Tea with Jodi S2-E1 - Doula Roundtable, Part 2 0f 3

The conversation centered around the professionalization and integration of doulas in the medical system. Speakers emphasized the importance of doulas in improving birth experiences, lowering cesarean rates, and creating positive trends in the birth industry. They also discussed the economic factors driving the increase in cesarean sections and the need for a comprehensive approach to evidence-based birth practices that balances medical expertise with empowered motherhood. Speakers highlighted the importance of prioritizing birthing persons' autonomy and informed decision-making, and raised concerns about the medical establishment's control over birth.

Summary

• Doulas' role in improving birth experiences. 0:08

  • Speaker advocates for doulas in hospitals, promotes collaboration.

  • Hospitals seek doulas to improve birth experiences and lower cesarean rates.

• Positive changes in the birth industry, trends across the US, and the importance of professionalism and respect for doulas. 4:47

  • Speaker 2 emphasizes importance of relationships and visibility for doulas.

  • Jodi Graves highlights need for respect and reverence in the birth industry.

  • Jodi Graves has 8 doulas on her team, while Lacey has 40.

  • Non-evidence based care trends include unregulated doula training programs and lack of standardized certification.

• The impact of research on birth practices, with a focus on induction and interventions. 10:20

  • Providers in San Francisco Bay Area are seeing a trend of women opting for early inductions at 39 weeks, leading to a higher C-section rate.

  • Speakers discuss disparities in implementation of evidence-based practices in obstetrics, with midwives prioritizing client wishes and normal physiological birth.

• Birth induction practices and their impact on outcomes. 14:29

  • Providers who are more likely to use gentle, low-intervention approaches to induce labor are also more likely to prioritize slow and steady induction, rather than trying to "shoot the baby out by 10am" (Tracy).

  • Confirmation bias may play a role in how providers interpret and apply the ARRIVE study findings, with some providers prioritizing their existing practices and biases over the study's recommendations (Speaker 4).

  • Speaker 4 expresses concern about medicalization of birth, feeling it can be at odds with natural physiological aspects.

  • Speaker 1 agrees that studies tend to lean towards what may be beneficial for hospitals, rather than undisturbed birth outcomes.

• Hospital interventions and their impact on birth outcomes. 19:25

  • Speaker 1 mentions money as the reason for hospitals to want more interventions during birth.

  • Speaker 5 clarifies that hospitals, not providers, benefit financially from C-sections.

  • Speaker 5 highlights the importance of provider practices and schedules in cesarean rates, suggesting that those who work longer shifts are less likely to perform cesareans at dinner time.

  • Speaker 6 raises the point that providers who make more money from cesareans may be more likely to perform them at dinner time, potentially impacting communities and birthing people.

• The Arrive Study and its impact on birth practices, including the benefits of using a doula agency. 24:45

  • Speaker 1 highlights the benefits of working with a doula agency, including local knowledge and provider relationships.

  • Jodi Graves references the Arrive study and its findings on early induction at 39 weeks, encouraging providers to refer back to the study for more information.

  • Jodi Graves and Speaker 5 discuss the limitations of the Arrive study and the importance of considering other evidence, such as clinical data from people who have given birth after the study.

  • Speaker 4 highlights the relevance of the "Induction for Due Date" article from Evidence Based Birth, which provides insights into the challenges of inducing labor on a specific date.

• Medical interventions in childbirth and their impact on bonding and natural processes. 29:51

  • Jodi Graves discusses the differences between obstetric and midwifery models of care, emphasizing the importance of trusting the physiological process of labor and birth.

  • Jodi Graves quotes a fantastic midwifery-related quote, "With a midwife, you have to prove that you cannot birth with an OB; you have to prove that you can."

  • Jodi Graves and Speaker 6 discuss the impact of medical interventions on the birthing process and bonding between mother and baby.

  • Speaker 2 shares a positive change in birth practices, while Speaker 1 and Jodi Graves express concerns about the use of Johnson and Johnson products on newborns.

• Improving postpartum care in hospitals. 34:38

  • Speaker highlights importance of postpartum care in midwifery model of care.

  • Speaker 4 expresses financial feasibility concerns for hospitals regarding modern birth and postpartum issues.

 

Link: Michigan Family Doulas

Participants:

Lacey Morgan - founder of King of Prussia Doulas

Kymberly Fleming - founder of Redwood Doulas, provides doula support in California and Washington

Aida Algarin - founder of Central Carolina Doulas, providing services to military families in North Carolina

Celeste Kraft - Michigan Southeast Based Agency Owner

Tracy Abney - founder of Rocket City Doulas, offers support from pregnancy to postpartum in North Alabama

Transcripts: Doula 'Roundtable' Conversation, segment 2 of 3