Veronica Garcia was talking a million miles per minute — explaining that her patient needed her and she had to go. As a doula at the St. Anthony North Health Campus, Garcia provides emotional, physical and informational support to women in labor. She also serves as a medical translator for patients and families who speak Spanish. Garcia's patient for the day was about to receive an epidural and kept telling her, "Please don't leave me, please don't leave me."
So, Garcia hurried back to the mother because, she said, that’s her job — supporting the mom 100 percent and making her feel comfortable.
“I love it,” Garcia said. “I wouldn’t change anything.”
Across the Denver metro area, and nationwide, there are an increasing number of doula and midwife options for expecting mothers.
Research over the past decade reveals that although a small percentage of deliveries use a doula, the trend is growing. The reasons: shortened labor times, decreased use of pain medication and a reduction of Caesarean sections by half.
The use of a midwife also has been increasing since the 1990s with an almost 5 percent increase, according to the Centers for Disease Control and Prevention.
A doula is a trained professional that focuses on what a woman in labor needs. Typically, doulas provide physical, emotional and informational support, but they do not provide any medical advice or help.
A doula can offer services no matter where the birth occurs — in a birthing center, a hospital or at home, according to Heather Scott, co-owner of Denver-based, full-service doula agency Cocoon Birth.
A doula is generally sought out and paid for individually by a family early on in a pregnancy.
Cocoon Birth uses an online registration process to try and make it easiest on families. The form helps to connect them to the right doula.
The program at the North Health Campus provides Spanish-speaking patients with a Spanish-speaking doula if desired, and it is free for the family.
“It does not cost the patient anything because it is grant-funded for Spanish-speaking patients,” said John Tynes, chief medical officer of St. Anthony North Health Campus.
The program was created in1999 because of the large Spanish-speaking population that comes to the hospital.
The hospital wanted the moms to have support with understanding medical choices and processes, Tynes said.
“If you are at a hospital where they do not speak your language, it is very hard to communicate,” Garcia said. “Patients tend to hate using a translation phone.”
Doulas are beneficial even when there isn’t a language barrier, according to Scott.
“Having someone by your side that knows what labor looks like is so helpful,” Scott said. “A doula will never make a decision for the family, but they help with education before labor to help with the eventual decisions.”
Laura Thielke was driven to try and improve healthy birth outcomes in the United States.
Thielke is a certified nurse midwife and director of midwifery at Baby + Company, a freestanding birth center that opened its doors in Wheat Ridge in July.
Midwives are licensed to practice medicine and assist women deliver in low-risk pregnancies. For example, a woman having twins would not be considered low-risk, Thielke said.
“We are the doctor figure in the room, but we don’t consider ourselves doctors,” Thielke said. “Doctors — they are experts in the abnormal.”
At Baby + Company, birth is different than at a hospital, according to Lizzie Mara who works in the company’s communications department.
Prenatal visits, for instance, last an hour, which is essential. “Trust is built, which is a very powerful aspect for mom seeking natural childbirth,” Mara said.
Another emphasized aspect of using a midwife is rigorous education prior to birth.
Baby + Company enter the mother-to-be and her partner into a care model that provides classes and appointments with midwives. One class each trimester provides intensive education and surrounds parents with resources specified to their needs.
Even during labor, a midwife is more than willing to help educate the parents.
“We are in the moment,” Theilke said, “whether it is educating or holding momma’s hand.”
A mother’s experience
As an engineer, Amy Simpkins did not treat research about birth lightly — she had assumed she would do what her mother had done, go to the hospital. But the more reading she did, the more she changed her mind.
“I found that you are treated like a patient,” Simpkins said about delivering a baby in a hospital, “not an empowered women going through a natural process.”
Simpkins and her husband decided to deliver their first baby at a birth center with a midwife and also hired a doula.
The labor Simpkins had with her first child lasted 16 hours; she said having a doula was very helpful. The doula was even able to relieve Simpkins’ husband to sleep for a little while, promising to wake him when he was needed.
But the best part, Simpkins said, was the support.
“Having a woman there that can look into your eyes and know what you’re going through,” she said. “Also, it was the not being alone — that was a big part of it.”
Being in a birth center with a midwife created a calm, homelike environment, Simpkins said. The best part was how quickly the family was able to go home.
“You’re not there long enough to be disturbed,” Simpkins said. “By the time everyone was ready to drift off to sleep, they send you home.”
For her second and third births, Simpkins kept with the same plan — although by the third baby, Simpkins and her husband felt a doula wasn’t necessary because they knew what they were doing.
Unfortunately, during her third birth, Simpkins was transferred to the hospital for precaution with a complication. And, as soon as the decision to transfer was made, the family hired a doula to help make the hospital experience was positive as possible.
“It was great having the support of a doula there in that scary moment,” Simpkins said.
In the end, the family’s third baby was born healthy.
For Simpkins, no matter where a mother chooses to give birth, a doula is a key to a better labor experience.
But, she said, “birth is a very individual experience, so it’s important to choose the right venue and right services for you.”