Doulas and midwives in Wisconsin are returning to ‘the ancient model of community’

During a recent event, birth workers discussed the postpartum period and barriers to doula and midwifery care

Birth doulas and midwives of color provide nurturing, sensitive and cost-saving care postpartum, but face financial and other barriers working alongside the traditional health care system.

That was the consensus of speakers at a virtual public forum entitled, “Postpartum: Perspectives on nurturing families during the ‘fourth trimester.’” It was sponsored by the O’Brien Fellowship in Public Service Journalism at Marquette University.

In Wisconsin, BadgerCare public health insurance funded by Medicaid covers midwifery services but not doula work.

Speakers, including practicing midwives and doulas, said that traditionally, people have to wait weeks to see their OB-GYN after giving birth, which can leave postpartum mood disorders unchecked for too long. Traditional OB-GYN birth services often lack cultural knowledge of the healing rituals and family support traditions of Black, Brown and Indigenous patients, speakers said at Monday’s event.

“We’ve returned to the ancient model of community,” said Lyanne Jordan, a doula and the executive director and co-founder of Maroon Calabash, a reproductive justice organization in Milwaukee. “Our model now is, ‘What do you need?’”

Panelists at the forum were interviewed by independent journalist Ashley Nguyen, who used her nine-month O’Brien Fellowship to delve into maternal health issues, including identifying states where Medicaid coverage includes doula services.

Marquette University student journalists Rachel Ryan and Sarah Lipo assisted Nguyen on the project and at the virtual event. The team’s stories appeared in The Lily and the Milwaukee Journal Sentinel.

Doulas make multiple home visits postpartum and communicate frequently with clients outside of those visits. They help recognize signs of emotional distress, give advice on nutrition and answer childcare questions, among other services, said speakers that also included Hope Mayotte, Indigenous doula and student midwife; doula Nicole Miles, the Birth Outcomes Made Better (BOMB) Doula program manager at the Milwaukee Health Department; Cheri Nemec, a leader in the Native Breastfeeding Coalition of Wisconsin; and certified professional midwife Sasha Bariffe of Prism Birth Services in Milwaukee.

Mayotte, owner of Wiiji-Nitaawiginaawasojig Indigenous Birth Services in Ashland, Wis., is working with a clinic to start a midwifery program in the area.

“Midwives are a godsend,” said Mayotte, a mother of six who recalled selling food and raising money through a garage sale to pay for a midwife. For her more recent births, midwife services were covered by BadgerCare.

Midwives help women before, during and after birth and can deliver babies at home. (Certain midwives can work in hospital settings, too.) Unlike most states, Wisconsin’s Medicaid health insurance program, BadgerCare, covers home births. In the case of private health insurance, coverage varies depending on each company’s policies.

Wisconsin’s Democratic Gov. Tony Evers supports extending BadgerCare to doula services, and extending BadgerCare coverage postpartum from the current 60 days to one year, Wisconsin Health Services Secretary Karen Timberlake said during Monday’s forum. In the past, the Republican-controlled Legislature has blocked those moves.

Half of all people who give birth in Wisconsin each year have their births paid for by the state’s Medicaid-funded program, Timberlake said.

Monday’s forum featured an excerpt from “Partum,” by Brown University medical student and documentary filmmaker Ade Osinubi, who is working on a project entitled, “Black Motherhood Through the Lens.”

In the film excerpt, Rhode Island resident Jai-Me Potter-Rutledge talked about her experience with postpartum depression. Potter-Rutledge is a health care professional and currently a PhD candidate at Salve Regina University, researching the impact of racial trauma and storytelling on health disparities and achieving health equity.

At the forum, Nguyen interviewed Dr. Kajua Lor, an associate professor and founding chair of the Clinical Sciences Department at the Medical College of Wisconsin School of Pharmacy in Milwaukee. Lor was the first Hmong pharmacist to obtain a pharmacy academia position in the nation.

Lor discussed her research on health disparities. She is conducting a survey of Hmong women about their experiences during the postpartum period.

To learn more about what doulas do, listen to this podcast produced by O’Brien interns Rachel Ryan and Sarah Lipo.