>> From WXXI News.

This is connections.

I'm Evan Dawson.

Our connection this hour was made in a headline back in 2017.

Here's the headline.

Doulas aren't just for rich people.

The Newsweek story focused on the perception of birth doulas, and sometimes the stigma that they are only for wealthy women or couples.

In reality, Newsweek reported, there were efforts underway to make doulas more widely available, more affordable.

A generation ago.

The number of births involving doulas was in the small single digits.

Today.

By the numbers I've seen, could be 6%, could be ten.

Around 8% rising.

Which brings us to an event happening tonight at the Little Theater.

My colleague Raquel Steven, will moderate a panel discussion following the screening of a new documentary about doulas, and the film will then go to Chicago, Albuquerque, Asheville, North Carolina.

The team bringing the film believes that community based doulas are one of the most promising strategies to address the maternal mortality crisis, and the film is called a Doula Story.

2025 an update to the original 2004 documentary.

This updated film is created to reflect on the evolution of the doula movement, with a specific focus on the development of a national black, brown, and indigenous doula coalition.

New York State Senator Samra Brouk has worked for years to bring support to new mothers and to support more doulas and more delivery rooms.

This movement has the weight of government, at least in some places.

We'll talk about that and we'll discuss what's going on tonight and what our guests want you to know.

They'd love to see you there, doctor.

Twyla DeLeon is president and CEO of Health Connect one.

Welcome.

Thank you for being with us.

>> Thank you.

Evan, thanks for having us.

>> Next to Dr.

Dylan is Phyllis Sharp, who is a doula with Royalty Birth Services.

Welcome.

Thanks for being with us.

>> Thank you for having me.

>> Also with me in studio is Jackie Lindsay, chief program officer of the Healthy Baby Network.

Thank you for being here.

>> Thank you for having me.

>> And welcome on the line to State Senator Samra Brouk, who is back with us.

Senator Brouk, welcome.

Thanks for being with us.

>> Thank you so much for having me as well.

>> Dr.

Dylan, let's start with what's going on tonight.

Let everyone know what's happening and how they can be involved.

>> So tonight we're hosting it's a small screening, so there's about 30 slots left.

a private screening of a dual story, 2025, which is a documentary that's following up on a prior one from 2004 to give an update where the community based doula movement is right now, as everyone knows, there's been many shifts and changes in reproductive justice and the role of a community based doula has changed dramatically.

Forming a coalition is vital to make sure that this profession is sustained.

And this documentary, which is still being filmed, is keeping track of what's going on as we go from city to city.

>> what time tonight?

>> It's the documentary will start around 615.

The screening doors open up at 6 p.m.

and I'll provide information as to who to contact.

If folks would like to attend.

>> okay.

so only about 30 slots left.

it's a really interesting subject and a shout out to my colleague Racquel Stephen, not only for the event tonight, but Raquel's work this summer and hosting conversations on this topic.

She's done great work there.

and, you know, it was interesting, doctor Dylan, when I went to sort of just kind of search around and try to get an update on how many people are using doulas and what what movements are afoot to kind of bring cost down or more availability.

A lot of the headlines I saw now, they were from 2015, 2017, but they were like our doulas just for rich people, our doulas just for white people.

I mean, it was like the perceptions were interesting over time.

Where is it in 2025?

What's the story.

>> To you?

>> The story in 2025, unfortunately, is a similar story to what was happening about 30 years ago when folks started discussing the reduction of maternal health inequities.

Right.

So the fact that black, brown, indigenous women face different outcomes, much worse outcomes than their white counterparts, we haven't really moved from that.

Despite putting a heavy focus on being able to do that.

Doulas are helping to mitigate some of those challenges by creating and shaping and changing the environments in which some of those folks are giving birth, right?

So they're mitigating some of the harms of systems.

So the biases that exist in these systems.

So that's the role that they're playing.

There's different kinds of payment structures that have come into place.

Because the recognition that doulas can mitigate some of that harm, not the whole solution, but a part of a solution, is something that's of crucial importance.

So we're starting to see a lot more of that.

We're also hearing from people maybe we didn't hear from before.

There's been a huge like surge, if you will, of black maternal health influencers, which is also important because that's helping folks to understand what they actually can access.

So all of these things are happening at once.

Unfortunately, it's taking a while for some of these outcomes to improve, but we are seeing definite improvements in all the birth outcomes.

C-sections, NICU stays, everything.

>> One of the quotes that stuck in my mind from about a decade ago, one of the first conversations on the subject we had, I had on this program was that if doulas were a medicine, a drug, it would be illegal to withhold them during labor.

you know that the outcomes and the effects are can be that powerful.

For listeners who still don't know what is a doula.

>> So we can define this a few ways.

So a doula is someone who provides social, emotional, physical support during the prenatal through postpartum period.

There are also variations on that theme.

There are death doulas now, right?

So there's doulas for all sorts of things.

community based doulas differ in the sense that they're from the community they serve.

So they're black, brown, indigenous, or other marginalized communities like in Appalachia, white communities that are lower income.

There are doulas that are actually embedded within that space.

So they understand who's who and how to best support people, support people.

They speak the same language, right?

They know how to access the systems.

And there's a shorter getting to know you period.

Right.

Because there's this understanding, this awareness.

So that's one of the reasons that community based doulas are so important, because when you have to, like, build this bridge between one culture and another, it makes it a little bit more difficult to actually get to that access and that trust.

>> So in a moment, we're going to ask Senator Brouk about what it means to put policy in the weight of government behind that.

And her time is short.

I just briefly want to make sure listeners understand who else is with us in studio.

And Phyllis has been a doula for six years now.

Is that right?

>> Yes.

Full time.

>> So tell listeners a little bit about the work that you do.

>> well, as a doula like she said, we help them emotionally, the couple as well.

So it's not just the mom.

it's the mom and the partner as well.

so we help them emotionally, educationally as well too.

And physically.

and it starts in that prenatal time when we really get to know each other, we can supply them with education as well, because education is really the key when you're in that birth space, for them to be able to make informed decisions as well too.

also helping them when they're in labor during the birth, helping them to be able to really navigate the hospital, stay, navigate the relationship between her provider and the nurses and whomever is taking care of her at the hospital to help that be such a smooth transition.

Right.

So I'm there to really just help them to understand what's going on, understand how to take care of themselves and how to make good decisions for themselves as well, too.

We don't make decisions for them, but we do make sure that they're empowered to make their own decisions.

>> And I will say this, Phyllis, I mentioned labor, of course, as you describe, it's a long process pre and post.

It's not just about however long your labor is, whether it's an hour or, you know, let's say two and a half, three days, you know, as as I might have experienced a couple of months ago.

So you just never know what that process is going to be like and how chaotic it can be.

And the reason my brain has been on labor is it wasn't a fun one this summer, but doulas are amazing in the chaos of the moment.

Because, you know, when you're losing, when the partners losing their mind, when mom's losing their minds, you don't lose your mind, fellas.

And thank goodness.

>> For you.

>> So we are the calm in the room.

>> Khalil.

>> Boy oh boy, is it necessary.

And Jackie, with a healthy baby network, what's your role in supporting doulas in the community here?

>> So at Healthy Baby Network, I'm the chief program officer and one of the programs I oversee is our community based doula program, as well as our black Doula Collaborative.

So as Twyla mentioned, the community based doula program our doulas are all from of the same community as the women that we support.

And so you know, one of my roles is working to help develop these programs.

And in developing, keeping in mind the community that we're going to serve from conceptualization of the program and developing the program.

>> Well, I mean, do you all in studio do you feel like the weight of government and policy is behind it, or is it kind of hit and miss?

I'm very curious to know, Jackie, when you think about what would actually support these kind of efforts from the government level, what does that look like?

>> So I think we're getting there.

and I think you know, government and people in general are starting to really understand and value doulas.

and the ways that we support women and also support different organizations, the hospital system, not only are we providing support to the women, but we are also reducing cost.

And I think that also becomes something that government and policy is actually interested in.

>> Dr.

Dylan is our guest on the line.

Someone who walks the walk.

Do you.

>> Think?

>> She definitely does in so many ways.

She's super valuable in this space and listens when it comes to what the doulas need.

I think the challenges that we face are further on downstream than getting the policy put in place, right?

Because implementation is another challenge.

And for a lot of doulas, we're talking about folks that we want them to be from our community.

Those folks aren't billers, right?

Like that's not the expectation.

And I think something that has come through in every state and that this is coming through in the documentary as we continue filming it, are the challenges when reimbursement is put in place in different states to get the doulas, you know, signed up to do it, to get the doulas to actually bill for them to be comfortable engaging in anything having to do with Medicaid, especially right now.

So I think that there are definitely challenges there.

But summer has been a wonderful partner in getting this over the finish line, and we're very grateful for that.

>> So.

>> Senator Brouk, let me just start by asking you for some general ideas that you have on this subject.

And then I want to kind of wade through some more of where policy is and where it might go.

But why is this a subject that you feel passionate about >>?

>> well, I have firsthand experience.

Evan, as probably most folks know, at this point, I was also one of those two three day labors.

>> I'm not laughing at you.

I'm laughing with you.

Sure.

Solidarity.

>> Laugh when we're on the other side of it.

Right.

but, you know, to be honest, this was something that we had taken an interest in before I even thought about becoming a mother.

But I think it really came into focus once I actually went through it.

And, you know, one of the beauties of coming into a legislative space with lived experience is no one can take that away from you.

They could not get me to shut up about the power of this doula care.

And I love the quote that you had around, you know, if this were a medication, it would be criminal or something like that, right?

It would be criminal not to provide it.

That's exactly how I feel.

And so I think what's so important is that, you know, my goal is any New Yorker who wants doula care should get it right.

There's still agency within that, right?

I know every person I know who's pregnant.

I've tried to say, find a doula, find a doula.

Sometimes it's for you, sometimes it's not.

But certainly we don't want to have any barriers to accessing it.

So, you know, I think we're really lucky that here in New York we do have more moms in office, more people who have given birth in office than we ever had, including our governor, who's been supportive on many of these things.

and so when I'm looking ahead at, you know, how do we create a more hospitable environment to ensure that more individuals have access to quality doula care?

We're thinking about things that I just talked about.

Right.

how do we get more of them into the community doula directory?

We're up to almost 300 now.

But, you know Medicaid covers half of the births in New York State.

That's almost 100,000 births.

So 300 community doulas is not enough.

We need to continue growing that we have to cut down on the administrative headaches because these are professionals who should be serving the birthing individual and their partners and not, you know, bogged down with piles and piles of paperwork.

So we've done a community doula grant fund every year.

We've gotten it refunded.

or, you know, reallocated two years in a row.

So, you know, those are some of the things that we're looking at now, as they talked about, it's one thing to pass the legislation.

It's another thing to really be monitoring the implementation and create accountability and keep our ears open for what's happening in the field.

>> Well.

>> And Senator, this is a time where Medicaid is under the microscope because of what's happening on the federal level, but also it is not new that critics of government expenditures, typically on the political right, think that Medicaid is too luxury.

There's too many things covered.

It's too broad ranging, it's too expensive.

They point to New York, they point to California, and I suspect there are plenty of critics who would say, you're going to put doulas on Medicaid.

I mean, that's just another cost that we can't afford.

What do you what do you say to them, Senator?

>> Well, I think I think it was someone in studio that mentioned it's actually a cost saving measure.

So when you look at the statistics of and there's at this point been ample studies around individuals who have had dual care and haven't, what you see is reduced length of labor.

So you'd ask your hospital, what does that mean for one day less in the hospital, right?

You see a decreased rate of C-sections.

So, you know, you ask your insurance companies, what does it mean to have fewer surgeries?

These are abdominal surgeries.

They're major abdominal surgeries.

When someone has a C-section, you have decreased rate of those C-sections, you have improved maternal mental health outcomes.

What does it mean to not cover as many maternal mental health?

you know, diagnoses, postpartum.

So, you know, I believe every life is worth it.

And we should make, you the investments necessary to ensure that mom and baby are healthy and set up for success when they get home.

But if you are a straight dollars and cents person, then the dollars and cents are actually the most obvious answer for a positive ROI.

On something like doula care, which is running the state at this point.

You know, under $2,000, whether you're downstate or upstate, that's the Medicaid reimbursement.

and so when you compare that to another day in the hospital, right when you compare that to an entire abdominal surgery, it actually is able to to save money.

>> what are your colleagues think of the idea of expanding state support for doulas?

>> You know, this is I have to.

>> Say, I think I am lucky in the way that between the maternal health work we've done around doula care and really, my mental health work, I have been able to enjoy incredible bipartisan support.

And when you look at the votes on the floor you can see that there is bipartisan support.

You know, I'm having conversations with my male Republican colleagues, and they're coming to me saying, oh, my daughter loves what you're doing with the doula care, which I love to hear, right?

I love to hear and so, you know, I do think that this is one of those places, especially in such a fraught federal atmosphere that we're in right now, at least at the state level.

We are able to have substantive conversations both Democratic and Republican colleagues around the need for doula care, around the need for the improvement of maternal mortality.

And I think the other thing that's important is that we've been very mindful to center the fact that black, brown, indigenous women are suffering the most.

And if we are able to solve this crisis for them, for us, we will end up improving outcomes for everyone.

And I think people are starting to see that, at least here in New York State.

>> Well, and before we let you go, Senator, I am curious to know what you think the timeline would be to really have the impact that you want.

As you point out, if there's 300 doulas currently in a network, in a state in which Medicaid covers half the births the need is I I'm not a math person.

I was going to say orders of magnitude.

It's a lot.

It's a lot more.

It's a lot more than 300.

So what has to happen?

I mean, maybe that's a question also in studio, which we'll talk about in our second half hour here.

But from your perspective as a lawmaker, is this something that realistically can get done anytime soon.?

>> As a lawmaker, the way I think of it is, and it's probably from my private sector you know, career before this, it's if you have, you know, yes, these are ambitious goals, right?

Because these are decades in the making, right?

These are systemic challenges that have existed, some of them on purpose for many, many decades.

If we want to solve this ambitious goal, we need to be ambitious and unprecedented with how we deal with it.

So I look at, you know, I'm grateful we've been able to keep a quarter million dollar budget line for the community.

Doula grant expansion program.

Right.

That probably needs to be three, four, five tenfold, right?

If we actually want to bolster this administrative backing of these doulas to get them into the system quicker, to get them paid more quickly so that they can support their own families so more of them can get involved.

That's something, right?

We need to see exponential growth with something like that.

We also need to build, and I hope that this will come up in the next 30 minutes.

We need to build more partnerships with our hospitals.

So, you know here locally, we have great relationships with our hospitals who are building these doula programs, but we need to do that statewide.

So, you know, we have legislation around designations as doula friendly spaces.

so I have legislation around that so that people know where they will be welcomed and where they will have collaborative partners with the hospitals.

So I think there is a path forward.

But it certainly is going to take more than kind of steady, sustained funding.

And we're really going to have to put our money where our mouth is to make sure that we are backing these community doulas.

>> And lastly an important event tonight.

Do you get the sense that hospitals and communities are more educated on this subject?

Senator, I ask because when I first learned about it, when my 13 year old was on his way into the world, this is not a subject that I knew anything about, and I remember some of the conversations with doctors and nurses, and it was mostly positive.

And there were some it was like, well, you know, some doulas might overstep.

And I don't think that that's the perception.

13 years later, I don't think but what is your perception on how the medical system views this issue and whether the medical system wants to see you succeed in getting more doulas in?

>> I have to say, you know, from the work that we've done, again, we started our work very grounded in the doula community.

It was driven by what they were seeing and what they needed to succeed.

But eventually, you know, if you want to pass legislation, it is working with organizations like Acog and talking to the Ob-gyns and the certified nurse midwives and the entire hospital administration.

So it is something we continue to try to do statewide.

Of course, I will say locally, I have thoroughly I'm very encouraged by the discussions we're having with a lot of our local hospital systems.

I do think that they understand it.

I also think they understand the ROI on it, right, of having doulas in their hospitals.

And I also think when anything's new, you know, you might have one difficult experience with a little friction.

And that kind of puts you off on something.

But the truth is, the more we are seeing doulas show up in these spaces, they're building relationships.

So I know when I am, you know, checking out hospitals, they're like, oh, who's your doula?

Oh yeah, we love her.

Spoiler.

It's Phyllis.

>> But, you know, building these.

>> Relationships locally, which I think is really, really important.

And I'm grateful that the doulas locally are taking that on themselves as well, as well as the OBS.

You know, the rooms were in their tag teaming, right?

Like they're in this together.

They want to make sure that mom and that baby get out healthy and happy.

And so I am I'm encouraged by that.

And I think we need to make sure that continues to happen.

around the state.

>> Senator, I'm going.

>> To read an email as I close with you, and then I will ask our guests in studio to respond to the emailer.

But the reason I want to start with you is I'm thinking about people who might be thinking about their own futures, about the career that they might have, wondering if I go into this, is it going to be supported?

Will the rug get pulled out?

Will I have a hard time with reimbursement or reimbursement rates going to lag?

They might look at nursing homes, they might look at pre-K, they might look at you know, early intervention services that have historically we know the battles that have happened and how difficult it's been to be providers in those spaces.

So this is an email from Ryan who says even in the panel, thank you for taking the time to discuss doulas.

Today, I'm finishing off my master's program, capstone project based on data collected from a survey I made on doula perceptions, motivations, and experiences in the mid-sized Minnesota city where I was for school.

While I have not yet needed a doula for myself as someone interested in women's health, doulas can be an important support for families.

And depending on how my med school application cycle goes, it might be an avenue to pursue for my own livelihood.

I'd love more information about the showing tonight since it is so timely.

Thank you for the information and the lively conversation.

That's from Rae Ann.

So Ryan's thinking about this.

Senator Brouk, do you think that there will be a consistent support for providers in the future if they choose to go into this line of work?

>> I think there can be and I want I want to say two things to Ryan.

That's amazing.

I love I'm so grateful for that email.

One is we are talking about Medicaid today because that's where we decided to start legislatively, because it would have the biggest shift for those who needed it the most in New York State.

But let's not lose sight of the fact that there's also legislation I have out there to have private insurance companies cover doula care.

So most any healthcare provider that you speak with, very few solely operate under Medicaid, right?

Many have some private pay, some insurance and some Medicaid.

And so we have to continue growing and passing further legislation.

I will tell you that some private insurance companies have already started covering doula care, really following the lead of the state and Medicaid.

So that's one thing I would imagine she would have, you know, a mixed bag of clientele.

The other thing I want to be very clear on, because this is the thing I get stopped in the grocery store about, is that these are non-medical professionals, right?

So these are not MDS.

These are not RNs, these are not lpns.

I mean, some might happen to be, but doulas are non-medical professionals offering support.

And so I also just want to be clear, they are always in addition to and not instead of having an OB or a midwife.

And so it is a very different career path, right, than going into, you know, a more traditional healthcare career.

But that's what I would tell her.

You know, I think you can talk to Phyllis, you can talk to doulas in the room.

I know it's a very rewarding career.

And the truth is, you all have the power to put people in, you know, positions of legislative influence who either believe in this or don't.

So if you ask me, is it sustainable?

As long as I'm here, it is.

>> As long as we.

>> Have people who understand these things, it is.

But you know that it gets decided by our policymakers and our policymakers are elected by by you all.

>> Senator, thanks for the time.

Come back on soon.

We'll talk about other business.

There's a lot going on.

>> There is.

I would love to.

Thank you so much.

>> Senator Samra Brouk joining us on the program.

And if you're just joining us, I'm going to ask Dr.

Dillon to tell you again what's happening tonight.

Maybe you can let Ryan know how to get in touch.

There you go.

and then in our second half hour, we're going to ask Jackie Lindsay from the Healthy Baby Network.

Phyllis Sharp Abdullah with Royalty Birth Services to weigh in on some of these issues.

I've got emails from listeners who also have questions or comments about what it means to have a doula in the room, what it means to go through that process, and what it means to get that access.

but briefly here tonight.

>> Go ahead.

>> Tonight at the little theater starting at 6 p.m.

Healthconnect one will be hosting a screening of our docu short, which is our documentary that's still being filmed.

in order to attend, this is an important piece of that information.

There are 30 seats left.

So if you would like to come, please email by 4 p.m.

Info info at.

Connect c o n e c t 1ONE dot.

So that's how you get in touch.

The screening of this docu short.

The docu short is really tracking work.

That's crucial for what Senator Brooke just said.

We're building a coalition of national community based doulas to help support the profession, to sustain the profession, and to talk about some of the challenges that are being faced.

You didn't have the numbers on how many births, so there are 203,000 births in 2023.

In New York State, that means 558 births a day in the state.

Senator Brooks shared that there are 300 doulas registered less doulas than there are births, 101,000 of those births are covered by Medicaid.

So when you do the math, which I just did, that's what I was doing.

that's 4200 doulas that are necessary to support those births.

If each doula is doing two births a month, which could be a lot, many doulas have additional jobs.

So that's one of the reasons for us to do this work, to film this documentary, to have this coalition, because we need to make sure the role is sustainable.

Right.

So I'll hand it back.

>> You need.

>> 14 times the number of currently registered doulas.

Yes.

Incredible.

>> Yep.

>> So a lot of work to do.

>> Lots of work.

>> So listeners, if you want to see a doula story 2025, that's how you do it tonight at the little let's take this only break.

We'll come back and talk to our guests in studio about what they just heard from Senator Brouk.

I'm Evan Dawson Tuesday on the next connections.

In our first hour, we talk about the shaky state of the NATO alliance and the idea that NATO could move on without the United States.

Where are things going?

Well, one of the people who might have a say is our guest in the second hour, Congressman Joe Morelli joins us.

We'll talk about a wide range of issues with the congressman, including how he sees the state of the federal government and the health of the balance of power.

That's Tuesday.

>> Support for your public radio station comes from our members and from Two Point Capital Management, an investment firm working with clients to create custom portfolios of stocks and bonds.

Two point is dedicated to helping people manage financial risk in good times and bad.

More at two point capital.com.

>> This is connections.

I'm Evan Dawson Phyllis Sharp, a doula with royalty Birth Services.

Senator Brouk says she thinks that it really does make sense for medical systems that they will embrace support for more doulas.

A lot more doulas than currently exist, and are able to be there throughout this process.

Is that your experience?

How has your experience been with the medical system when it comes to your role and how it sort of how you fit in?

>> with my role as a doula and the support that I've had in the hospitals here in the area has been incredible.

okay.

For me personally.

And that's not with every doula, but with me personally.

I'm going to make sure I put that right out there.

Sure.

and I think one of the reasons is because I believe in building communities.

And every time I go into the hospital, I introduce myself to everyone at the desk, no matter who's there.

I am in the room.

Every nurse that comes in, I talk to them.

Every doctor that comes in, I talk to them.

I make them feel at home and make them feel comfortable with me.

And I am not in any way trying to tell my client what to do.

I don't try to interfere.

I'm not a doctor.

I didn't go to school for 12, 13, 15 years, so I can't speak for them.

But I really make sure that my client is educated and that they ask great questions.

And that the relationship between the the care providers and the nurses and all those relationships are going smoothly so that my client can have the best experience possible.

And I think when we go into the hospital with a mindset that everything is going to go okay, and not that everything's going to go to heck it changes the atmosphere in the room.

And so our job as doulas is to change the atmosphere in the room.

So whether our client is having her experience is not going great or her experience is going wonderful, our job is to to change the environment in the room.

And sometimes that means like having that good relationship with the care providers that are around her as well, especially when you have someone in there that's black and everyone that's taking care of her is white.

And so they feel very uncomfortable.

And my job is to make them feel at ease.

>> Have you talked to other doulas in the area who have had some negative experiences?

>> oh yes, I've had a few in the beginning, but now it's great.

But okay.

But in the beginning, especially during COVID and I totally understand the stress that the staff was under as well as, you know, our clients as well, too.

but sometimes things don't go as well as we want them to, and sometimes you can tell when someone is like telling your client what they want to do to them.

and not asking their permission.

And so a lot of that was happening.

And so I would just step in and just say stuff like, oh, is that what you want?

Do you want to have your water broken?

You know, instead of someone walking in the room and say, we're going to break your water now instead of asking their permission?

And so I think a lot of that was changing the mindset of the staff, of the doctors, of the nurses, changing their mindset on how are we talking to to our patients.

Right.

And so some people or some doulas may get a little hostile with me.

And I always say I was blaming on my age is that I love to ask questions.

So I'll always ask a question like, is that necessary?

so what are the medical reasons behind what we want to do?

And I think when we come in with that attitude and you come in asking questions, it makes the relationship a lot better.

>> So the friction that you occasionally felt earlier in your career is largely gone.

>> Yes.

>> That's that's remarkable.

Yeah.

And I'm sure that's important for everyone involved.

Nobody wants to feel that uncomfortable friction.

Right.

Like whether it's mom, whether it's the doula, whether it's the medical team, the nurses.

So and sometimes I think it's just understanding the role in getting used to that relationship, probably within the room here.

I want to ask Jackie Lindsay from the Healthy Baby Network.

Are you confident that medical systems will keep embracing this expanded role for doulas?

If what the senator wants to do happens, and if the coalition is successful, what do you think?

>> So I think that, yes, I feel comfortable that you know, systems will continue to embrace and welcome doulas at a higher rate.

I think relationship is so important as well.

So as we were building our community based doula program part of our meetings would be with the hospital systems meeting with them quarterly or more frequently to talk about our work, what we're what our plans are, what the doula work will look like in the hospital.

And but then also working with individual providers in the hospital system as well, I think is really important because, you know, as a doula, you can go in for a birth and maybe one nurse on a shift can be really welcoming, but also really knowledgeable about what a doula is.

And then shift change can happen and the next nurse can come in and be like, who are you?

You know, what's your role?

So I think it really starts with education on all providers.

And I think nurses are a key piece.

So looking at when they're first educated, when they're going through school, when they're first in the hospital system, introducing doulas as part of that system, also with the understanding that doulas and nurses have different roles, but they are all working together for the same goal.

>> Well, I mean, I wonder how you feel, Dr.

Jillian, as the president and CEO of Health Connect one, how healthy in general do you see that relationship between dualism and the system, and how has that changed?

>> So again, it depends.

It depends on the system.

The doula that day, I think I've learned from Phyllis, and Phyllis is incredible in the sense that if someone's having what she thinks might be a bad day, she actually asks them.

She doesn't necessarily go back at them with the same energy.

And I, I hope one day I can be that way.

But what I will say is that there are, as, Senator Brooke mentioned, that there's a need to have programing that helps the doulas and the systems work better together, because not every interaction is going to be positive.

And at the end of the day, the goal is to make sure that the birthing family has the best possible experience, both from you know, how they're feeling to how everybody comes out on the other side of it.

So if that's the priority, we have to figure those relationships out.

Healthconnect one has a program that we actually learned a lot from our partnership with Healthy Baby Network, who's one of our partners and other partners we've had across the country.

And we actually work with hospital systems now.

we have a CNA and a CME accreditation to train providers and help administrators establish policies.

We learned a lot from Healthy Baby Network in the sense that doulas, as they enter the hospital, they were coming in with badges now, right.

Because during the pandemic, you got to have something to show that you're, you know, you're coming in and that's just one really easy, low cost intervention to reduce the challenges of being able to support the people who you're there to support.

so to go back, it's really just day by day interaction, by interaction.

And that's unfortunate.

The establishment of coalitions, the establishment of models like Loretta that we're starting now, we have one in North Carolina.

We're working across the whole state.

We're going to be working in Chicago as well in the coming year.

there are other models downstate.

There's doula friendly hospital initiative.

There's several different approaches to it.

I'm not fussed which approach, as long as there's something that's done intentionally to reduce that friction.

Right.

and then also measuring the effectiveness.

Right.

Our organization does training, advocacy and research.

There's plenty of evidence to indicate that doulas work well, understanding how well doulas and hospitals work together.

That's a whole other, whole other conversation that needs to be, you know, investigated and invested in.

>> So it's a process.

It's ongoing.

>> Yes.

>> Better than it used to be in general.

>> In general.

But ongoing.

>> And doesn't mean perfect and the same in every place in.

>> Every day.

Precisely.

>> okay.

Fair enough.

I'm going to read Alex's email, and Alex reminds me to tell listeners, I would love to hear from you.

if you've had the experience of having a doula and what that was like for you, its connections at wxxi.org you can call us if you like.

844295 talk.

It's 8442958255263 WXXI.

If you're in Rochester, 2639994 Alex says, my wife and I used a doula and highly recommend it.

Now, having gone through the process with a doula, I usually argue for it on moral grounds, like universal health care.

Everyone should have access to this, but it seems like only clinical data on maternal mortality is what got the needle moving for funding Medicaid.

Doulas.

When you're talking to stakeholders, what is your go to argument for doula care?

>> Good question.

>> I love that question.

>> You want to take it first?

>> I can give you an answer.

So Phyllis was in the room when I had my last child.

Phyllis is everywhere, in case you didn't know.

but it's what you feel.

It's the feeling, right?

You feel held right.

I've had four children.

My first experience was not the best experience.

Best kid ever, but not the best experience.

This last birth, my room was like a party afterwards, and my husband was able to go home because I felt held, I felt connected, I didn't feel worried.

Right?

It's that extra person who's paying attention to all the things that you're not able to pay attention to.

It's that person who comes over and checks on you.

It's that person who connects with you and remains connected with you.

I like connection a lot.

I'm on connections.

but but making sure that that's ongoing.

These relationships don't just go anywhere.

I have a whole group chat with all my doulas, right?

It just doesn't go anywhere.

So I think that that's really what it is.

It's a village.

We don't have that same kind of environment here any longer.

A lot of people are far away from family, don't have people nearby, or maybe moms single, right?

Having someone who is your person, who you can contact at any time and ask any question, that's that's just crucial.

And I'm not letting Phyllis go anywhere.

>> Let me just follow.

>> Up that point, and then I want to both of our other guests are answer Alex's.

>> Question.

>> I really for a moment want to just say that having been more freshly through the process, I really have so much affection and frankly, concern for single moms.

it is a lot, no matter how privileged you are.

but if you are disadvantaged in certain ways, how hard it must be, and I have to think, Dr.

Dylan, that a lot of single mothers may have this jaundiced view, this this cynical view of what the system will do to support them, a system that hasn't historically often supported them.

And might not know about or think they could ever get access to a doula that's going to take some time to change that perception, isn't it?

>> definitely.

I think that there are a lot of assumptions that are made just by what a mother looks like, right?

I know I've experienced that even as a PhD MBA, I've experienced that.

So for someone who maybe doesn't have that level of access or privilege, it's even more profound because you're constantly being weathered right all day, every day.

There's something coming at you.

If it's someone just, you know, walking down the street wearing something offensive, right?

There could be any number of things.

So when you add on top of that that you're carrying and growing a human and you're doing it on your own, having someone you can call and ask questions, someone who can come over and and do hip rubs or help, you know, you probably heard that guy not long ago.

but someone who can do that for you when there isn't anyone else to do it.

There's nothing like that.

There's absolutely nothing like that.

And if we want things to get better, if we want these births to have better outcomes that stress, we know that that stress leads to poor birth outcomes.

We know that there's no denying it.

There's books on this, right?

There's articles on this.

We know.

Right?

Anyone who's under constant stress is going to have negative health outcomes.

Anyone.

But when you add on top of that race and bias and all of that, it just makes it so much worse.

So having another person there who can help you and can support you, especially when there isn't anyone else, there's nothing more important than that.

>> Alex wants to know what is your go to what's your go to argument for doula care when you talk to stakeholders?

Jackie?

Lindsay, what about you?

>> So I think for me, one of my go to's is just black women.

And how they are 3 to 4 times more likely to die during childbirth.

how?

As Twyla mentioned there's a lot of stereotypes and racism that black women face.

so looking at the fact that care and education is not one size fits all having a doula that is your from your culture, from your community having someone who is able to not only advocate for you, but teach you how to advocate for yourself, to help you recognize that the handout that you get at the doctor's office, just because it doesn't fit what you want, doesn't mean that your choices for your birth is wrong.

And so for community based doulas, especially, because that is what I always talk about and advocate for.

just having somebody who understands, who has oftentimes similar lived experience similar birth experience, which is also which is oftentimes not great.

as a black woman to be there to support you during birth.

>> Same question.

Phyllis Sharp, what's your what would be your go to argument for arguing for more dualism, supporting doula care?

>> I'm just going to piggyback on what both of them, they both said as well, too.

it's it's really all about that relationship.

It's really all about taking care of them, having someone there just for them.

and that makes such a huge difference when you're in that space.

And like, we were talking about, like, maternal mortality.

it's so important because they know about it.

Black and brown people know about it.

When I get a call from someone that wants a doula, I don't want to die.

That's what they're saying.

I don't want to die while I'm having my baby.

And I also think it's so important as well to educate.

Like she said, nurses educate.

the residents that are coming in and what a doula actually does.

And I think I can use an example of I had, a resident come into a room that I was in, and they checked the client to see where she was dilation wise and what position the baby was in.

And this particular resident, I saw him one time and I never saw him again.

And it was a male, he said, why don't you just use that peanut ball and turn her this way?

I was like, oh, it was so nice to be able to have a resident that came in the door and knew about a doula, what a doula does and different positions.

You can put patients in to get the baby out.

and so that's a wonderful thing too.

So I think one of the things too, is to really make sure that we're educating the residents, these doctors that are coming in.

and, and to make sure they're not biased by older doctors that may have like back in my day when I had my kids, you know, it was like, we're going to do this.

We're going to do.

No one asked me anything ever.

>> Do you.

>> See a generational divide in medical staffs?

And there were relationship.

Oh, yeah.

>> Oh, yes.

>> Yeah.

Oh, yes.

They're coming in the room now.

The residents are coming in the room.

They're introducing themselves.

They are asking permission before they even touch you.

So it's really been a nice shift.

I've even seen some.

I call it the OG doctors.

that have during COVID were not asking permission because that's what they normally did.

Unless I brought something up, it's like, okay, so I'm going to check you now.

I'm like, do you want to be checked just to remind them to ask permission?

Right.

And now the same doctor, they ask every single time.

Right.

And so we want to see that shift happen more and more and more.

Right.

And so that is huge is to have them be able to ask permission.

really explain things to people, sit on the bed and not stand over them.

Those things are very important.

>> I want.

>> To ask a clumsy question that follows up on a point you were just making.

Because at the root of this is, as Alex noted in his email, it starts with a desire to change the big disparity in maternal mortality.

And when you talk about having clients who say, I don't want to die during birth, I'm not saying there aren't wealthy people who haven't felt that way.

Wealthy moms or white moms.

I mean, different people have different fears.

But if that is more routinely a fear in the black community, I have two sons.

I have wanted the best birth process possible, the least pain, the most comfort.

But I'm not.

I have never worried about dying.

Realistically, and that's probably the kind of I know it's sort of ghost even used this term, but that's probably the privilege.

So can you just describe what it's like to talk to a client who's actually worried about dying.

>> During birth?

>> It's really scary.

for them, especially when they hear things on the news.

they hear that somebody else died.

it's really, really scary.

And I think that as doulas, how do we ease their conscience?

How do we get them to be less fearful?

Because I think almost every woman that goes into labor is a little bit fearful.

But to how to how to help them be less fearful about dying.

and really, it's really about the education, educating them on these are your choices.

You I want to make sure that you understand what's happening to you.

I'm going to make sure you understand what's happening to you.

I'm going to make sure that you understand what you're saying yes to and what you're saying no to.

and that really eases their mind.

and I think that even if something didn't quite go right, because we know not everything goes the way that we plan it, maybe they might end up in a C-section.

Maybe not.

But if things aren't going perfectly they have someone there that they can bounce things off of, that we can chat.

We can talk.

That really, really helps to ease their fear a little bit more.

I had one client who she was going through labor.

Her baby was just in this odd position.

Would not move.

they talked about doing a C-section with her, and she was like, okay, I'll go into the C-section.

So she goes into the room and then they call me in and I'm like, what's going on?

Like she's like hysterical.

She's crying.

I don't want to die, Phyllis.

I don't want to die.

I don't want to die.

I'm like, okay, so we're not going to die today.

I am right here by your side, okay?

And I stayed in there from the time that they started, until the time that we left that room and just having me there because they normally would not let someone into the C-section that early.

Like they take you in and they get you prepped.

You ready?

I was allowed in the in the operating room while they were prepping her, so that she can feel a little bit easier about like what what was about to happen.

So it can be it's just I had five children.

I had five wonderful births.

okay?

I had unmedicated vaginal births with a great black doctor.

he took great care of me and I came into this profession because of the great birth that I had.

not really realizing that other things were happening around me.

Right.

Because we don't think about other we don't think about all this other stuff that's going on unless it happens to you.

Right.

And so now I'm in this profession and I see so many different things all the time.

but it is very scary.

I feel like women are so close to death, just giving birth alone that anything could happen.

Hemorrhage can happen.

going into a C-section can happen.

All of these different things that can happen to them while they're giving birth.

After they give birth.

Pre-eclampsia, huge killer.

Right?

Making sure my clients have blood pressure cuffs during their second trimester at home so they can take their own blood pressure is crucial, like different things like that are very, very crucial to making sure that our that that black and brown people and white women, black women, every woman feels comfortable going in to having their baby that we can anything that we can do to help them feel more comfortable is really going to be helpful to them.

>> I can see why people want you by.

>> Their side.

>> I really can.

It's really remarkable.

let me let me read an email from Jean who says, what a wonderful program today, 25 years ago, as a high risk pregnancy, my OB recommended a doula who was also a certified counselor to help me with all involved in my pregnancy.

It was wonderful to have her as my advocate during the prenatal, and especially for my delivery time.

I also had her for my next two pregnancies, which were also high risk.

Her presence throughout the entire pregnancy was so comforting to me and my husband.

Highly recommended for all pregnant women.

>> That's Jean.

>> thank you Jean, and I'm glad that it went well for you.

I'm glad it was good experience for you.

It's been a pretty remarkable hour to kind of get a fuller picture of where things are now.

but we're also talking about a lot of change that could be coming.

We're talking about change that's happened over the last generation or two.

But if our guests in the room are successful, you're going to see a scale of it's going to be a lot different and there's going to be a lot more access.

And really availability here.

Are you confident that's where we're going, doctor Dylan, do you really believe that?

>> It's what I fight for every single day.

So, yes.

I think we need to make folks more aware of this access.

And as things continue to change in the health systems, as more maternal health deserts emerge, because it's inevitable, as Medicaid reductions happen, that certain hospitals will close, having that first point of contact in your community is going to become ever more crucial.

So we're going to keep fighting for this.

The establishment of this coalition is to fight for this.

Our collaboration with Senator Brook is to fight for this, knowing the number that's needed in New York State and in many other states is important as we continue ensuring this access for folks and stories like the one that was just shared, right.

People have to talk to other folks.

Whenever I see a pregnant person, I know we all do this.

Whenever I see a pregnant person, my first question is, do you have a doula?

If they say, well, I don't know what that is, I sit them down.

We have a conversation.

>> How often do they know what it is versus not know?

>> Depends on where I am.

more often than not they have an idea of what one is.

Sometimes they say, well, how would I be able to afford that?

That's almost always the next question.

Yeah.

we're doing a lot of work in Rochester, and I'll talk about this at another point in time.

to help people have better understanding and awareness of what tools are and how they can access them.

But yeah, it's usually the question.

The second question is always, how can I afford that?

That's how expensive.

How do I yeah.

>> Yeah yeah, yeah.

So you're not surprised that when I googled around, that's what I was finding.

All those all those stories.

>> Yeah.

No not.

>> All is for rich people.

That is.

so let's close with this point then when you talk about community based doula as a term, what what does it mean to be a community based doula?

>> You are literally working in and for your community, right?

And as we recruit people to do this work, Jackie and I've done this together.

I know Phyllis has done this.

We look for folks who are already connected, right?

Is it the lady at church that always, you know, goes over and helps somebody when they're breastfeeding?

And I do mean that, right?

Is that the person?

Is it the person who did what I just did asks if someone has support?

It may not be a doula, but baby, is there someone who can help you like those types of people?

Folks who have a caring nature.

People like Phyllis just because she's next to me.

I keep pointing to her.

But folks like that who are going to really be there and people trust them.

I don't know if there's anything more important than that.

They're trusted individuals in their community and they're pillars of their community.

>> Well, a doula story 2025 is an update to the original 2004 documentary called Doula Story.

And tonight.

615 6:00 doors are open.

The little 615 you can see it and a discussion afterwards with the guests we've had today.

My colleague Racquel Stephen.

Now listen, email in advance there.

They're going to they're going to pack the place.

Don't you show up tonight.

Let them know you're coming.

Get.

And if you need to get in touch, we'll share the email address with listeners.

If you want to reach out to us at connections at wxxi.org.

In the meantime, Dr.

Twyla Dillon, president and CEO of Healthconnect one.

Thank you for being here today.

Thank you.

Our thanks to Jackie Lindsay from the Healthy Baby Network.

Thanks for being here.

>> Thank you.

>> Phyllis Sharp, doula with Royalty Birth Services.

Thank you so much.

>> You're welcome.

Thank you.

>> From all of us.

All of us at connection.

Thanks for watching.

Thanks for listening.

We're back with you tomorrow on member supported public media.

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