On April 1 Teasha Tennyson gave birth to a six-pound, five-ounce baby at Good Samaritan Hospital. She'd already had a less than ideal birthing process there with her first child.
"I didn't like that experience there because my pain level was not controlled," she says. "I wasn't really told what was going on. I felt very pressured to breastfeed and not really educated."
In Ohio, black women are two and a half times more likely to die than white women from causes related to pregnancy.
So, this time around, Tennyson hired a doula to advocate for her needs and to teach her techniques that she hadn't quite mastered. Doulas give physical, emotional and relational support to people going through milestone health experiences like childbirth. But three weeks before her due date, Tennyson was forced to choose between her mother or her doula being present for the birth and recovery process.
In March, Cincinnati area hospitals like UC Health and TriHealth implemented restricted visitor policies to curb the spread of COVID-19, some of which have now been lifted. Under the policy, expectant mothers could only choose one visitor for their entire stay. That raises concerns for some mothers that they will have less people advocating on their behalf.
Tennyson says she chose her mom because she was concerned about her doula leaving her own newborn baby during the pandemic and she knew her mom could stay with her for a longer period.
The birthing team was attentive and accommodating, but once Tennyson reached the recovery floor her needs began to be ignored, she says. "At this point my mom is already irritated because it feels like the very first birth we had," she says. "Where there were pain issues and no one cared."
In an email response, TriHealth said it couldn't address Tennyson's concerns specifically and that exceptions can be made to the visitor policy when patients raise concerns to their provider.
Tennyson is currently recovering from an emergency she had six weeks after giving birth to address excessive bleeding.
What Doulas Do
A Cochrane study shows continuous support during labor can provide clinically meaningful benefits for women and infants. But in hospitals throughout the world, the practice is the exception not the rule.
The Harvard Chan Maternal Health Task Force says there isn't enough scientific evidence that doulas can mitigate the mortality risk black mothers face.
At one time, expecting mothers were able to count on mothers in their community during the delivery process but the modernization of birthing has changed that.
"Women who are trying to give birth at this time are scared and they need as much support as they can have," Associate Director at the Maternal Health Task Force Bethany Kotlar says. "So maybe trying to think through some precautions that can be put in place, while still making sure a birthing woman has the support system that she feels that she needs." She says the modernization has been good in some respects but in some cases its come at the cost of patient choice.
TriHealth says it's evaluating its guidelines to ensure safety and the best care possible.
'We Have To Overly Prepare Families'
Blaq Birth Circle Community Engagement Coordinator Sesheta Tafari says it's been difficult for birth workers in the Cincinnati area to prove their value to expecting mothers while policies in place potentially restrict them from being present when they're needed most. "We have to overly prepare families to deal with these things amongst themselves," she says. "So, we are working to raise moms' and partners' confidence for speaking up for themselves." She says they're training families about how to respond when they feel their voices aren't being heard.
Doula Bree Hope wants visitor policies to allow a doula and primary support person to be present.
"I'm sorry but people are dying and being harmed as a result of not being heard properly," she says. "That's a big sign that something's not working. So us being a voice, an advocate, I believe is a big part of bridging that gap."
Kotlar says Hope is somewhat right on this. People are dying and the health care system needs to address the disparities.
But Kotlar isn't sure doulas have the power necessary in the U.S. health care system to take on the role of chiseling away at the larger systemic issue.