Local View: In Northland, doulas fill gaps, save money, improve outcomes

Northland mothers are white-knuckling it. They're not OK. Statistics are grim, and we know why. There's a broken healthcare system, the closure of rural labor and delivery units, and the toll of the opioid epidemic. Extended family, who once served as crucial support, are struggling in equally grueling ways. Absurd demands to return to work fuel unrealistic expectations for recovery and sleep. I've been a licensed midwife serving our community for many years, a former doula, a retired midwifery college instructor, and a mother. I know birth, and I know my community. I'm here to tell you the landscape has changed. Our young families — especially in rural areas — need help. I was shocked to recently learn the No. 1 cause of maternal death in Minnesota is mental health. It's followed by its dark sister, substance use disorder. If you are like me, this news is more than surprising. It's terrifying. New mothers need perinatal mental health support that is informed, individualized, and accessible. There are a number of therapists, psychologists, and public health resources that are responding, but I know of another solution. Doulas are poised to support Northland families. A doula is a person who provides emotional and physical support before, during, and after childbirth. Trained, certified doulas offer continuity, relationship, and community. Doulas can be a solution, even a mandate. Researcher and pediatrician Dr. John Kennell famously said, 'If a doula were a drug, it would be unethical not to use it.' Thousands of births are attended by doulas in Minnesota annually, and it makes a difference in birth outcomes. For example, while the national C-section rate hovers around 34%, the rate for C-sections among births attended by doulas with the nonprofit I work for, Everyday Miracles, is just 17%. Everyday Miracles recently expanded to Northeastern Minnesota, with a Duluth office and a group of nearly 20 local doulas. Our nonprofit was founded in 2003 on the belief that every birthing family has a right to evidence-based prenatal care and that everyone should be empowered, supported, and celebrated during pregnancy, birth, and the postpartum period — regardless of age, race, or socioeconomic status. Our mission is to improve birth outcomes and reduce health disparities by providing evidence-based education, compassionate and culturally aware support, and a nonjudgmental and caring community. We know doulas offer connection and relationship. It's simple: better birth at lower costs, with measurably improved outcomes. From our own data, derived from more than 12,000 doula-attended births, we know doulas reduce preterm birth rates, increase breastfeeding, and offer birthing mothers continuous labor support that reduces interventions and costs. Doulas aren't just present at birth. Ideally, they are with the birthing family throughout the childbearing year, serving as care coordinators and trusted community navigators who connect birthing people to a broad range of services and supports during the prenatal and postpartum periods. During the delicate weeks after a birth, doulas recognize the difference between being tired with a newborn in the family and being dangerously depressed: the difference between being worried about a newborn and the telltale signs of postpartum anxiety disorder. Doulas are connected to the world of birthing and mental health professionals who know how to support these new families. In many ways, a doula fills the gap left when extended family can't be present to support baby and parents. In the maternity desert that is Northeastern Minnesota, where small-town community hospitals have closed their labor and delivery units, doulas offer continuity and local connection. Doulas are trained professionals, servants of the heart, and companions during one of life's most significant and challenging transitions. In rural Northeastern Minnesota, where isolation, long distances, and a lack of local care prevail, doulas may be the regional answer to a complex and difficult reality. Jana Studelska of Duluth is an author, educator, and advocate working with Everyday Miracles (everyday-miracles.org), a Minneapolis-based nonprofit with a location in Duluth that pairs families with doulas. GET INVOLVED What: A two-night community conversation about postpartum mental health When: Sept. 9 and Sept. 10 at 6 p.m. each evening Where: The fourth-floor rotunda of the Kathryn Martin Library at the University of Minnesota Duluth Tickets: Free, open to the public, and no reservation is required Your Hosts: The University of Minnesota Duluth Details: Sept. 9 will include a presentation from the Minnesota Department of Health and a lived-experience panel. On Sept. 10, professionals from different fields will discuss postpartum mental health support. A guide to postpartum mental health resources will be developed following the event.