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New moms get a helping hand
A progressive health program for pregnant women is leaving its mark on California’s heartland. Funded by an unlikely ally, a state tax on cigarette sales, soon-to-be mothers in Kern County are eligible to receive the services of a doula, or a birth aide.

The tax, passed by California voters in 1998, for the past two years has funded the county’s Healthy Mothers, Healthy Babies project, which oversees the doula program and breast-feeding education and counseling. In its first year, almost 160 women used the doula program – 50 more than expected. Organizers say they hope to see the program grow to serve 360 women, or about one woman per day.

Program co-founder and manager Leah Elliot says finding expectant moms is no problem. In March, for example, the program had run out of available doulas, and had to put some pregnant women on a waiting list.

For those lucky enough to find a spot among the busy schedules of the 12 doulas that contract with the program, birth takes on a whole new perspective.

"I was extremely nervous about the pain [but the experience] was awesome," says Bakersfield resident Misty Sandoval, the 24-year-old mother of Jose Issac. "I didn’t even feel the pain because I had so much support. [My doula] was there, massaging me and talking me through contractions."

As increasing medical costs result in reduced personal contact from doctors and nurses, the demand for doulas has grown. Like midwives, they combine verbal and emotional support with the practical female understanding of the birth process – a traditional wisdom relied upon by women around the globe.

Unlike midwives, however, doulas do not take the place of a physician. They act simply as a support person coaching and cheering the mother on.

Statistics show that women who use doula services are less likely to request pain medication, have fewer medical complications, require fewer caesarean sections, and report greater success with breastfeeding.

Says Elliot, "The goal is to make sure that the mom has a good experience, as this is the most important day of her life. If she feels respected and in control, she has better memories."

The Kern County program provides 35 hours of doula services for $25, regardless of the client’s income. (Private doula services can cost as much as $600, Elliot says.) The woman chooses her doula through an interview process, and then receives a prenatal meeting, on-site labor coaching and 14 hours of postnatal follow-up.

The doulas are trained through the program to perform a range of services, including: answering questions about the birth process and birth options (Elliot says the program does not advocate any one type of birth); teaching breathing and other relaxation techniques; and during labor, providing hand, foot and low-back massage, playing soothing music, and sometimes providing water therapy. "Doulas have a whole bag of tricks. We are constantly changing," says Elliot. "What may work in early labor may not work later in labor."

In addition to offering support for the new moms, doulas also help nervous fathers through the exciting, but often intimidating, birth process.

"My husband really wanted to be hands-on," says Sandoval, "so [the doula] would show him what to do and he would do it perfect. It was an awesome combination."
After the baby is born, the doula comes to the new mother’s house to check in on her and the baby, and answer questions about the new demands of motherhood.
The popularity of the program among woman of all ages and income levels, speaks to the desire for hands-on support during birth.

"It’s so exciting to see their expression when [expectant mothers] first have their baby and are satisfied with their experience," says LaMonica Hillberg, a doula who contracts with the Kern County program. Hillberg is a second-generation doula; her mother, Nancy, also contracts with the Kern County program.

"I haven’t met anyone who is unpleased," LaMonica Hillberg added. "Everyone is excited about having someone there to help them."
 – Kelle Walsh

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