Commentary, Opinion

Access for all birthing Vermonters

By Jess Kimball

Editor’s note: Jess Kimball is an administrative assistant at The National Midwifery Institute and managing editor of the Journal for Pre and Perinatal Psychology. Jess runs a private practice, Jess Kimball Wellness (formerly Sunflower Postpartum Care LLC), providing families with birth and postpartum doula support and lactation counseling. She is also a writer for the motherhood blog EveryMoo.

biI have always been impressed by the access to quality reproductive health care in Vermont, but in the past year the struggle to access that quality care has become even more obvious. I am a well-educated and connected community member that makes a good salary, but despite my connections and experience in reproductive health care, I was still denied access to contraception and family planning support by my doctors because they did not agree with my decisions around trying to conceive.

If Vermont has such great access to care, why couldn’t I access it? And if a well-educated, active community member couldn’t access adequate care, what was happening to those more vulnerable members of our population?

The more research I have done on the gaps in reproductive health care the more I have come to realize how fixable they truly are.

The amount of residents in their reproductive years has increased throughout the pandemic. Waitlists are longer and it is much harder to get an appointment. Especially with the number of providers that have retired. The pandemic really fast tracked the reproductive health field burnout. Many doulas, midwives and other vital members of a family’s fertility journey are no longer working. I believe this is because of the stresses caused by the pandemic, providers who have views that do not align with CDC recommendations and hospital visitation policies.

In order to reduce some of the gaps I have noticed, I created a nonprofit with other reproductive health advocates in my family. My mother birthed seven babies, one in the car and one at home! She raised multiple children who are actively working in roles that support new families. She is also working in that type of role herself. Our board is made up of trustees who are lactation counselors, doulas, peer parent supports and a personal trainer.

We offer families free of charge services such as birth and postpartum doula services, pre- and post-natal fitness classes, new parent education courses, cloth diaper starter kits, a lending library with over 40 baby carriers and limited scholarships to work with any doula in the community (for families who want to work with a certain provider, but need help covering the cost).

Our volunteers are expanding their education through Postpartum Support International’s PMH-C program and through various training programs, leading to credentials such as CLC (certified lactation counselor) in order to offer lactation support and education as well as screening for PMADs.

Increasing access to care and support for new families is one of the biggest investments we can make in our community. It leads to lower rates of domestic violence and child abuse and more active and present parents (both moms and dads).

Research shows that doula care leads to:

Fewer cesarean births, fewer adverse maternal outcomes and improved quality-adjusted life years (QALYs) in the woman’s first and subsequent births.

People are more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births and cesareans. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth.

Lower rates of Perinatal Mood and Anxiety Disorders (PMADS).

Birthing parent is more active in decision-making process when it comes to health care.

Baby is less likely to have a low five-minute Apgar score.

Both birthing parents and babies are statistically more likely to have better outcomes!

The purpose of the Kimball Wellness Association, Inc. is to further access to doula care and educational resources by offering community-based doula care and a variety of doula-led groups and classes. KWA aims to reduce disparities in birth outcomes, especially for low-income, LGBTQ+ and BIPOC birthing people.

We are currently raising funds to build a mobile clinic that will function as our office and classroom as well as a location for pop-up clinics providing STD testing, PAP smears and other reproductive health services all over Vermont

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