Becoming new parents for the first time is a wonderful but nerve-wracking experience—especially if you don’t completely understand the changes taking place within the mother’s body. And if you have an added complication, like a chronic illness, the worry and fear can become overwhelming.
When Katelyn Traughber Simpson and husband Zach became pregnant through in-vitro fertilization in 2017, they decided they didn’t want to succumb to fears. The couple made it a point to become as prepared for the birth of their child as they could be—and that included enlisting the help of a doula.
Katelyn had long suffered from a chronic bladder disease known as interstitial cystitis, the symptoms of which include severe pain and abdominal discomfort. Katelyn had yearned for a baby in spite of the disease and had undergone years of hormone therapy and in-vitro fertilization before finally becoming pregnant. Because of her chronic illness, though, Katelyn was anxious about the birthing process. In particular, she had learned through her illness that placement of a catheter was, for her, an exquisitely painful experience—and because it was commonplace with an epidural—she knew going into the pregnancy that she wanted to avoid an epidural if at all possible.
She also knew that her particular circumstances and wishes would make it vital to have a knowledgeable support system in place to help her naturally manage her pain. This is when the couple turned to Mary Duke, owner of My Sunshine Birth Network and a trained doula.
Doulas meet with families before a birth to develop birth plans and provide emotional and physical labor support at home and in hospitals. They don’t replace medical professionals or midwives in the delivery room or home but instead work with them to ensure the mother is as comfortable as possible.
A common misconception is that doulas only support women through unmedicated births or home births, but doulas support all birth plans, and Duke and her network of providers work regularly in hospitals throughout Kentucky and Tennessee.
“Even if you plan an epidural, Lamaze childbirth education and doula support will help you know the best time to go to the hospital, when to get your epidural and how to cope if your epidural fails to bring you comfort,” Duke said. “Doulas support you through decision-making, pushing and during postpartum. And a lot of families use us in a hospital setting because we provide continuous support, while doctors and nurses have other patients and responsibilities.”
Duke is also a certified lamaze educator and in addition to directly providing services, manages Kentucky’s largest referral database of doulas and other birth service providers. This includes referrals for birth photography, VBAC, or vaginal birth after cesarean, and gentle cesarean support, lactation counseling, postpartum care and more. Duke said inspiration for the network came out of necessity.
The network offers the only certified lactation counselor, Amanda Poteet-Woolen, who provides private in-home care. Her services are provided for all of Duke’s doula clients who plan to breastfeed.
“As a birth worker, I knew I couldn’t do everything myself,” she said. “While I am an educator and doula, I needed other birth workers with varied specialties to ensure my clients received the best care from start to finish. I wanted to help create a one stop shop for local expectant families, while creating community and opportunity for local birth professionals.”
And an advantage of the network is that it connects clients with professionals with a proven track record. Duke said many doctors have had bad experiences with untrained doulas or friends posing as doulas—experiences that can cause negative feelings toward the doula community. However, the professionalism expressed by the network’s providers has, over time, allowed many healthcare providers to see the value of their services. My Sunshine Network now gets referrals from doctors whose patients have expressed a need for additional education or support.
Once contacted by the Simpsons, Duke met with them in their home and talked to them about Katelyn’s unique situation and what they hoped would be the ideal birth plan.
“I believe firmly that knowledge is power,” Katelyn said. “And she taught us so much about the different stages of birth, what to expect and what our options were. This empowered us to ask the questions of my medical provider that we might have been afraid to otherwise. Like, why can’t I get up and walk around once I’m in the hospital? And what is your position on this particular issue? Because of Mary, we were comfortable asking my doctor questions.”
The couple were also comfortable in providing her doctor with a simple birth plan that she, Zach and Duke had developed laying out the couple’s wishes to avoid certain interventions. Katelyn felt confident when she handed it to her OBGYN to discuss the birth.
“It basically said this is how I wanted my birth to go, and these are the people I want in the room, and these are the boundaries I need set,” Katelyn said. “Sometimes it takes a village, even to give birth, and my doctor was very supportive. He said if that’s what it takes to make a mom feel empowered and comfortable during birth, then he was all for it.”
And so, when Katelyn went into labor at 5 a.m., March 11, after calling her husband she called Duke and Samantha Steen, the birth photographer she hired through the network. Both of them came to her home. When Katelyn started to panic, asking herself “Is this labor?” “What do I do now?”, Duke and Steen were calm and collected, helping her to breathe through the pain and remain calm and focused. They took away some of the guesswork. Yes, this is labor. No, it’s not time to go to the hospital yet. Yes, that’s completely normal. They also supported Zach as he cared for her. They walked with the couple. Sat with them. Coached them. Praised them. Let them know what was happening inside her body and what to expect.
“Most people think that a doula is there just to support the mother but they support your spouse, too,” Katelyn said. “Zach was my right-hand man, my first person. But Mary and Samantha were there to support him as well, and it eased his mind.”
Duke and Steen followed the couple to the labor and delivery unit and were there with them over the next several hours, massaging her back, coaching her through breathing, preserving the memorable day with photographs and letting both mother and spouse know they were doing a great job. As day turned to night and darkness fell outside the hospital walls, Katelyn continued to labor, and Duke and Steen remained by her side.
Finally, Katelyn dilated to 10 centimeters and pushed for two solid hours. But the baby was not coming out. The doctor determined the baby’s head had turned and a cesarean-section would be needed.
Katelyn talked with her doctor, husband and doula. As long as there would be little risk of harm to her or the baby, she asked if she could try to push for one more hour before resorting to a C-section. It’s a question she said she might not have otherwise felt empowered to even ask, had Duke not been by her side. The physician agreed, and Katelyn tried for another hour to have a natural vaginal delivery.
But the baby wasn’t coming. A C-section was scheduled. Because of the C-section, Katelyn had no choice but to receive an epidural and catheter—both interventions she had planned to avoid when she made out her birth plan.
At 10:30 p.m., a baby girl was born by Cesarean. The couple named her Tyler.
“Everyone asks if I’m sad that I wasn’t able to have a vaginal birth like I had wanted in my birth plan, and I’m not at all,” Katelyn said. “Because I had a doula who provided me with knowledge and insight and talked with me about any problems I was having, I felt confident in the decisions I was making. I don’t regret my birth one bit, and I don’t feel regret because together with Zach, my doctor and doulas, I made informed decisions.”
And medical staff were still able to honor almost all of the requests Zach and Katelyn had made in their original birth plan. She was able to receive intermittent instead of constant monitoring, which meant she could walk the halls and change positions. And the couple had also planned ahead of time that no matter what, Zach would stay with the baby. Katelyn was especially grateful they had talked through that beforehand.
“When you’re tired and in pain and just had major surgery, no one had to ask ‘What does she want us to do?’ Because they already knew.”
The support of Duke and the My Sunshine Birth Network continued once Katelyn returned home. Duke made a postpartum visit. Woolen also made the provided visit and Katelyn and Zach hired her to coach her through the art of breastfeeding. Duke said this is one of the key services the network provides to expectant mothers.
“My grandmother didn’t breastfeed my mom, and my mom didn’t breastfeed me,” Katelyn said. “So they didn’t have that experience to draw from to help me when I decided it was what I wanted to do.”
That is where Woolen came in.
“Breastfeeding is exhausting,” Katelyn said. “Especially during those first few days when your milk is coming down, your husband is exhausted and no one can really help you but yourself.”
Tyler didn’t seem to be latching on properly, and the issues seemed to go above and beyond what proper positioning could cure. Woolen discovered—and a pediatrician later confirmed—that the baby was born with a defect known as tongue-tie, a condition in which the string of tissue below a baby’s tongue is too short, which prevents them from moving their tongue freely or sticking the tongue out past the lower front teeth. This affects the ability to feed, both by breast and bottle. In Tyler’s case, treatment required clipping the tissue so that her tongue could move freely. The procedure helped the baby to latch on and to begin feeding and gaining weight.
Tyler’s birth was atypical in so many ways—from conception to postpartum. But because of all the complications and challenges, having a strong and experienced support system of medical professionals and birthing experts was crucial to hers being a successful birth story.
“I’m so thankful that I was connected to this network of supportive and knowledgeable women through the network,“ Katelyn said. “Even if I’d planned on an epidural … I still would have wanted to have a doula to help walk me through the birth process and help me stay focused. I still would have wanted to go to Lamaze not only for me but so that my husband, mom and sister would have the tools to help me through my pain. I’m a new mom, and I’d never done any of this before, and I’m so glad I knew what was going on and what my options were.”
And most importantly, that support system helped her to stay calm, focused and confident in her choices as she faced each setback.
“I never tell a family that I can guarantee an outcome,” Duke said. “What I do for all my students and clients is help them advocate for themselves and make informed decisions so that no matter the outcome, they can say ‘This was the best possible outcome for me and my baby.’”
That, she says, brings with it a peace of mind, something Katelyn can attest to.
“There’s not a single part of my birth story that I regret,” Katelyn said. “I felt empowered because I knew my options and had the confidence to ask questions.”