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Fringe Benefits: a doula's-eye view of childbirth

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Gwenan Wilbur was working at the literary journal TriQuarterly when she began volunteering at Chicago Women's Health Center. The 20-year-old nonprofit collective in Lakeview had been founded in 1975 by members of the pre-Roe v. Wade underground abortion service known as Jane; it offered gynecological and obstetric care as well as counseling, education, and outreach programs regardless of a woman's ability to pay. When a full-time position in the center's prenatal program opened in 1998, Wilbur left her job as managing editor to join the staff as a health worker and doula.

Doulas are women trained to provide prenatal, labor, and postpartum support to mothers; CWHC was the first organization in the city to incorporate doulas into standard prenatal care. They don't perform clinical tasks but can help a woman communicate with her medical staff, provide massage and other pain relief services, give breast-feeding advice, and even clean up around the house while the new mother gets her bearings.

Doulas have become more commonplace since the 70s, but the degree of attention paid by those at CWHC is still unusual: they generally attend all prenatal visits and are available around the clock throughout the pregnancy.

For example, says Wilbur, "A woman not yet 20 weeks pregnant thought she was miscarrying--she was bleeding and it was the middle of the night. The way it works is that a client always speaks to a doula first. I was the one on call, and I put her in touch with the doctor, who sent her to the emergency room." Wilbur met her there. "It was a very emotional time--we're in the ER, it took quite a while for her to be seen, and she thought her pregnancy was ending." The woman didn't miscarry, and she invited Wilbur to her daughter's first birthday.

Studies have shown that when a doula is involved, cesarean rates are reduced, there are fewer complications, and a woman's satisfaction with her birth experience tends to be higher. "Pools and showers can really help women with pain relief during labor," says Wilbur, "but they aren't offered by nurses; epidurals are offered. Doulas can help women have the labor that they want. We're there to be an advocate for a woman when she has to use all her concentration and energy just to deal with the labor and she doesn't have energy left over to negotiate."

Wilbur has participated in hundreds of pregnancies and has attended almost 40 births, all of them at Illinois Masonic Medical Center. The hospital has a birthing center designed to support natural, family-centered births, and for the last 20 years doctors and midwives on staff there have volunteered their time to CWHC. But after Illinois Masonic merged with Advocate Health Care early last year, the doctors and midwives started having less time to devote to CWHC, so last fall the center arranged to work with a south-side practice of midwives.

After only a few months, however, the midwife practice discovered that because CWHC was outside of its service area, its federal funding might be in jeopardy. The midwives agreed to complete open cases but had to pull out of the partnership. As a result the center hasn't been able to accept any new prenatal patients since early December. It'll have to shut down the program entirely if it doesn't find new providers soon.

Since starting nursing school in 2000, Wilbur no longer works full-time at the clinic. But she remains on the center's steering committee, which is searching for new doctors and midwives and working to raise money. Meanwhile, CWHC's other programs continue to serve approximately 5,000 women a year. "I'm sure I'll still be volunteering at the health center when I'm an RN," Wilbur says. "I can't imagine not working there as long as I'm in Chicago."

As part of its fund-raising effort, Chicago Women's Health Center is throwing two benefits at the Empty Bottle, 1035 N. Western. Chiyoko, Rabbit Rabbit, Archer Prewitt, and Sam Prekop play this Friday, February 1; admission is $10. Next Friday, February 8, Bosco & Jorge open for Tortoise; admission is $20. Both shows start at 10; call 773-276-3600 for more information.

Art accompanying story in printed newspaper (not available in this archive): photo/Nathan Mandell.

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