As a mother of two children, Laura Kiefer feels birth is a transformative experience for women—one that can affect how they view their entire motherhood.
Even so, not all birth experiences are created equal. When Kiefer gave birth to her first child in Marion, Ind., in 2016, she experienced trauma and medical neglect. But her second birth was a stark contrast to the first, and Kiefer recalls it as “empowering.”
“I took the time to really educate myself because I didn’t with my first baby,” Kiefer says. “I just figured, ‘Well, if the doctor says whatever, I’ll just do that without thinking about it.’”
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Doulas in Fort Wayne are empowering mothers in their birthing experiences and working to lower the city's infant mortality rates.
Seeing how increased knowledge about pregnancy and birthing options transformed her own experience, Kiefer set out to share this knowledge with other moms in Fort Wayne by earning certifications to become a birth doula this year, starting her business, Ora Doula Services.
Kiefer’s doula service is one of many in the city of Fort Wayne providing additions and alternatives to traditional healthcare. Fort Wayne has a few networks and independent doula agencies, like the Doula Network of Fort Wayne and the Community Doula Collective.
Throughout history, there has always been a role for doula-like caregivers at birth. As the field of obstetrics developed, women started giving birth in hospitals with doctors, rather than at home with a skilled midwife or female family member. Doulas today provide physical, emotional, and informational support, which gives their clients the power to make decisions for themselves, take better care of themselves, and recognize when something isn’t right with their pregnancy or treatment.
Along with empowering women, doulas support moms whose needs aren’t being met by traditional healthcare systems, Kiefer says. This often includes women in historically underserved groups, including low-income women, women of color, teens, and women whose first language isn’t English.
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According to research from Duke University, Black women experience the highest infant mortality rates among any racial or ethnic group in the United States. Studies have shown that including doulas on birthing teams leads to healthier moms and babies
According to research from Duke University, Black women experience the highest infant mortality rates among any racial or ethnic group in the United States. Studies have shown that including doulas on birthing teams leads to healthier moms and babies. According to a study done in 2019, women considered “low-resource” in Alabama had better birth experiences and breastfeeding outcomes when a doula was on their birth team. Moms who use a doula are also twice as less likely to experience a birth complication for themselves or their babies, and their babies are four times as less likely to have a low birth weight, according to a 2013 study published in the Journal of Perinatal Education.
As a result, Kiefer is applying her doula knowledge and services in Fort Wayne’s 46806 zip code on the Southeast side, where she lives and where the infant mortality rate is almost three times the national average. Since it was redlined, the city’s Southeast side has been home to a disproportionately high rate of low-income, multi-racial, and non-English speaking populations, which Kiefer feels the healthcare system is failing to serve, as evident the area’s infant mortality rates.
To help meet her community’s needs, she runs Ora Doula Services on a sliding scale, and takes on the occasional pro-bono client. She says she will not turn away any of her neighbors living in the 46806 area.
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Shanna Bradley, second from left, and Laura Kiefer, second from right, pose together at a meeting of the Journey Birth and Wellness team and the Auburn Birthing Center midwives.
Another doula service combating infant mortality rates in the city’s 46806 zip code with a similar, neighborhood-based model is Journey Birth and Wellness, a nonprofit organization that provides doula services to immigrant and refugee populations in Fort Wayne.
Shanna Bradley, a mother of five, is Executive Director of the nonprofit. She says her experience as a former EMT is what led her to become a doula.
“My first two births were drastically different, and I wanted to figure out what made one traumatic and one peaceful,” Bradley says. “That led me to research birth, birth options, and eventually discover doulas. I knew I wanted to offer others all the things I didn’t have with my first birth, proper information and support, which I now know can make all the difference.”
Through Journey Birth and Wellness, Bradley hopes to do more than educate women and families about the birthing process. She says her team’s goal is to “equip from within” Fort Wayne’s immigrant and refugee communities by training women in those communities to become doulas themselves.
“If there was a woman from within a community or a church who could offer doula services to her community, that would open up a whole lot of options for these populations, as well as opportunity and what’s available because it literally just doesn’t exist to them at this point,” Bradley says.
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Journey Birth and Wellness's first cohort of doulas trained in January 2020 include, left to right, Sharahah Garcia, Shanna Bradley, Kaye Seelye, Nina Bogle, and Ronae Cleland.
Fort Wayne has a gap in maternal healthcare, and Bradley says women of color, immigrants, and refugees are underrepresented. For example, medical information and paperwork are typically in English, and for some, they don’t have the option to read this information in their first language.
Many of these gaps and challenges came to light in 2020 at the onset of the COVID-19 pandemic, as diverse communities struggled to find and understand health guidelines. One way the region’s largest healthcare provider Parkview Health is bridging the gaps, particularly in infant mortality, is through its Community Health Worker program, funded by a Safety PIN grant from the state of Indiana to address infant mortality in the 46806 zip code.
The Community Health Worker program empowers women within the community to become a healthcare point person for their neighbors and communities.
Bradley and Kiefer both say Parkview Health’s program provides similar services and resources as doulas, but they both cite some key differences.
“The difference is we can provide doulas services in the birth room,” Bradley says. “So, we’re taking our care to another level and giving continuity of care from pregnancy, into the birth room, into the postpartum.”
Bradley says she loves that the hospital is providing this kind of service, but there is a bigger need than what it reaches. She says the services leave out moms who use the Lutheran Network and moms who may not typically seek out services from the hospital, which is why doula services like the ones Journey Birth and Wellness and Ora Doula Services offer are important resources in underserved communities.
Kiefer points out that most doulas work independently, on a contract basis for clients, which allows them to meet each client’s unique needs.
“I don’t have any hospital overhead or agenda, so I can focus solely on supporting my client and supporting what it is they want from their birth experience,” Kiefer says. “Often, clients come to me because they want something other than a typical hospital birth.”