WithLoveBirths doula takes anthropological approach to serve families

 

#blackbirthworkersrock

Rose Hurd once looked to her great grandmother’s stories as a midwife for inspiration. From a young girl curious about childbirth, to a teenage mother, to a certified birth doula, gentle birth educator, postpartum care provider, Certified Lactation Counselor (CLC) student and now grandmother, we look to Hurd for the same wisdom she found in her great grandmother. 

Immersion in the birth world at a young age allowed Hurd to connect to her culture, she says, although it wasn’t always easy. As an African-American woman not knowing which of the 54 African countries her family originated from, she gleaned whatever she could about African people, she explains. 

Interested in her Indigenous ancestry too, Hurd digested all of the knowledge her mother shared with her, passed down from her mother’s mother, about using plants to heal and food as medicine.   

In her work today, Hurd takes this anthropological approach to serve her clients, melding clinical care with their lived experiences. She embraces holistic care which includes the whole mother, the mother baby dyad, and the family unit. 

 

Informed decision-making

Reflecting back on her first birth experience, Hurd says that a lot of her health decisions were made for her and not with her. 

“There was no Google back then,” Hurd chuckles. 

Decades ago, birthing people often didn’t know about the options that they had, she explains. Today, the internet’s influx of information can mean a few things, Hurd points out. Birthing people may have access to more information, but it doesn’t necessarily mean that they are well-informed or that the available options fit well in the context of their lives.

With more information, more questions arise, and in our medical insurance steamed systems, birthing people are often shuffled through doctors’ offices without much time to talk about their concerns or ask their questions. 

Hurd sees herself filling this need. 

“I am able to sit down, weed out concerns, do the evidence-based research and help families make decisions,” she explains. 

 

Listening and doubt 

The keystone to helping clients make informed-decisions about their health, Hurd says, is listening. 

As an Accessing the Milky Way scholarship recipient, she says that the Lactation Counselor Training Course (LCTC) allows her to connect even deeper with her clients. 

Hurd has found that although most of her clients are part of marginalized communities, they want to know how to breastfeed their babies. 

“They are willing to learn,” she says. 

There is a shadow of doubt often cast over families living in marginalized communities that they can’t, won’t or don’t want to breastfeed.  

Hurd’s own breastfeeding story as a teenage mother offers a porthole into that world. 

Shortly after birth, her baby was in the nursery. She called up and told them that she needed to breastfeed her daughter. 

“There were a few eyebrows that raised up. ‘Oh! This little, Black girl wants to breastfeed? Black people don’t breastfeed. Teenagers don’t breastfeed.’ That was the statistic,”  she remembers the air in the room. 

Hurd continues her story, “I was sitting up and this tiny little, Black nurse comes in with my five pound 11 ounce baby, gives her to me and I am fumbling around with my little top on and as she was leaving the room, she backed up and came to me.”

“‘Here, Baby,’” Hurd remembers her voice as she approached to help. “She helped me prop up the baby and said, ‘Try to get as much of the brown in as you can. Feed the baby whenever she is hungry.’ I was so blessed that this lady came in…”  

Two weeks later, Hurd’s daughter had doubled her birth weight. She shattered any doubt or any statistic that might have otherwise discouraged her success.  

 

Lifelong learning 

The glaring racial disparities in breastfeeding initiation and duration propel Hurd to help families shatter the statistics the way she did. 

Part of this mission includes providing education that extends beyond the mother baby dyad. She often works with mothers who may be the first in their generation to breastfeed, so she educates entire families on what breastfeeding might look like and how to support a breastfeeding dyad. 

Especially through COVID as doulas’ access to their clients is limited, Hurd has provided instruction to family members on how to support the laboring person through real-time, virtual platforms. 

She hosts monthly breastfeeding support groups, now virtual due to COVID, where she incorporates mini-lessons. 

Not only an educator, Hurd considers herself a life-long learner, eager to always know more about her clients and about maternal child health in general.

“Find those people in the birth working community that will support you and be your resource,” she advises. “Iron sharpens iron.” 

“I would also like to add…that self care is important,” Hurd says. “Being at your mental, physical, and spiritual best helps you to serve at your best.”

You can connect with Hurd @WithLoveBirths.

Breastfeeding Resiliency, Engagement, and Empowerment (BFREE) Team offers weekly, virtual support helping families access lactation services amidst pandemic

Before the onset of COVID, families living in four catchment areas on Long Island: Glen Cove, Islip, Wyandanch, and Southampton, could find breastfeeding support groups at many community establishments. In-person baby cafes following Baby Café USA’s structure were hosted at community centers, libraries, food pantries, churches, etc. 

On a mission to create supportive, breastfeeding-friendly communities along the care continuum– in obstetric and pediatric practices, child care centers, worksites, and community support groups– the Breastfeeding Resiliency, Engagement, and Empowerment (BFREE) Team at Cohen Children’s Medical Center has adapted to COVID times and is now offering free virtual breastfeeding support groups led by lactation professionals each week so that families can continue to access lactation services amidst the pandemic.

BFREE aims to reduce racial, ethnic, and community disparities in medically underserved neighborhoods. Their efforts are part of a five-year grant funded by the New York State Department of Health. Today, BFREE uses a virtual HIPAA-compliant video platform that families can easily access twice a week, no matter where they are, with the option of Spanish translation. They also offer a toll-free telephone conference line.  

BFREE team member Abby Coco, BA reports that they’ve gotten a lot of positive feedback from families thus far. 

“They’ve expressed liking the ability to get help in the comfort of their own homes,” she says. 

With this in mind, when COVID limitations begin to lift, the team plans to resume in-person support groups, but they’re also considering the option of maintaining a virtual platform for those who prefer this method.  

This summer, Long Island weathered a storm that left many families without power. One mother during the virtual baby cafe expressed concern about safely storing her milk. Another mother heard her worry, and offered to drive to her home to retrieve her milk, and store it for her until her power returned. 

“It’s awesome to see mothers in nearby communities willing to help each other out even when socially distanced,” Coco comments.  

She adds, “It’s also awesome to see moms who continue to return to our groups and become mini experts based on their own experiences.”

Several BFREE team members and Former Associate Program Coordinators are Certified Lactation Counselors (CLC). Coco is currently completing the Lactation Counselor Training Course (LCTC). She says the content is “really applicable” to their work, specifically to better support mothers, but also to help them engage with community partners and to provide educational resources.  

“Having a deeper understanding [of infant feeding] has been extremely influential in helping us be able to do our jobs better,” she says. 

In addition to helping establishments achieve criteria for the New York State Ten Steps to a Breastfeeding Friendly Practice, BFREE provides funds to staff to complete the LCTC.  

Overall, Coco reports that community organizations are receptive to their work, although they have run into some roadblocks with religious organizations who think their work is “a little too progressive,” she says. 

What’s more, “during Covid, so many people are overwhelmed and don’t think they have the capacity to take on another project,” Coco explains. 

She notes that a lull here hasn’t been particularly detrimental considering they have already saturated neighborhoods with breastfeeding-friendly establishments. 

“It’s a good problem to have,” she laughs. 

Fostering partnerships and strengthening networks not only makes advocates’ jobs easier, it makes the job of being a parent easier too. 

You can connect with BFREE and their services on Facebook

Their next virtual baby cafe is Tuesday evening.

Accessing the Milky Way scholarship recipient inspires positive change in generations to come

When news of the Accessing the Milky Way scholarship was released, Jackson Memorial Hospital nurse Lupi Nicholls-Reyes RN, BSN, IBCLC quickly thought of her colleague Santana St. Remy.

St. Remy feeds her baby after graduation ceremony.

“She is an amazing advocate for breastfeeding,” Nicholls-Reyes  writes.  “As a Lactation Specialist, I have seen how she supports mothers with breastfeeding during the night shift because I see the positive effects when I rounded on the mothers during the day.”

St. Remy says she was overjoyed when she found out that she received the scholarship.  

“It has been an important endeavor of mine to be a resource for other women and to make a substantial effort to decrease the maternal and infant mortality rates especially among the most vulnerable population,” St. Remy begins.  “Becoming a mother/baby nurse has been the first step in achieving that goal… The way I see it is if I am able to help one woman as it relates to the care of herself and the nurturing of her baby, I have successfully played a role in creating change in a generation of women. Her children will learn from her as well as her children’s children and so forth.” 

St. Remy says of the Lactation Counselor Training Course (LCTC):

“My experience with the course has been phenomenal. I love the evidence-based research. I enjoy listening to the faculty’s experiences.  I especially enjoy the live video office hours.  

There was a veteran postpartum nurse that recently retired on my unit.  I remember some of the nurses feeling sad that she was leaving. Imagine someone working beside you with a wealth of knowledge that you could just walk up to and ask a question or advice on any situation you may be experiencing. That insight is invaluable.  When you look in a book or you use a popular search engine it just doesn’t compare.   

That is the way I feel about this course; the compassion, care, and empirical knowledge is invaluable.  I have learnt so much and have already implemented a lot of what I learnt into practice.”  

As a night nurse, St. Remy is positioned to help families move through the challenges of new parenthood during a time when, generally speaking, babies are more likely to be given formula during their hospital stay. 

For one, many parents have the expectation that their baby will sleep during the night, and they will be able to rest. 

“The moms only have access to a lactation specialist during the daytime,” St. Remy goes on to explain.  “So, it is up to the nurse to provide the mother with postpartum care as well as breastfeeding support which can be challenging sometimes because for a new mother this requires a lot more time than the nurse can spare.”

What’s more, St. Remy and her colleagues care for a large population of birthing people with high-risk pregnancies, challenged by conditions like Pregnancy Induced Hypertension (PIH) or Pre-eclampsia, Eclampsia, Gestational Diabetes, Chronic Kidney disease, Sickle Cell, and mothers who have endured strokes.

“It is very fascinating to see the capability of a woman’s body to deliver a baby despite having multiple comorbidities,” St. Remy comments. 

It’s with this sentiment that she approaches new families: through encouragement, reassurance and anticipatory guidance despite any roadblock they may be up against.  

“As new parents, it can sometimes be overwhelming trying to figure out how to care for this little human,” she says.  “It really does not matter the race, creed, or socio-economic status, the worries are often quite similar. For moms, the biggest concern is if their baby is getting enough milk.”

St. Remy offers education on what to look for to ensure that the baby is getting enough milk. She also teaches hand expression early on, not only as a visual reminder of the colostrum or milk that is present, but because it is such an important tool for parents to have going forward. 

Families who are not breastfeeding are not forgotten in St. Remy’s practice. She encourages skin-to-skin contact, teaches proper formula preparation and storage and safe bottle-feeding. Mothers who are not breastfeeding also need to learn how to prevent engorgement, St. Remy reminds us. 

With the onset of COVID, hospital staff and families have had to adapt to new visitation policies implemented to help reduce the spread of the virus. 

“In my opinion, mothers have been more receptive about breastfeeding; they want to learn more about ways to protect their newborn during these uncertain times,” St. Remy comments on an ever-changing environment due to COVID.  “It is important to maximize this opportunity by answering their questions and concerns which ultimately builds their confidence. ” 

Limiting visitors at their hospital has presented hardship in many cases; for instance, when doulas are prohibited from attending births, but limited visitors during the postpartum period has sometimes shown to be helpful, especially during the Magical Hour and beyond when newborns and their parents can bond without distraction from friends and relatives. 

Still, St. Remy recognizes the importance of familial support– something she experienced personally.

“I was determined to breastfeed my daughter and we were able to do so for about 2 years and 9 months,” St. Remy begins.  “In the beginning I thought I had everything under control with my background in nursing… it would be a piece of cake! I knew the theory behind it, but the actual lived experience was different.   I did not realize how much support I would need in the beginning and I was fortunate to have the support of my husband and other family members…”

After St. Remy would feed her baby, her husband would take over and spend time with their daughter. 

“He would have skin-to-skin time with her and sing her to sleep,” she remembers.  “She is three now and her favorite song for sleep time I found out a few weeks ago from dad is, Amazing Grace by George Jones.  It must be this specific singer when I ask Alexa to play it. I do not know why this song or this singer but those were the instructions from dad, and it really works.” 

Acknowledging the non-birthing partner as a competent, involved parent is another important facet to St. Remy’s practice. 

Reiterating her earlier statement, “…if I am able to help one woman… I have successfully played a role in creating change in a generation of women. Her children will learn from her as well as her children’s children and so forth…” 

St. Remy’s reach extends even beyond that though. She is an inspiration not only to mothers, but to non-birthing partners and to other maternal child health advocates and health professionals.

Alabama birth worker facilitates holistic, sustainable care for families

*Trigger warning: pregnancy loss

Doula and childbirth/breastfeeding educator Kayla Bitten’s (processing PMH-C. IBCLC student, midwifery student) road to maternal child health advocacy was paved in part by tragedy. 

One day while driving with her cousin and aunt who was pregnant, her aunt swerved into a wall in an attempt to avoid a driver who’d run a stop sign. 

Bitten remembers the aftermath of the crash; her aunt laying in the stretcher, unattended to. Later when transferred to the hospital, her aunt’s concerns about her developing baby were dismissed.

“Everything was fine,” care providers told her and sent her home.  This phenomenon, where Black Indigenous People of Color (BIPOC) are dismissed in medical settings is not uncommon. 

“She knew something was off,” Bitten recalls. 

The next evening, Bitten’s aunt miscarried the baby. 

“Somehow, I was able to doula her through that miscarriage,” Bitten says. “It was very second nature. I knew how to help her breath through it, hold space for her emotionally.” 

“Hearing her say that it hurt so much emotionally and physically triggered something in me,” Bitten continues. 

From that point on, she consumed research, dove deep into conversations about BIPOC health, started writing about birth, surrounded herself with community health workers and studied under their care.  

She started making connections between the generational ailments that challenged the women in her family– things like uterine fibroids and infertility— and the systemic forces at play

Fueled, Bitten launched The Postpartum Clinic, a one-of-a-kind lactation and postpartum wellness facility that centers People of Color.

Through memberships, private appointment sessions, and support groups, The Postpartum Clinic offers comprehensive, inclusive, and culturally competent care to families as well as a network of  local resources for primary care and psychotherapy professionals around Birmingham, Ala.

With nearly 60 percent of Alabama’s population identifying as Black, Bitten notes that “it’s insane” that a care facility like this didn’t already exist. 

“I’m really proud of it and really excited about it,” she says. 

Bitten also leads Coloring Between The Lines – Mothers Of Color Breastfeeding Support (CBTL) which uplifts more than 160 women. The non-profit provides education through virtual and in-person meetings, online mini courses, emotional support, and breastfeeding supplies through donations from local women and businesses at no cost to participants. 

CBTL is rooted in advocacy and activism.

Instead of simply handing out pamphlets and sending families on their way, with CBTL, healthy infant feeding “becomes a sustainable journey not just a one stop shop,” Bitten explains. 

Most of the mothers Bitten and her colleagues work with through their community support groups arrive almost completely defeated by the demands of parenthood and the reality of living as a Person of Color.

“Immediately there are a lot of emotions and literal tears,” Bitten describes. “Once there’s support and community surrounding them, that completely changes.”  

With many of their clients living in North Alabama, skilled birth workers, education and support is hard to come by, so many families have to travel quite far for competent care; interestingly though, the onset of COVID has been mostly positive, Bitten reports. In the midst of the pandemic, different programs have offered free internet to those in need, so Bitten is now able to reach populations she might not have otherwise. 

CBTL partner Jasmine Hammonds and Bitten are conducting research with the goal of policy change in Alabama. The research aims to understand the lived experiences of families and help them pinpoint policies that will support healthy birth and infant feeding outcomes for BIPOC. 

Bitten is a recent recipient of the Accessing the Milky Way scholarship and is currently a CLC student. She says her experience with the Lactation Counselor Training Course (LCTC) has been “really good.”

“What I appreciate most is the different teaching styles… and the evidence-based education,” she says. 

Bitten adds, “With a CLC behind my name, I will be able to not only provide emotional support, supplies, and basic education for  mothers, but I will also have the opportunity to support them with more in-depth services.”

Learn more and connect with Bitten here and here.

Milwaukee birth worker embraces the unknown unknowns, especially during global pandemic

In March, just before COVID hit Milwaukee, Wis. Evelyn Rhodes completed her doula training with Doulaing the Doula. Since then, COVID hasn’t slowed her down. If anything, it’s motivated her more to serve families as they’re challenged by the pandemic.

“If you want to be a birth worker, do it now,” she advises.  “Don’t wait for the pandemic to be over. Birthing people need you now. If you have a passion, then you’ll find your place within this work!” 

In only a few months, Rhodes has completed CAPPA training to become a Childbirth Educator through Well Pregnancy and started working with the African American Breastfeeding Network (AABN) through its WeRise doula program. As an Accessing the Milky Way scholarship recipient, Rhodes is well into her Lactation Counselor Training Course (LCTC) material too. 

“It is going really well,” she reports. “I like the set-up and the check-ins to ensure you are learning and retain the information. The videos are very detailed and offer a lot of information, so it is nice to have the quizzes after each section…. It is also helpful that they have live office hours where you can talk to a person if you have any questions.

Rhodes adds, “I’m really learning about how our social dynamic, cultural norms and legislation all impact the ability for women to be successful in breastfeeding.” 

Rhodes calls the scholarship an amazing opportunity to equip people with the knowledge and skills to help others and really make an impact. 

“That is why it is so important that if you have a passion for this, you take the responsibility to do something about it and make a difference in someone’s birthing or breastfeeding story,” she says. 

Since she was a teenager, Rhodes has been interested in working with pregnant people and babies.

“But my passion really erupted when I had my own kids with a lot of complex issues,” she says. 

Over time, she learned that her story was not as isolated as she thought.

“Complications that I experienced… were more the norm than the exception for birthing people who looked like me,” she explains. “I learned about the statistics for women of color and it is scary, especially for women here in Milwaukee. I really wanted to be a part of changing people’s birthing stories and outcomes to be more positive.

Rhodes developed preeclampsia in her first pregnancy. 

“I knew something was wrong but my doctor just kept brushing me off,” she remembers. 

Rhodes took matters into her own hands and moved from Duluth, Minn. to the Twin Cities in search of different care. During her first and only appointment with a perinatologist,  Rhodes’s oldest daughter was born via C-section at 29 weeks.  Although it was a challenging start, Rhodes provided breastmilk for her baby. 

She went on to exclusively pump for her second daughter who was born with a cleft palate and a heart condition that required surgery at three months. When her third baby was born, she managed the challenges of her baby’s tongue tie that was revised, but she did not receive proper aftercare education, which caused another layer of breastfeeding challenges. 

Despite it all, Rhodes says that breastfeeding her babies was an amazing bonding experience. 

She says, “It creates this connection with your child in that ‘I’m the only person that can give you exactly what you need’. Research tells us that when we smell our babies, our breasts like magic respond to that and produce whatever it is that our baby needs. It’s a gift that makes you feel like a Goddess. It makes you feel good when your baby is crying and you’re like,  ‘Awe, you just need your Mama and these boobs with my liquid gold.’” 

At the same time, Rhodes acknowledges the responsibility and stress that can be coupled with that joy. 

“In my work… I try to make sure that moms know if anything is wrong or making breastfeeding difficult, to seek help,” she says. 

The tenacity that guided Rhodes through sometimes challenging birth and breastfeeding experiences has helped her persevere professionally through the environment that COVID has shaped.  

“…Our kids are with us all day everyday so we no longer have the privilege of someone else caring for our children while we work, study or complete training,” she explains. “I’ve had to do training while tending to my kids or set the kids up with snacks, toys and a movie and lock myself in my room to be able to focus on my training taking breaks to check on them, refill their water, and put on a new TV show to keep them occupied. Sometimes my husband and I both have places we need to be virtually. We even went out and bought our kids new LOL surprise dolls, you know the ones that you have to open 50 different tiny things, because we knew we’d be occupied all day.”  

Reflecting further on her professional life, Rhodes says her work with WeRise has been the most challenging. 

“The work we do is very intimate and in order to take precautions to keep everyone safe, we’ve had to interact in less intimate ways than we normally would,” she explains. “For example we’ve held meetings in public places and practiced social distancing and utilized virtual platforms like Zoom and even FaceTime to conduct prenatal meetings and get to know each other whereas we normally would have done this face-to-face and in the privacy of their homes.” 

“Because of the pandemic, our pregnant mothers are dealing with more stress which as we all know can cause more complications with pregnancy, delivery and even developmental issues once the baby is here. So my work has been a lot more emotional support and finding resources for the mother and the family throughout the pregnancy,” she continues. 

In the face of COVID, certain maternity care facilities are limiting the number of support people present during births, so Rhodes and other doulas are forced to find creative ways to offer support.  

With one client in mind, Rhodes explains, “We are going over a birth plan to help her advocate for certain things, practicing positioning and when certain positions will be most helpful and ensuring that we can be set up virtually if mom desires that interaction during labor.” 

The work that Rhodes, other birth workers and maternal child health advocates are doing is making a difference. 

“I have no choice but to be optimistic about the future of maternal child health,” Rhodes says.  “I think at this point, we have no way to go but up.”

She adds, “…Everyone has to continue to be advocates for themselves as well as others. If we know something, we have a responsibility to our community to share that knowledge because there are so many unknown unknowns. Sometimes we know something doesn’t feel right but we don’t know why. Explore that feeling, ask questions, ask for more information. Share your story and your outcomes positive and negative. Someone might learn from it!”