While I heartily agree that we, as a country, do not really support our 
new mothers as we should, the case you profile here is, at best, an 
exception (thank God).

The reason I am answering here is that as an inpatient LDRP nurse as well 
as a maternal/child public health nurse, I know that there are services 
available for people in need. Now I am not naive enough to think that 
everyone will get every service they need, but I have also been working in 
the system enough to know that there are services of all kinds for the 
people who need them. One of the national private insurances around here 
even pays for post-partum doula services. Medicaid has probably better and 
more comprehensive benefits than most of the private insurances. We all 
know that. Cities often have high school programs for their teens to 
return to after the birth of the baby. I was just at our local program 
this morning, weighing the baby and checking on Mom as well. I know all 
but two of the girls, as they had been patients in our facility or I had 
worked with them in their homes after the birth. It is my job, as a 
visiting nurse, to access additional care requirements and services for 
those I think need it. But the referral has to come from me and passed on 
to a physician or advanced practice nurse.  Personally, I work in a city 
that has a fund just for people without the means to pay for our services. 
Home health agencies and visiting nurse agencies all have home health 
aides whose job it is to help out in whatever the situation is.

As  doula, if you find someone to be in need, your best bet is to 
encourage your client to call their health care provider, go through WIC, 
the VNA or other agencies/indivioduals whose job it is to access these 
services.

I think as a doula, it is wonderful that you are so passionate about your 
cause and I have no doubt that you will meet with success. However, while 
you are educating yourself about this, dig a little deeper and find out 
just what avenues the medical community has to assure that needy people 
(no matter what theri income level) get the help they need. It is out 
there. Sometimes it's just a matter of where you look and who is looking.

Best of luck to you.

Betsy Riedel RNC, IBCLC
Connecticut

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