Between Contractions
In this episode, Amsy and Stephanie dig into a headline-making story: the University of Chicago Medical Center announced it will staff around-the-clock doulas for patients with qualifying insurance, at no cost. The response online has been deeply divided — and the hosts get into why, approaching the topic with the nuance it deserves. Rather than a simple thumbs up or down, they walk through both the real concerns and the genuine benefits of hospital-employed doula programs, and what it could mean for the future of birth support in the U.S. The concerns: * Whose loyalty is it? A doula employed by the hospital has her paycheck — and her job security — tied to that institution, not to the laboring person. That can limit how much she's willing to advocate, push back, or offer alternatives when a provider wants to move in a particular direction. * No prenatal relationship. Much of the research showing doulas reduce C-sections, low birth weight, and postpartum mood disorders is tied to the ongoing relationship built before birth. A doula who meets you for the first time in active labor can't provide that same foundation. * No postpartum continuity. Doula support after birth — check-ins, emotional support, recovery help — is a meaningful part of what makes doulas effective. Hospital-based doulas typically end at discharge. * Patient-to-doula ratios. The program plans ratios similar to nurses, with up to two patients per doula per shift. Continuous, one-on-one support is exactly what the research is based on — splitting attention undermines that. * Impact on independent doulas. Could hospital doula programs eventually be used to limit or exclude independent doulas from entering the building? U Chicago says no — but not every hospital system will have the same safeguards. The benefits: * Access for those who need it most. Single moms, teen moms, uninsured patients, and Black women — who face disproportionately high rates of maternal mortality — are the most likely to be laboring alone without support. Having any doula present is meaningful. * Culturally congruent care. The Chicago program is intentionally recruiting doulas who reflect the communities they serve, recognizing that shared lived experience matters in building trust and providing relevant support. * Still better than nothing. One of the Chicago doulas, Andrea Von, put it directly: 90% of their clients would have been completely alone without this program — and many of them are Black women already navigating a system that isn't built for them. The bottom line: Both hosts land on cautious optimism. The questions are real, and not every hospital that adopts a similar program will build in the same protections. But for the people most underserved by the current system, access to any support during birth is a meaningful step — even if it's not a perfect one. LINK TO THE ARTICLE: https://blockclubchicago.org/2026/04/09/around-the-clock-doulas-now-available-in-uchicagos-labor-and-delivery-ward/ Amsy Dees - @amsydees.doula // amsydeesdoula.com Stephanie Dawson - @grow.lakeland // growlakeland.com DISCLAMER: The views shared on this podcast are our own and do not represent any specific organization. This podcast is intended for educational and informational purposes only and is not a substitute for medical advice. Please consult your healthcare provider for guidance specific to your care.
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