PA Birthing Program Aids Disadvantaged Mothers

May 28--Marissa Parm is afraid of doctors and hospitals so she wanted to deliver her baby at The Midwife Center.

But the baby grew too large, and it was recommended the midwife deliver her at UPMC Mercy to be safe.

It then became a big part of doula Megan Shope's job to make Ms. Parm, 19, of Highland Park comfortable with the idea.

After Ms. Parm toured Mercy, Ms. Shope sat down with her client and Ms. Parm's mother and brainstormed, asking, "How can we make this better?"

Ms. Shope, 33, who works out of The Birth Circle in East Liberty, eased her client's fears and answered her questions. Then on Feb. 17 she provided emotional and physical support when Ms. Parm gave birth to Sophia Bailey, 9 pounds and 11 ounces.

"I ended up having to be induced, which I didn't plan on," Ms. Parm said, "and I needed an epidural. But it was the best-case scenario anyway because I didn't want a C-section."

"Marissa labored for hours and hours and hours and hours," Ms. Shope said proudly.

In addition to providing support prenatally and during birth, community doulas like those at The Birth Circle continue to help out postpartum, answering questions a new mother might be embarrassed to ask a doctor.

"You have a relationship. It's more of a friendship," Ms. Parm said.

"An obstetrician is 10 to 15 minutes," Ms. Shope added. "We're available to our moms 24 hours a day 365 days a year." There's a backup system of doulas in place in case of emergencies at The Birth Circle. Under a federal program, Ms. Shope will be with Ms. Parm until Sophia is about 6 months old. They started their relationship three months into the pregnancy.

Since 2009, The Birth Circle has enrolled 1,104 disadvantaged women in its program. Its staff of eight community-based doulas and 12 on-call part-timers has supported more than 700 mothers at birth.

"There's such an interest and such a need," said director Cynthia Salter. "Right now we're limited by funding."

But that may be changing.

Part of the East Liberty Family Health Center since it was founded with outreach, breast feeding and ambassadors programs in 2001, The Birth Circle recently was taken over by the University of Pittsburgh Department of Family Medicine.

"We would like to try to expand the services, and that's not only locally, but to look at expanding that model to other areas outside the county," said family physician Gregory Smith, vice chairman of the Pitt department.

Dr. Smith said the department saw the takeover as an opportunity to create a natural synergy to serve the same population.

"One of our main areas [of focus] ... is providing care for the underserved population, and The Birth Circle is designed to serve that same population," he said.

The department provides obstetrical services -- there are about 70 residents -- that will be a good resource for mothers going to The Birth Circle.

"I think in particular we realized that the population The Birth Circle works with, there's a lot of premature births, low birth rates, low rates of breast feeding," he said. "We feel the things The Birth Circle is trying to do will help us with what we're trying to do. Those are things we feel strongly about as well. We feel by working with them we can come up with programs to improve on those things as well."

The Birth Circle doulas, all certified by DONA International, the largest and oldest certifying agency in the country, have statistics that show they are teaching their clients well.

Breast feeding initiation among mothers who had a doula at their birth was 55 percent in 2009, 65 percent in 2010 and 74 percent in 2011.

Ms. Parm said she intends to breast feed Sophia until she is 1, though she will introduce solid food along the way.

Meanwhile, The Birth Circle's rate of caesarean delivery also has improved in recent years. It was 29.6 percent in 2009; 25.6 percent in 2010; 23.9 percent in 2011 and so far this year, 22.1 percent.

But there always is room for continued improvement.

Dr. Smith said he does not see the takeover as changing The Birth Circle program in any way.

"I think philosophically we feel that The Birth Circle is a community resource, and that we want [the doulas] to be available to all patients who need their services regardless of the insurance or where they're going to deliver," he said. "Because their patients have gone not only to Magee but to West Penn and Forbes, and we would not restrict them. And we would want they should get their care."

Pohla Smith: [email protected] or 412-263-1228.

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