Caitlin Whyte (Host): Welcome to In Their Words, brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA. In the landscape of maternal health, some stories have the power to transform not just individual experiences, but entire communities. Today, we dive into a narrative that bridges personal passion with systemic change. The story of Sabrina Torres, a doula whose journey is rewriting the script of maternal care. We've all heard statistics about maternal health disparities, but today we're moving beyond numbers and into the lived experience of a woman who is actively reshaping the narrative for black and Latinx birthing persons in Lancaster county.

Following our illuminating conversation with Dr. Sharee Livingston. We now hear directly from Sabrina, a certified doula whose own transformative birthing experience became the catalyst for a profound mission. Her work with the Diversifying Doulas Initiative isn't just a job, it's a calling. A commitment to creating the kind of supportive culturally aligned care that every birthing person deserves.

Sabrina Torres: Hello. I'm Sabrina Torres. I am the Director of Community Programs for Patients R Waiting. I'm also a certified doula, certified breastfeeding specialist, a mother to a two-year-old boy, and I also have my Bachelor's of Science in Public Health from Temple University. So, all of those things combined have all sparked a different place in my heart for my passion in maternal health, mental health, public health, all things above.

For my doula journey, the thing that really sparked my passion and my interest into doula work was actually having a doula myself. So, I am currently the program director for our Diversifying Doulas Initiative. But almost three years ago now, I was actually a patient or a client of theirs. So, I went through the Diversifying Doulas Initiative Program myself as a client. I was paired with one of their doulas trained through their program, and she was amazing. I had an amazing, natural, unmedicated birth with my son. And she provided me with so much information and support and just really helped my husband and I feel fully prepared and empowered to allow me to have and encourage me to have the birth that I wanted, which wasn't a natural unmedicated birth. And we did that.

And at first, I had no idea what a doula was, and I was just like, "Well, I'm such a big mental health person. If there's any tools that I can continue adding to my tool belt, why not?" So, I heard about a doula through just looking online and stuff and watching YouTube videos. And then, actually, at my doctor's office, they told me about the program, so I applied and I got paired and it was just amazing.

And so, fast forward two years ,later when they were opening up their applications to train another cohort, I was like, "Why not?" I received an email, so I signed up. And I am a part of Cohort 4, which was the training group that had just just finished training this year. So, we matriculated through January through April of 2024. So, I am a DDI training doula as well, and that was just an amazing experience. The program is super robust. It just has so much information, and it's just like so nice to be around women that have the same passion as you, that look like you, black and brown women, and are serving their communities.

And now, fast forward a couple months later, Dr. Livingston and Dr. Hamlin, the founders of Patients R Waiting, contacted me and they were just really impressed by like my passion and my involvement with DDI and they offered me this position for Director of Community Programs and the stars just aligned.

I truly have to thank God for opening up these doors for me and now here I am. I think almost six months now that I've been in this position, and I have learned so much, have grown so much, and I'm just so excited for the future of Diversifying Doula's Initiative and Patients R Waiting. And myself as a doula have my first client, she actually has an induction next week. So, I'm just really excited to continue pursuing my passion.

I think I was around 22, 23 weeks when I applied for the program, which I really encourage any mamas interested in getting a doula. The earlier you connect with your doula, I usually recommend as soon as you enter your second trimester, 16 weeks and on, start looking for doula support, even if it's just getting some information, doing some birth planning and things like that. The more information that you equip yourself with, the better prepared that you'll be, whether that's a doula, YouTube, evidence-based birth, Motherboard, all those things are free resources for you to just learn more about the birthing process.

So, I applied for DDI around 20-ish weeks. And I heard back and I was paired with my doula, Madhu. So, me and her connected. And off of our first meeting, me and my husband just looked at each other and we're like, "Yeah, this feels right." We've naturally connected her kind of mission and things aligned with us. So, I'm a big words of affirmation person. I love just natural remedies and things like that. And she was super on board with that and she really wanted to help me have a natural unmedicated birth, just as much as I wanted one for myself. So, she really kind of honed in on that and provided me with so many resources, sent me YouTube videos.

She came over to my house and kind of coached my husband through some comfort measures. So, a lot of what doulas do is education, information, hands-on physical support, emotional support, and kind of instilling that in whoever your birth support team is, whether that's your partner, your mom, your sister. So, she really did that to my husband. And my husband felt so prepared to be there as an anchor for me and kind of really coached me through having a unmedicated birth. He applied a lot of acupressure. So, there's different things that you can do for the birthing person to kind of help ease the pain of labor and contractions. So, there's hip squeezes, massaging, different positions to encourage them to get into, whether that's on the wall, on the bed with a peanut, even on the toilet. And just words of affirmation. And also, setting the room, just dimming the lights, having some music playing in the background.

So, the biggest thing I tell anyone that wants some unmedicated work, practice your breath work, because that is essential to having an unmedicated breath on top of obviously the other things I've listed, positions and acupressure. So, I was in labor for 19 hours, pushed for three hours. And then, my handsome, beautiful baby boy was here after that.

Host: So, if you are wondering, how do you take something as deeply personal as your own birth story and transform it into a professional approach that can support and empower other mothers? Sabrina has an answer for that.

Sabrina Torres: In my doula business, I want to encourage birthing people to try to pursue an unmedicated birth as much as possible because, at the end of the day, female bodies were meant to birth. Like, that's what we were put on this earth for. That is how God built our bodies. We were meant to bring life, and this is the most natural thing that your body can do.

So, I really encourage them to lean into that because God's not going to let you do anything you are not able to do. So, I always encourage them like, "Hey, yeah, I know you can do this. You are built to do this." Obviously, that's not the journey for everyone. So, I support them and meet them wherever they are at. But I try to just put that little chip in their head. And especially, if they already are on that mission and their birth preference, even the more happier that I can be of support because I've been through it, and I know what it takes to get through it.

So for me, I'm a big information person, so all the information that I can bring that is evidence-based so that they can make the best informed decisions for themselves and their baby. So, I've listed a few resources. Evidence-based birth is amazing. They cover a lot of good topics and they are helpful for every single person that is in the birthing field: doctor, midwife, doula, lactation consultant, patient, dad, grandma. Everything you need that you might have a question about, they might have.

There's also Motherboard and YouTube. YouTube has so much information out there, whether it's like how to breathe, how to have a natural birth, what are some positions that I can do to get my baby into position, what are different positions I can do while in labor, and things like that. So, that's how I equip myself with information just compiling those resources, and I tailor them to each of my clients and their needs.

So, I have my current client. This is her fourth baby. She's had a rough pregnancy, and she is just like, "I know I could do it naturally, but I honestly just want a kind of a little bit of a relief before I know I have to push and things." And so, she wants an epidural and I'm like, "Okay, cool." And so, we went through what other options besides an epidural she has as far as comfort measures and medication and things. And she didn't know that about nitrous oxide, which is another kind of way to find some comfort through medication And so, we just went over the risk and benefits, and she's been having a lot of physical discomfort. So, me and her husband practiced some of those acupressure comfort measures that can kind of provide some relief for her because her body is very near the end of pregnancy, and that's usually the most uncomfortable and you can't find a position that kind of feels good at any point. So, the biggest thing is kind of creating some alignment in those hips sometimes and providing pressure and kind of just giving her some relief off of the weight that the baby is putting and pressure the baby is putting.

Birth is so unique to each individual person. So, I usually try to tailor my services to what their preferences might be. And really just giving them the information they need with risk and benefits, what are some alternatives? And also, I always encourage them, trust your intuition. No one knows your body or your baby better than you. Like, yes, I can tell you what signs and symptoms to look for if you feel like something might be wrong. But at the day, you need to trust yourself and trust your instincts as to, "Okay, maybe I do need to go to the hospital" or "I should call my provider" or anything like that.

And so, I went through the acronym BRAIN: benefits, risks, alternatives, intuition, and then there's N, which is what if I do nothing or say no. And so, us doulas love that acronym. That's the biggest way to kind of just provide your patient with autonomy and any information and just kind of give them the floor to make the informed decision. Because at the day, that's what we're there for.

We're not there to be their voice or to make decisions for them. We are there to advocate and encourage them to speak up for themselves or their partners for support, people to speak up for them and make those informed decisions. And the keyword is informed so that they understand everything they're getting their selves into.

Host: As we continue this journey into the heart of compassionate care, we ask Sabrina to tell us what it means to her, when patients say those two simple words, thank you.

Sabrina Torres: So, we have over 300 past clients that have given birth through our program. And so, I sent out a mass email just saying, "Hey, I'm looking for any client testimonials just so we can share, especially with some of the fundraising events that we've had with Extra Give and Giving Tuesday coming up tomorrow and things like that, and just so we have kind of that feedback from them and to stay connected with our DDI community. And my inbox was just flooded with everyone just saying how grateful they are for having a doula and how much of a positive experience they've had with a doula through our program, and that they really recommend it to their friends and things like that in the community.

So, it was just so nice to hear that how many people have been touched by a doula in our program and really felt supported and empowered by having a doula. I wish doula care was more accessible so that all birthing people can have this experience and have the support and the empowerment that doula care really provides. Obviously, we're making progress in that realm, but I just wish it was a little more accessible.

Visit our website at patientsrwaiting.com/ddi. We are actually opening up our applications in end of January and we are having an information session, so we will be training Cohort Six at the beginning of next year, so 2025. So January 15th, we will be having our information session, which is mandatory. If you are interested in applying for our program, we do an eight-week training followed by a hands-on weekend. It's an amazing program, super robust. And it is a time commitment. It is a commitment to yourself and to this program. But you receive so much information and so much support and are just entering an amazing community that we really empower and look out for each other.

And your cohort, like you really become bonded together. Me and my cohort, Cohort Four, we still text. We have a group text and we're always just checking in on each other, like how our service is going with your clients and things like that. Obviously, it is a time commitment. We have mandatory dates. So if that's something that's not feasible for you, there are a bunch of different options for doula training. Of course, that would be some out-of-pocket costs, but our doula trainer, Rae Johnson-Bundy, she does one-on-one virtual trainings as well. She's amazing. She's the first Black doula here in Lancaster County, and she really works with women that want to become a doula but aren't quite a good fit for a program or maybe the dates don't work for them. She's amazing, and she's so sweet, and she really just wants to make doula training more accessible for people as well.

Host: With all the incredible work being done by individuals like Sabrina, Dr. Livingston, and the many doulas within diversifying doulas who support birthing people, what does it mean when organizations like the UPMC Pinnacle Foundation step in to make sure this vital service can exist at no cost?

Sabrina Torres: I mean, one, we are so grateful for the support of UPMC Pinnacle Foundation and other organizations that have supported our mission and our program so that we can continue providing these services to black and brown women here in Central Pennsylvania. We currently serve Lancaster County, York County, and Harrisburg. And it just feels so good knowing that we are creating an impact. And like you said, it creates a ripple effect because once we touch one life, you know, and they've had a positive experience, they're going to talk about it. They're going to tell their children. They're going to tell their friends. They're going to tell their sisters. They're going to tell other birthing people, "Have you heard about a doula? Mine was so amazing. I had such an amazing experience. I felt so empowered. I wish everyone could have a doula when they give birth." And so, it creates that ripple effect.

And Black women are three to four times more likely to die in childbirth, which is astounding and infuriating and frustrating. And so, that's really why Dr. Livingston founded the Diversifying Doulas Initiative to combat black and brown maternal health, morbidity, and mortality. So, you know, if we can limit the risk of birthing women of color through doula care and just empower them and create that ripple effect through our program, that's all we need, honestly. I wish it was more accessible across the nation. I think what's really important really important and we're making progress in getting insurances and state-governed insurances on board with doula care and them acknowledging the impact that doula care has on birthing people and how important it can be to saving a life. And saving not only mom's life, but also baby's life. And so, we're making progress. Pennsylvania, currently doula care's Medicaid-eligible to be reimbursed. Obviously, with any insurance, there's a couple of hoops to jump through and things like that, but we knocked down that first barrier with just getting them to accept and acknowledge that doula care is important so that they reimburse us.

Next, obviously, is private insurances and I'm hopeful that we can make progress there too. It's so important to just continue informing people because I feel like people still have this misconception that doula care is only for if you're having a home birth or if you're rich and things like that, which is not true. A lot of doula care actually happens in hospital settings.

Host: As our conversation with Sabrina draws to a close, one thing becomes crystal clear, doula care is so much more than a professional service. It's a calling, bridge, a lifeline to support that transforms not just individual birthing experiences, but entire communities. Sabrina has shown us how personal passion can become collective healing, how one woman's journey can open doors for countless others. Her work with the Diversifying Doulas Initiative isn't just changing statistics, it's changing lives.

For those of you who want to learn more about this incredible initiative, be sure to check out the episode, show notes. There, you can find more information about the Diversifying Doulas Program and how it's working to create more equitable, compassionate, maternal care in Lancaster county. You've been listening to In Their Words, brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA. Until next time.