KUOW Morning Edition: Story of Natural Birth

Thanks to board member Lisa Chin for pointing out this great piece by KUOW this morning:

There Will Always Be Three Now: A Story Of Natural Birth

You can listen online at their website.

When it comes to giving birth in America, there are choices. What doctor? What hospital? What medication? What kind of birth do you want? Less than 1 percent of couples choose a natural birth, a birth with no drugs and little to no intervention. Producer Katy Sewall brings an intimate look at one couple's decision to go that way. What is your birth story? How did you make the decisions you did? Are you satisfied with the choices that you made, or that were made for you? Call 1.800.289.KUOW (5869).

Special thanks to the midwives at the Puget Sound Birth Center and at Group Health Seattle.

The program is about choices in childbirth - in particular this is about the 1% who choose a "natural childbirth". I chuckled a bit because many in the birth field know "natural childbirth" can mean different things to different people and as such, is a very confusing, and sometimes loaded, term.

To some, natural childbirth simply means having a vaginal birth, regardless of the interventions - just not a cesarean birth. To others, natural childbirth means birth without pain medications, and sometimes without any interventions at all. This program, however, seems to refer to natural childbirth as out-of-hospital birth, including home birth and birth center birth, which is why they say only 1% of families choose it. A listener commented on the show about obstetric or nurse-midwife practices in-hospital, which have a high percentage (50% or more) of birthing moms who deliver without intervention or medication, but still in the hospital setting.

One of the people interviewed in this piece is Penny Simkin, a doula and childbirth educator here in Seattle and one of the founding board members of Open Arms. Penny provides some fabulous information about doulas in this program as well as reiterating some of the statistics about c-sections - the shocking rising rate of c-sections, for example - up 50% since 1996! She says this is due to the inflated sense of dangers of vaginal birth and unrealistic appraisal on the part of parents of dangers of cesarean. She also talks about the variation in the "cesarean epidemic" across the country, where different states and areas are apt to have widely differing c-section rates. For example, you're far more likely to get c-section in New Jersey than Utah. One of the reasons? Malpractice fear. Another reason for the rise was breech birth. Penny explains there was one very widely study finding bad outcomes in breech births that since has been completely discredited, but now 7-8 years later, medical schools are no longer teaching new physicians how to vaginally deliver a breech baby. So, with no training, few doctors can do them now.

All in all, this was a lovely program. For those of you doulas listening in, it's so nice to hear a peaceful birth on a radio show - you'll appreciate it. My husband rolls his eyes every time there's a birth on television. All that drama and huffing and puffing - he knows I'll make some sort of comment about that initial contraction and boom! she's in labor and boom! out pops the baby with screaming and hollering. It's nice to hear a birth happen in calm and peace.

On another note, this program has a caller that talked about the hard fight women had to gain their birthing choices - in her case, admitting the father to the birthing room. That work isn't done. Have you all seen the recent controversy about the Ohio medical practice that bans doulas? It's pretty interesting - read the comments on that blog. Those of us in Seattle are used to having quite a few more birth choices than in other areas of the country, or even other areas of the state. The fight for birth choices isn't over.

Building a Community-Based Doula Program in Your Area

Occasionally, people visit our blog who have read about the effectiveness of community-based doula models and are researching how to create a program in their area.

If this describes you, please contact us for information or just to talk about what you're considering. Open Arms has had a community-based doula program for years now and have learned a few things along the way, especially as we've built our Outreach Doula program with the White Center Early Learning Initiative, and we are happy to share that expertise with you to help your program get off the ground.

The Open Arms program is based on the Chicago HealthConnect One community-based doula model. To follow that model, there are several key steps that a program must adhere to:

• Employ women who are trusted members of the target community
• Extend and intensify the role of doula with families from early pregnancy through the first months postpartum.
• Collaborate with community stakeholders/institutions and use a diverse team approach
• Facilitate experiential learning using popular education techniques and the HealthConnect One training curriculum
• Value the doulas' work with salary, supervision and support

Although there are other web pages and programs out there that describe how to start a community-based doula program, we strongly feel that this model provides an excellent foundation for this kind of program. There are reasons for each of these steps, and they have been proven to increase the effectiveness of the program. They also help a community-based program to be truly community-based ... if you skip any of these steps, it's easy to veer off course and provide a program that isn't actually from the community it serves and therefore will have reduced effectiveness and simply won't be as valuable to your clients.

Contact us by email or phone at 206-723-6868 and we'd be happy to talk with you.

Open Arms featured today on KONG TV's Learning for Life series

Today's Learning for Life show on KONG featured an interview with Open Arms Executive Director Sheila Capestany, speaking about our Outreach Doula program.



Here's the description from the website:

Giving birth and raising children should be among the most natural things in life.

But for women going through the process without the support of family and friends, the experience can be intimidating and lonely. This is especially true for women who come from a different country and culture and speak a different language.

The Outreach Doula program, started by Open Arms Perinatal Services last year as part of the larger White Center Early Learning Initiative, supports both immigrant Latina women and Somali refugees in their own languages by women of and from their own communities.

Outreach Doulas work with families from early pregnancy through a child's second birthday.

Sheila Capestany, executive director of Open Arms, talks about the Outreach Doula program and the difference it's making in the community

Happy Father's Day from Open Arms!

Father's Day - a day to celebrate the dads in our lives ... our own, our spouses or partners, our children who themselves might have become fathers, and father figures who step in at important times in our lives and our children's lives to give support and encouragement. If you're a father yourself, know that your role is very much appreciated. A lot of people think these holidays are just another opportunity to sell cards and presents, but I do think there's huge value in remembering to say thank you to those we love and appreciate. Hope your day was an enjoyable one.

As a doula, one of my biggest joys was supporting fathers in their transition to parenthood. I know that a lot of the focus in pregnancy is about the mother and baby. She goes through pregnancy, the baby grows, the labor and birth are joint efforts between mom and baby - but dads, I can only imagine what goes through your mind as the woman you love gives birth. What a joy to watch a dad relax into his own knowledge that he can be of help, that he doesn't have to know everything or be in control in order to give a huge positive influence to his partner or his child.

I've been on vacation recently (therefore no posts to this blog!) and I've loved watching my husband be around for our kids. I see how much more easily they go to him to make themselves feel better when he's been around more, and the confidence he exudes around them. I see the way he interacts with our children - different from me, and so very valuable.

To all the dads out there: thank you for everything you do for your families.

Contagious Positive Impact: An Interview with Yen Baynes, Open Arms Outreach Doula

This is an interview that Open Arms did for our latest newsletter. Hope you enjoy it!

In our first interview, we introduce Yen Baynes, Latina Outreach Doula. Outreach doula services begin in early pregnancy and continue up to two years after delivery. You can read more about the Outreach Doula Program here.

In the photo, Yen Baynes is on the right.

What's your name, job position, and how long have you been at Open Arms?

My name is Yen Baynes. I'm a Latina Outreach Doula for the White Center Early Learning Initiative (WCELI) Outreach Doula Program. I've worked as a full-time staff person since June 2009, but I've been an Open Arms Volunteer Doula since 2006.

Why did you become a doula?

I became a doula because I had a doula at my birth who spoke my language and helped me during my perinatal period. Because she spoke my language, she could relate to my family, and that helped hold the emotional space I needed in order to have a positively transformative birth experience. It was amazing -- I had an amazing birth!

What is the most meaningful thing about being a doula?

It's an honor to be with women during a transformative time - pregnancy and birth. I especially love that I have a long term relationship with my clients and I'm with families from pregnancy to age two. It gives me a lot of comfort that I'll know these babies and families for a long time. I also love experiencing birth with my clients - it's my favorite! I call it my journeys to "birth land," because it's a kind of time warp when everything else falls away and you're just in the present with the birthing woman as they go through the passage that is their birth experience. I love holding the space for women in birth. Despite the exhaustion, it brings me a kind of energy boost that informs my whole way of being in the world.

Is there an instance you remember where having you as an Open Arms doula made a big difference for a family?

I always feel like it's really important to be there - families are often on a track that is already very biased against them. They tend to get more interventions and a more disempowering experience. But one client does come into mind - she has a medical condition that requires that she be induced. Because it's somewhat uncommon, it is hard to understand, even with an interpreter, the intricacies of the condition and why an induction is the best course of action.

As we've worked together for a few months, she's been writing down what questions she has for her doctor so she can get all the information she needs to make an informed decision about her care. This practice has turned out to be very useful now that there are health concerns. She is now able to go into her birth feeling she's choosing the induction rather it be something that is being done to her. I think emotionally, going in with that mindset, her birth will be more empowered and more manageable.

People often see doulas as supporting only idyllic, natural births with no interventions. In reality, it does happen quite often that clients are actually facing births where interventions are appropriate. At its core, what we doulas can do well has more to do with holding space for choice and empowerment. It's about building a relationship in which the model is to trust the woman's strengths in decision making when it comes to what is happening with her pregnancy and her baby.

What would you like to tell people about Open Arms that they might not already know?

I think something that is very powerful but hard to describe from an outsider's perspective is our reflective practice. Often people say they see us as this pack of super powerful women - we've had comments at restaurants about this powerful aura that we have - and that's how it manifests, but what's happening is that we're very interconnected through a deeply reflective way of being with each other and with our clients. It's been a very intentional (and sometimes arduous!) approach that is both from the top-down - from board to executive director to staff to doulas to clients to babies, and from the bottom up. Our interactions are imbued with honoring each other's strengths as we move forward.

As an Open Arms employee, I get a lot of support and space-holding from my supervisors, and that's the model I use for how to hold space and provide support for clients. In turn, my clients model their relationships with their babies and their community in this way, as well. It's contagious positive impact! Women can have multiple children and still have this new infant and new relationship be completely different, because their way of being with their new baby has been based on a reflective model since pregnancy.

Can you describe reflective practice?

Reflective practice honors what the person already knows. It is based on wondering and being curious about what a person has already mastered in order to get to where they are today. As a provider, my wanting to understand what a woman already knows about herself and her situation strengthens her ability to learn new information. For example, with my client - after hearing she needed an induction, my first question was "do you have enough information?" And, once we figured out what she needed to know about the condition, I was able to ask "what do you know about induction?" I don't mean facts, although it turns out she knows a whole lot -- she was a nurse in her home country and she has a lot of factual knowledge. But what did it mean for her to have an induction next week when she was planning to give birth next month? What were the implications for herself and her baby? It wasn't for me to tell her - she had that information herself. It was in feeling heard that she could hash out a good plan for what should happen next. In being heard, she is able to go into the experience trusting that her personal, embodied way of knowing is not only valid, but crucial when it comes to making decisions in her health and in her life.

This was the same way I was trained here at Open Arms back before we even started taking Outreach clients. And, it is the same way we speak to each other in the office day in and day out. This kind of honoring and the effect it can have is not specific to any one population or situation. As humans, we all do better when we can trust our powerful ways of knowing. We do better when we know better. The exact same skills will prove useful when my client's child is in school and she has to talk with a teacher or principal. By using reflective practice, she will understand and advocate for her child. People first see it modeled, and then can practice it. At its core, reflective practice makes for an important building block toward becoming better parents.

Seattle Human Services Coalition Award Ceremony

Last week on June 3rd, Open Arms was deeply honored to receive the Human Services Coalition award for Innovative Program.

The following is a transcript from the awards ceremony. We are pleased - and humbled - to receive this award, and know that it is the result of deep commitment to serving our clients and our community.

If you are interested in seeing some of the other award winners for this year, please visit the Seattle Human Services Coalition Awards web page.

Here's the transcript of the award.

Innovative Program Award

Germaine Covington – MC, Introduction of Innovative Program Award:

Our next award celebrates creativity through unique programs and services developed by agencies and community based organizations to respond to emerging or existing needs. The Innovative Program award is presented to an organization that has implemented a new program, or substantially re-designed program within the past 5 years and has creatively used resources and has demonstrated a commitment to providing culturally relevant resources.

Now, please join me in welcoming Seattle City Councilmember Sally Clark who will be presenting the Innovative Program Award to Open Arms Perinatal Services.

Councilmember Sally Clark:

Open Arms Perinatal Services provides birth doula services to low-income women, women of color, refugee and immigrant women and teens which help support, educate, respect, honor and empower women and their families throughout the childbearing year and beyond. The programs’ goals are to decrease infant mortality rates, especially for Latina and African American women who are disproportionally affected and to provide the opportunity for more women with empowering birth experiences that usher them into motherhood feeling prepared and successful in advocating for themselves and their children.

Often, new parents are unaware of what constitutes normal newborn growth and development and normal postpartum recovery for the mother. Moreover, immigrant and refugee women often face additional challenges because they are in an unfamiliar land, with unfamiliar customs and environments, and might not understand the language. The risks for teens are even greater. In addition to the challenge of birthing and raising a child, teen mothers face severe challenges in completing their education and are at higher risk of severe health problems, all of which make them more likely to be reduced or confined to poverty.

Through Open Arms, certified bi-lingual birth doulas receive cultural competence and anti-racism training provide high quality care in 6 languages and emotional support while removing barriers that exist for many women needing health care.

Recently, Open Arms launched a Doula Outreach and Training Project which offers a career path and professional certification to the mothers they serve while at the same time enabling and empowering women to work in their own communities. Outreach doulas provide services to women and their families who need more intensive support during pregnancy and early parenting. They begin outreach in early in pregnancy and continue up to 2 years after delivery. In addition to doula training, outreach doulas receive training in assessment, case management, and other social service skills.

By helping families from the very beginning, they set the stage for the long-term health and the well being of each family they serve. By removing barriers to service, increasing awareness and personal advocacy, providing education about pregnancy, birth options, breastfeeding and positive early parenting and reducing medical interventions and the costs of perinatal care, Open Arms is able to fill in the gaps left in our customary perinatal practices and give families a healthy start.

Sheila Capestany, Open Arms Executive Director walks forward, accepts award, shakes hand and poses for picture, brief remarks

Resources and information

I have a number of blog posts half-composed in my head, but have not had a spare moment to write them down, what with summer vacation coming up and so many things to do in the meantime. Soon, soon - stay tuned!

Today though I saw the HealthConnect One Facebook page, and wow, is it ever full of great resources, information and workshops.

If community doula programs are your thing, or if you're researching creating one in your area, or if you're in the birth field, or if you're just interested in these issues, go check them out.