us? And sometimes it will be the doctor that will say you know what I see that you're trying and this is how I can help you, and we'll come up with kind of a new alternative that's more helpful to the specific person but maybe not the same, as, like we do a cervical check for everybody, and I don't think it would be possible for a hospital system to write a rule that would truly take into account everybody's needs. So from my perspective, it's really trying to help people get that individualized care within the parameters of what does good care look like, because we never, ever, ever want to sacrifice getting attention when it's needed due to any philosophies that may or may not be applicable in a specific moment in time.
Speaker 1:I think that's a really good point, that it isn't possible that all the rules that hospitals come up with are essentially to keep people safe, maintain lower liability. Right, we need to have standardized care so that we know that we've got evidence behind what we're doing, but also hospitals are attempting to have patient-centered care. So how do those two things come together? That's a difficult job, especially if you're working in the hospital and taking care of multiple patients, and so we need people that understand how to help with patient-centered care, that also understand how hospitals work and how to work within the confines of what hospitals can offer, because we can't necessarily offer a home birth environment, or even some can't offer the birth center environment, just given the infrastructure.
Speaker 1:There are more and more hospitals that are getting on board with that, but how often are old hospitals upgrading to new buildings? Probably not more than every 20, 30 years, so we're going to be a little behind the times. There's so much that you have to consider cost-wise, you know there's not as much real estate times. There's so much that you have to consider cost-wise, you know there's not as much real estate in some areas, and so then you have space that you have limitations, and so when you go to a hospital where there's going to be multiple people birthing on one floor, there's going to be limits to what they can offer we would want to offer a birth pool to everyone.
Speaker 1:We want to offer an environment that looks like your home to everyone. To everyone. We want to offer an environment that looks like your home to everyone. We would love to offer one nurse, one midwife, one doctor, one doula to each patient. That requires a lot of money that isn't necessarily available and insurance companies aren't necessarily going to pay for, and we have to also offer certain levels of technology in order to keep the high-risk safe.
Speaker 1:It's a totally different animal than someone that's giving birth at home because they are physiologically healthy and their pregnancy is 100% low-risk, and so far we have not seen any kind of indication that we're going anywhere towards medium to high-risk. It's completely different and I think it's so important to have an understanding of what that means and how to help have the birth that someone wants, given those confines, and, as nurses, to make that happen. We are trained about the medical and the physiological aspects of birth and then what to do when things are medicalized. We are taught how to handle a postpartum hemorrhage. We're taught how to help resuscitate a baby. We're taught the emergency situations, and that is what is emphasized.
Speaker 2:And that is so critically important.
Speaker 1:It is, and so, then, to be able to support the people that are there for the emergencies no-transcript help dads or partners and also they are not an expert in supporting somebody through low-risk birth right and to have somebody that is trained in supporting someone in low-risk birth at the bedside is amazing, and I wish that hospitals would employ more doulas so that we could have somebody at the bedside all the time, and so there is less conflict when we do have somebody coming in from the outside that may not know how our hospital system works, and so you would have to go research each hospital, and I think it's so important.
Speaker 1:You have a perspective that I haven't had a chance to look into, and that is how to get a doula through insurance. I think one of the biggest barriers to getting doula care is that birth can be so expensive for people, even if you have adequate insurance coverage. There's a lot of money that goes into birth insurance coverage. There's a lot of money that goes into birth. So to have that extra cost of a doula is sometimes a little bit of a challenge for some couples, especially when you're considering how much money you're going to be putting forth for a baby all of that stuff. So now that there is the option at least the Medicaid option are all insurance companies now getting on board with doula care?
Speaker 2:Yeah. So that's a fabulous question and I completely agree with you because when I think back to my own pregnancies and births, there is no way. I remember very clearly one day when I was sitting at my office I worked at an investment bank at the time. Later I became a stay-at-home mom in the gap between my kids and so we were much more financially strapped before my second one. But I remember having a conversation with me and there were two other people on my team and their wives were pregnant and my friend Travis was like we just got a doula, we're taking these classes and they were kind of like super into all the natural things and when I heard how much it cost, I like almost died and I was like there is no way I would ever pay that for any of this. So I do find it a little bit ironic that like that was my first thought when it came to doulas and my first exposure was like why would anyone pay for something that expensive?
Speaker 2:Not every insurance company covers doulas. Hopefully that will change. I hope it becomes much more accessible and not every state covers it in their Medicaid programs. It is something that's been ongoing where more and more states there's a handful of states that are currently reimbursing doula care coverage. There is a handful of states, like mine, where it has been approved by the legislature to cover doula coverages, but the programs are being built out and then there are states where it's being considered and there's states where it's not even being talked about at all. So it really does depend on where you live.
Speaker 2:There's also a lot of employers that are offering reimbursement programs for doulas. I know in my area like Boeing just added a program through their HR. Microsoft. There's a handful of companies here. So if you're unsure about can you get help paying for a doula? Call your HR if you work for a larger company and find out. Some people are surprised when they found out like, oh, my company does pay for a doula, I just have to submit a form and then I get reimbursed. Should we go over like the states that are actively? Do you want to know?
Speaker 1:Yeah, I think that would be helpful because I think a lot of people just don't know and I think that a lot of people would look for those options if they knew they were available.
Speaker 2:Right, I am really excited. I know here in Washington our program, our Medicaid, covers about 40% of births, so that is 40% of women that will have doulas reimbursed once the program goes through all the way. All right, so we've got. California is already reimbursing and processing for doula coverage. The District of Columbia, florida, maryland, michigan, minnesota, new Jersey, nevada, oklahoma, oregon, rhode Island and Virginia are the states that currently now if you're looking for a doula and you live in one of those states and you're on Medicaid, you can get a doula covered through your Medicaid insurance. Connecticut, delaware, illinois, louisiana, massachusetts, new York, ohio, pennsylvania and Washington. We have all passed legislature to add it, but the programs aren't quite built out yet. So in the next couple of years you should see that becoming an option. That's amazing.
Speaker 1:And then is it through the employer's insurance or is it like if, for instance, boeing? Is it just a matter you just contact HR, or do you need to contact your employer insurance, or does it depend?
Speaker 2:I think it depends, but for most of the reimbursement programs where I've filled out the paperwork as a doula, I typically have to provide my certification number, my training dates, the EIN of my business, things like that. For the paperwork that I fill out people are mostly submitting to their HR. I would recommend check with your HR and, if they don't yet, maybe mention it to your company, like hey, other companies are doing this and maybe you should too.
Speaker 1:Yeah, that's really important. So from my end, as I'm a labor nurse and I provide birth prep, I will help people find a doula. I mostly work with people that are going to birth in the hospital, because that's what I know, and so my goal when I'm trying to find a doula is to find somebody that is supportive of the hospital.
Speaker 1:Birth that might have some complications, what would be some things that they would look for, or key questions that they would ask, to make sure that they're finding someone that's going to work well with the hospital staff and the hospital environment and the hospital equipment.
Speaker 2:Yeah, I think that's really important because sometimes I do hear people say like I won't go to the hospital and that always surprises me, that attitude but it does exist and it's good to be aware that the person that you're hiring to support you is actually supporting your plan and not trying to give you a different vision right, not trying to change your plan. I would say first you can start with a Google search for like doula. In my area there's a great website called doula match where you can put in your zip code and your due date and it's more popular in some places than others, but I know here almost every doula is on there. I would start by like read their reviews. If a doula has experience and they're active in their community, people are going to be leaving reviews either on Google or Doula Match, and so you can kind of see what the experiences and the type of births that other parents have had with that specific doula. Then always, I always recommend interviewing more than one doula.
Speaker 2:I know I think I interviewed three or four before. I was like you're my person and ask them, tell them. Hopefully, the first thing that they're asking you is about what is your birth plan and what are you worried about? What are the obstacles in your birth? What are you excited about? How do you approach challenges? And you should be able to have really good conversations that are based on empathy and logic, and you can see through their answers the doula has followed through.
Speaker 2:I always think it's helpful to hear specific stories. One thing that I'll do for my clients is right now working with a mom that is a VBAC mom, and she unfortunately had a very poor experience with her first VBAC at the hospital. She has a lot of trauma from that, and so she was trying to figure out I want to be back at the hospital. She has a lot of trauma from that, and so she was trying to figure out I want to be back at the hospital, I don't want to have that same type of care, and so for her, I connected her to a couple of moms that I had worked with had feedbacks in the hospitals that she was considering, so she could talk through somebody about what was the experience like, what was good about it, what was bad about it.
Speaker 1:And.
Speaker 2:I think doulas are really good about helping you get those closer experiences from others that have been in the same place as you.
Speaker 1:Yeah, I think that that's important, because when you're asking those questions and you know what your goals are, if someone starts to push back on that, then you kind of know if they're not a good match. If you feel good, if you're starting to feel stressed out and defensive when you're talking to somebody that you're hoping to support you through your birth, that's a sign that that's not going to be a good fit, because you don't want to feel that way in your birth. Which leads me to my next question, which is a hospital environment is not necessarily the most comfortable and welcoming environment to deliver a baby. You and I both know that the stress response counteracts the labor response, right. So if we're stressed out by the hospital environment, we need to figure out how to move through that to be able to get to the point where we're like relaxing in labor land, as you were saying, and that has to be low stress. So how do you protect that bubble of labor land?
Speaker 1:when you're in the hospital environment.
Speaker 2:I think. First, prenatal, where you go through the birth plan. I cannot stress enough how much of a difference that makes to have already thought through this is what it's going to be. If we're doing a natural birth, nothing seems wrong. They're appropriate. It's appropriate to do intermittent monitoring. Labor happens at night all the time. Then, yes, bring some little light up candles that are battery operated, turn on music that you love, turn on a diffuser, if it's okay with your nurse. Some people are very sensitive, so we want to be aware of that.
Speaker 2:One of the things I love about hypnobirthing is all the visualizations. If you've never heard of that method of birth prep, it's a lot of meditation and affirmations and a lot of visualization. And if you have put a little bit of effort and energy and thought into picturing a very joyful birth in a busy location, you can be in the busiest location ever and it can still feel slow and peaceful and open. And I think a lot of that energy is what we bring to it, because you can be in a very busy hospital environment and still have it feel not that different from being at home in your bedroom. You have to have talked about your fears of the hospital. If you carry those fears, maybe done a little fear release around that Turning down the beeping on the monitors helps.
Speaker 2:Asking your nurse to help you with that, actually because nobody should touch the monitors in the room and so if you've practiced and thought through and planned for how am I going to bring joy and what am I going to do in those moments of doubt and fear. It's very much like a carousel, right. It's normal to feel great and then have doubt and worry and not be sure if you can do it, and then come back up to feeling like, oh, you know what I can do. This, this is good, I am in the right place, I do like it here. The very simple things and then the intention that you bring.
Speaker 1:I think I thought of one other thing that came up for me how can nurses support a natural birth? Or maybe the best way to word it is how can nurses avoid interfering with a natural birth because of all of the stuff that we have to check off?
Speaker 2:our list. I think most of the things are pretty simple. I so appreciate nurses that know how to do intermittent monitoring, learning that skill. I so so appreciate it. I know you have a million intake questions that you have to get through and it's not really an option. But if you can find those gaps in between contractions or let a mom get into the birth tub and ask her between contractions while she's already in the tub, I can run the tub while you're doing the initial checking the blood pressure and doing all that kind of stuff. And first let's make sure the pain control is staying managed and second, then the questions. And third, just know that one thing that I have moms tell me a lot for their second baby is if they're reaching out to me like oh, I tried a natural birth and it didn't work, so now I want a doula for my second one to help.
Speaker 2:It's that a lot of people will say my nurse only offered me an epidural and what I needed was encouragement. Only offered me an epidural and what I needed was encouragement. So I think, like, if someone has a natural birth plan, you can ask questions like do you want me to offer you an epidural if, as your labor is progressing, and if her answer is no, then just trust that she will ask for one if she needs it and you can say things like. You are so strong.
Speaker 2:I've never seen anyone so beautiful during a contraction. Your connection with your breath is really powerful. Do you want to do it now or in three contractions? Sometimes just having a very short amount of time before having an IV placed or doing something like that that needs to get done helps the mom kind of get into the mental space. If I'm leaving labor land, I'm coming to do what you need and then I'm going back to labor land. I appreciate our nurses so much, though. You carry so much on your plate, and when I watch all the charting my mind is always just in awe of the hundreds of things that you seem to be doing while I'm doing a simple hip squeeze.
Speaker 2:It's not fun trying to not bother someone and get all that other stuff. No, sometimes it's needed, though. I mean, it's how you keep not just one person safe, but everybody safe in the hundreds and thousands of different scenarios that can happen during birth.
Speaker 1:Was there anything else that you wanted to talk about that we didn't cover?
Speaker 2:I just want to say to moms you are all so powerful and I hope that as you go through the birth process, that it is really empowering to you, like somebody who graduates from college or finishes a marathon or accomplishes anything worthwhile. As you go through the process, you see your commitment, your growth, your change, and you're not defined by the low moments. You're defined by the victory that is yours, no matter how you came through the experience, the joy that is yours.
Speaker 1:Yeah, that's so important. It is a transformation and no matter how it looks, you'll be a completely different person afterwards when you prepare for that. It will be a beautiful transformation. Yeah Well, thank you so much. I really appreciate all your insight.
Speaker 2:Thank you, I so appreciate it. It's nice to be able to talk from the different perspectives of nurse and doulas. I feel like we should always be like BFFs. We totally should, yeah.
Speaker 1:Yeah, let's start a nurse doula BFF club. Yes, please. How would anybody contact you if they wanted to hire you as a doula or get your insights or learn from you?
Speaker 2:Oh yeah, my website is shebirthsbravelycom. We have a fun quiz that's what does your birth plan say about your personality? It kind of goes into like, based on your answers, like here's some of your strengths, here's some of the things to think about and here's what makes you an amazing mom. It's fun If you go to shebirthsbravelycom you can sign up for free consultation, for doula services and then, within my childbirth class, every mom that comes through my childbirth class gets two prenatals where we'll do that birth plan checklist that we talked about, and then I have you go take it to your doctor and then we come back, because most people have more questions about that after they do that. And that's just part of the birth class as well, which is also just at shebirthsfraigleycom.
Speaker 1:Amazing. Well, thank you so much for joining me and for all your insight, and I really appreciate the opportunity to talk to you.
Speaker 2:Thank you so much for having me.
