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Are you in the military or know a woman who is? Have you ever thought of what it is like for a woman to give birth in the military is? Look no further, this is the episode that will share the truth.

Carolina dives into detail with Birth Worker Kayla Kohl on what it is like to serve military families in Nebraska as a birth doula. She is the only birth doula to be covered by Tr-Care in the state of Nebraska, which is the military’s insurance.

Kayla will bust through many misconceptions about birth workers, how they are paid, and the lack of options women are given for their birth in the military.

What you’ll learn:
1:35 Know more about Kayla as a birth worker
10:04 Kayla’s services
15:30 The reality of being in the military
 21:30 Are there enough birth workers in the military?
29:40 Birth planning in the military

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Professional bio
The Carolina Sotomayor Podcast is brought to you by Carolina Sotomayor and the Fertility Foundation.


Carolina Sotomayor is an Expert Womb Healer who helps women conceive by removing physiological blockages with Reiki. She is the host of the Carolina Sotomayor Podcast, a show that covers everything from fertility to postpartum to motherhood, and the creator of Fertility Foundation Collective, an online membership that helps women heal at their own pace to boost their fertility.


Carolina has served over 500 women from around the world to heal. She is passionate about helping women create their families. As a result, there are over 60 reiki babies in the world.


Fertility Foundation Collective: https://carolinasotomayor.com/membership
Carolina Sotomayor Reiki: https://carolinasotomayor.com/Facebook: https://www.facebook.com/carolinasotomayorreiki/
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Podcast Episode Transcript

Hi, I’m Carolina, your podcast host and expert wound healer. Over the past five years, I’ve served over 500 women to remove physical blockages in their bodies. We achieve this with Reiki. I believe healing doesn’t have to be done alone, nor should it be. We will hear stories of healing methods to heal with and guest speakers covering taboo topics you won’t hear anywhere else.

Let’s continue this journey of wound healing together.

Hi, I’m Caroline. You’re a podcast host in Reiki Womb Healer. Before we dive in today, make sure you take a moment to go ahead and give us a rating and review to support the podcast and make sure that you’re subscribing so you receive every Tuesday and Friday’s episode. So today’s episode is going to be epic.

We’re talking about serving military families as a birth worker with Ms. Kayla Cole. Thank you so much for being here, Kayla. I’m so excited to dive into today’s topic with. Thank you so much for having me. It’s so fun talking to another birth worker and professional . You know what? I need to identify more as a birth worker than I actually do.

I know that I do birth work in what we do. Nice. Yes. But I need to recognize that. So can you give us a little background? What led you to being a birth worker and then like how do you define a birth worker? So I come from a family of a lot of girls and all of my cousins had their babies before me and I was diagnosed with some infertility stuff at a really young age.

So I immediately was jealous of all of my cousins having their babies and just like would deep dive into all of their pregnancies. And their options, and I’ve just always been obsessed. And then when I decided to leave teaching, which is what my background is, I wanted more flexibility. I learned from another actually military spouse that there’s going to be a postpartum doula training in the area.

And I took it and was like, oh yeah, this is my career now. And I just. Slept into this world of sort of doula work, birth work, and it’s just taken off. And since I started with postpartum, I’ve added on birth infant care, and I’m currently training to be a lactation counselor as well. I’ll probably never stop adding to my toolbox, and that’s why I’m a birth worker.

I work in different modalities to support people in birth. I love that. So why not just call yourself a birth doula? So I do sometimes Omaha is kind of recognizes the word doula and knows what that means, but the origin of the word doula, it’s Greek for female slave. and traditionally birth work is a black culture aspect.

It’s sort of, especially in the United States, when enslaved women were having their children, they relied on other people in their community to support them. They did not have access to midwives. They had what we would call granny midwives. There are some amazing books about that, but a lot of black and indigenous.

Birth workers, they’re sort of reclaiming the word doula for themselves as a mode of empowerment. So while I do kind of switch between the two, I prefer birth worker. I’m just trying to make that term a little bit more well known in the area I live in. I think it’s really important to understand the cultural differences and the meanings of the words, and in the spiritual space, this is also understanding the origin of the tools that you’re using, how to honor those cultures, and also making sure you’re not appropriating.

I really honor. I am thanking you for educating us on that. Cause I had heard, but I didn’t know really like what was the meaning behind the origin of the word. So it’s really important. So birth worker, so serving military families. So this is something amazing because the military as a complex.

Organization. I have a friend, her husband’s in a pilot Air Force, and I just learned so much like she, you know, how they had gotten options and then they ended up in a different place than they originally thought. And it wasn’t like, there’s just so much that goes into like choosing Yes. What options you have.

And then, so then I learned about something. A little is something called tricare, and apparently that’s the healthcare insurance that is given to the military. And then there is like, just like any other insurance, there’s different levels. Mm-hmm. . But you are the only TRICARE approved doula birth worker in Nebraska.

What is the term that the insurance uses? So the in demonstration that TRICARE has launched is actually called the childbirth and breastfeeding support demonstration, but, Title within TRICARE is certified Labor Doula. So TRICARE uses the word, so they use the word doula? Mm-hmm. . Got it. So just so our listeners know, we are located in the state of Nebraska and we’re in the Omaha Metro, so we are in our military bases of it, right.

Off it. Yes. And it’s a pretty big deal. My husband had told me facts about the Air Force base here is that it’s like really special because that’s where like the president goes if like he needs a safe place to hide underground or something like that. . . I’m probably messing this up again. Did I mess that up?

No, I just, you know, there’s so much that outfit does and there’s just so much, I don’t know, it’s just a. My husband is active duty. Oh, he’s actually, oh, he is? So you know more than me. Oh my goodness. My hu we’re like totally so far removed from the military. Not even like in any capacity at all. My husband’s a writer and he’s like, do you know that’s where the president goes?

Like if there’s like a threat to his life and they like go and hide him. I was like, to Nebraska. He’s coming here Maybe. Like, I know he’s, he’s come through before it just totally come through before. Yeah, it totally depends. My husband and I are actually second generation military, so, uh, both of our parents were in the army and so now, so I was a dependent.

which would be considered like a child of an active duty soldier. Yeah. And then a dependent, the spouse of an active duty airman. And we’re raising our kids who are now dependents. And so I’ve been through a couple different, you know, just having Tricare myself as an adult and as a parent, kind of gone through that system.

So even though I don’t work for tricare, I’m approved for Tricare. I now get, I get letters for myself and then I get letters for my business all sent . That is so like, that’s full circle. I don’t think that , yeah, that is full circle. So, okay. So what does it mean to actually be a birth worker? In Tricare for military families, what services are you providing?

Yeah, so they released back in October of 2021, this announcement in what’s called a federal register, about all the things they were adding in this program. They’re expanding lactation support, and then they’re adding in doula services. Well, I’m not sure that Tricare knew or who was on the panel to put this together, but TRICARE covers prenatal visits and postpartum visits up to six, and they are untimed.

So it doesn’t matter how long you’re with that client, you get this amount of money. And then they also cover continuous labor support for this amount of money. Doesn’t matter how long you’re supporting them. This, you know, you get X. Is that positive or negative? It’s positive because it’s a step in the right direct.

Okay. However, there are things in being a birth worker, like time on call or if, if I’m getting that’s true, paid for a prenatal visit, they based it by the state, so every state gets a different amount of compensation. I can’t do what I do for hours and hours for $42. That would be what I would get paid for one prenatal visit if I was in network.

So they’re in-network providers and out of network providers and out of network providers can balance bill 15% on top. And so that’s what I do because I need to be paid up top my services. I need that extra income to, you know, I’m never gonna go in the red for my business. This is a business, it’s not, um, just a hobby.

So I out of known girlfriend, I get that. I get that a hundred percent and you don’t treat. Like hobby, either like that’s the difference, like I’ve always wanted to treat. All of my business, cuz in my head I’m a serial entrepreneur. . But like , I’m, I’m sure I’m not, but I have had a couple businesses in my life,

Anyway, and my minds, I’m a serial entrepreneur. I’m very serious about my businesses anyway. But like I’ve always wanted it to be taken seriously. I’ve always wanted it to make sure like, And not just picking it up off the shelf. So I, I knew that immediately when I looked at your website and when I spoke to you, I was like, oh, thank you.

This is my absolute passion. You know, I can tell. firsthand what it’s like to experience infertility and what coverage is available there. And then I know what it’s like to get pregnant and have a pregnancy through this insurance. Not only with insurance, but without family around, without support. It’s so painful.

So we talked about a little bit about like the structure so that you get paid for prenatal. Mm-hmm. birth and. Yes, yes. But I do so much more than just three things, . So tell us more. Exactly. So I guess this is finishing up, the last question is, what is like the full skill? So if somebody came to you that was a military member, female, male, and sail member, and she wanted services and you had capacity.

Yes. What, and she signed a contract with you, what would that look? So from the time that you’re hired, you get my personal phone number or that I’m hired, not my business phone number. So you ring through and if you hear my phone, it’s somebody going into labor. You get a special ringtone, you get a special text home.

Let’s, let’s summon that.

We want our baby. Come on this podcast. Sweet. Got a full loon. So they’re coming, the juice is there, corn has the juice. You wiped the ticky talkie hazards and keep going, going. They get my personal phone number. They have access to me 24 7. I have, right next to me is my library full of books. And so they get to check out, um, any of the birth books that I have, lactation books, baby feeding books, postpartum books.

So it’s just one less thing they’re spending money on. And then, We are there to talk back and forth. I also send out several e guides, so there’s an onboarding e guide about what to expect in every single visit. There’s an e guide that is simply just a list to talk about with your provider. It’s prenatal preferences, so you’re gonna learn all of the things that could be used during your.

Prenatal care, labor and postpartum, as well as the newborn care decisions you have to make right after you give birth. And with that list, you know, my clients will go over with their providers, see if there are any red flags. We create sort of like a birth plan or birth goals. And then our in-person visit is where we’re going over, I’m showing them.

early labor positions, comfort measures that their partner can perform on them At home, we’re going over different positions to push. We’re visualizing if their goal is to have an unmedicated birth, you know, we are going through all of the different sensations they may feel we’re gonna time out a contraction together In these positions, we’re prepping for everything, and then when it’s time and they go into labor, my clients call me when they’re ready for.

And I’m there until that baby is born and that golden hour is protected. And then afterwards I send them all of the pictures I’ve taken on my phone at the labor process of meeting their baby. And then I go home and they get text support while they’re in their birth location until their postpartum visit with me, where I like to come to their home within the first two weeks of postpartum.

I like to assess for any mental health. Concerns or physical red flags I’m seeing for not just mom and baby, but anybody living in the home. And then we kind of just become best friends and they know that they can text me whenever, but once they hit that six to 12 week postpartum, I’m not going to wake up in the middle of the night for their texts.

They will be silenced . But basically from the time you hired me to six weeks postpartum, you’ve got 24 7 access to me, that’s insane. I wish I had a doula like you. My birth doula, , that’s another episode. birth workers are not created equal. Like that’s just, they’re not, you know, it’s also more common now.

I’ve seen at least three videos on TikTok where women had hired, and this is not Nebraska. The new one was in Ohio, and then I don’t know what the other state, so there were like nobody locally, I know personally, but I saw three TikTok video. In the recent month that where they just didn’t show up. They signed contracts, they had support during their birth, during their pregnancy, and they never showed up for the, my jaws on the floor.

So three I mine left early. So like, and to have that level of support during your pregnancy, so no matter amount money is like, For that. That’s unheard of. And just like knowing how much you care and visibly passionate about this, it makes me wanna get pregnant again. Just to do, have like nine months with you

Oh my gosh, yes. Let’s have a baby. Let’s have a baby together. So thank so much. Like, listen, I loved my wedding. It was great, but my wedding does not affect my physical body every day for the rest of my life, the way birth does. Oh my gosh. And having. Having that support emotionally and physically the entire time having somebody present with you.

So that way if your partner needs to pee, I can take over. They can pee and come back to you like you are never gonna be alone. And I think just having somebody there to protect your space, especially for these military families. They can’t just have a spontaneous labor and have their mom or their sister there, they’re asking their families.

Most of them are trying to budget out that plane ticket for their families to fly to them, and they don’t want them to fly there and them not to have the baby. They want their parents to get there and get time with the baby and help them postpartum. So these families, , if they’re planning, they’re planning on their family not arriving till like 41 weeks or 42 weeks of their pregnancy.

Most of these PE people have their babies whenever and then are alone for two, three weeks before their family can get to them. I didn’t understand. I had such a like, , ignorant, naive view of the military. Until I got educated, I just literally thought everyone in the military was well taken care of like that.

They were like, I learned that some military are on food stamps. I learned, I learned about barracks that the military housing might have mold. I literally thought when a person was in the military that they were taken care of. And I, there’s no bash in the military, the service that anyone provides, but, and we’re thankful for that, for the servicemen and women.

Yes. But I ignorantly thought that until one, I met people in the military and they’re like, no, their servicemen are on, you know, food stamps. Mm-hmm. in their, they’re very lonely. There’s limited. , and I don’t know why I was so naive to think, but I also don’t have a whole lot of real life experience with the military.

Mm-hmm. at all. So it’s really important to understand like, Support and birth really is so transformative for a woman because it makes her feel safe. Mm-hmm. how that baby is born, like the environment and that they’re born into, affects their relationship. It can even affect the trajectory of baby and how they come out, so like in their long-term life.

Yeah. It also will affect the bond if dad is present or not present, like birth support or not having birth. is life changing. Even if you do have support and there can be trauma, there’s greater risk of more trauma and more intervention, and there’s just more risk of going wrong if there is not labor support.

And that can look very different for many people. Yes, depending on medical complications environment that you’re giving birth. I’m mixed. I’m half Hispanic, half white. So for me, I. Gave birth and it was fine and I had support. But for these families that are in the military, and I can’t imagine like how stressful it must be to be pregnant in the military.

And I know I can’t really speak for that, but like mm-hmm. , I can only imagine like, If there’s so many like restrictions and things like that. Mm-hmm. I bet you it’s really tough. Can you talk about the requirements it took for you to become a TRICARE approved doula? Cuz I bet you that wasn’t easy. They had like 18 requirements.

Share that because if you’re the only one. Like, why isn’t there more of you? You know, in Omaha, there’s a really popular doula certifying organization, and it is not on the approved list for tricare, if you wanna be a TRICARE doula, you have to get your labor doula certification with one of five like different organizations.

Gotcha. And only one of them is semi-popular in this area, so there’s just not. In-person trainings for those organizations here, and then it’s just the cost of everything. You have to be a legitimate business. You can’t just do it as a hobby. You have to have your llc, you have to have to have your npi, you have to have a business account.

There’s a lot, which means you need to do QuickBooks and bookkeeping and all the things that like, yes. Yeah. You have to keep track. You have to. Business receipts, you have to be a business owner. And there are tons of doulas who are business owners, but they also know financially what they need to break even.

And some doulas have higher operating costs than I do, and so they just can’t work for tricare. I know I personally could not be an in-network provider. That means my clients would pay me nothing. Nothing. And then I would have to wait for TRICARE to reimburse me. And it has taken some people months to get that money from tricare.

And if I am servicing you at your birth, I cannot wait months for that money. Just financially. That’s not an option for my family. And I also think if you don’t have any financial investment in your support, there are doulas who. They do not get called if they, they doula for a friend or they doula for free, and then the person decides last minute, they don’t want them there and they don’t call them or they take advantage of that and they overuse their doula.

And so for me, having a legal contract and getting paid up upfront is really important. And so I’m an out of network doula and I think that. We need more doulas to take insurance. We need more insurance companies to step up and let people use their FSA or HSA for doula support, and that would be wonderful.

It’s a lot. And I think that some of the other requirements for Tricare, there’s, you know, different levels of education and training they want you to have. They also need you to have attended three births, and two of them need to be vaginal births. So if you’re a doula and you’re just starting out and you don’t have these births under your belt, or if you’re a doula, Only serves cesarean births.

There are doulas who they find the niche that they love, so some doulas. Oh, wow. Only service cesarean births and provide that support. So you then would not have the vaginal birth experience to qualify. , which is, and you’re also putting pressure on your clients then to have a vaginal birth so you can get into the program.

And I don’t believe in using, can’t, clients can’t ethically influence anything. Yeah. That’s not ethical. Yeah. So it is what a whirlwind into . There’s so much I started working on, actually had to cross certify. with an organization that was approved. I met all the other trainings, but that one, so I cross certified in January and then they rolled out the program in March.

And so it took about like 90, 60 days for my application to like, they get to the application process from the time I met all the certifications as well. So it’s lengthy, it’s time consuming. Definitely worth it. So the question is now, Is there enough of you to go around to all the service service numbers?

There is not. It is, it’s you have a wait list or you don’t do a wait list. I don’t do a wait list because my clients don’t cancel on me. . Well that , like I keep hearing the corner of the cob song from sick, TikTok. You know, like , she has juice. So like people are gonna listen to this episode and be like, What’s she talking about?

just look it up. The little kid sings the corn has the juice and it’s like every time you’re like, my planes don’t cancel on me so much. So, okay, so this means that you’re booked out? I am booked in May, the beginning of May of this year, I booked my 2022. Wow. And I launched, I launched my rebrand in January and I finalized being a TRICARE approved doula, I wanna say in March.

So from March to May, I booked the rest of my year with military families and families as well. But it’s kind of become my thing. My non-military clients, I have so much love for them and it’s been wonderful forming those relationships. But primarily now I serve military families and there was a time, I would say probably from.

May to August, I was getting somebody reaching out every week trying to book me that I was having to turn down because I was already booked. And so thankfully I know other JS in the area and I was able to connect them. But for some of these families, they said, you know, without the possibility of getting some reimbursement from tricare, we just can’t afford them.

Wow. And, and that’s really hard to hear. But at the same time, I know what I am capable of. Right. When I give my all to my clients and I know what I’m capable of. To give to my family, and so I just can’t, I, once I set that boundary, if I’m full, I cannot take anybody else on, but what I can do is just prenatal education with ’em or just postpartum visits with ’em instead of being available for their entirely.

I had a couple, I had a couple clients do that where they just booked me for prenatal education and then a postpartum visit to sort of sit together and process their birth story together and so important. So important. So tell me what does your 2023 look like? My first quarter’s books, I am interviewing

This makes me so much joy for you as like an an online business owner. I know you’re not online, but you’re in person, but like as a female business owner, it’s so beautiful to hear like, yes, I’m booked out for first quarter of next. It makes me really happy. I also like when I’m booked, like I, for this year, I didn’t take on any late December clients cuz I wanted to spend the holidays with my family love.

So yeah, I love, I could’ve squeeze somebody else in, but they wouldn’t have gotten the best of me. So being able to say, I’m booked and I’m also taking you’re whole mood and vibe. I want to c clone you. I think that that’s so, I. My birth doula left because she was tired and she, her daughter’s birthday was the next day, and I’ve already taken July off for my daughter’s first birthday.

I already have put out that I will not be doing July births because I don’t wanna miss my daughter’s first birthday. When you’re due go, you know, only 4% of babies come on their due date, so you’re either sacrificing your month or you’re not like, Got it. And for the people who who are asking what I’m referring to in my birth, one of my contributing factors to my birth trauma story is that my doula left my birth.

And for anyone that comes from me, come from me. But I’m gonna just tell you that it’s just some things you can heal. And there’s some things that are forgivable. And in my book, that’s probably something I’ll never forgive because I have an only child. That was my one birth. That was my one shot, and she was a hired person.

When we didn’t have support, like I didn’t have any family in the area, just my husband’s parents, and I didn’t want them in the room. Not that they’re not perfectly wonderful people, but like, you know, I just didn’t want her. My private parts anyway. Yes, and I love her. She’s wonderful. But yeah, so like come for me and just, that’s why I always say interview your birth worker, your birth doula.

Yes. Like interview. And you have to really vibe with them. I always recommend a personal referral. Over, like something you might read online. Like, and always trust your gut when you’re hiring someone that’s gonna be this intimate with you, because they’re gonna be around your partner, they’re gonna be probably someone that’s gonna be around your baby and, but you’re gonna be spending, you know, like we’re talking about.

Bringing in the most important person into your life, this little child. So this person is gonna be so important to you. So now that we’ve talked about like what you provide to women in a birth worker services package to them, do you feel comfortable to talk about what it is like for women being pregnant in the military?

Yeah. Preparing for birth and specifically like. Some things that might be challenging for them. Yeah. So if you are an active duty service member, meaning you are the one who is serving, you see your base doctor, you’re not going off base, you’re not interviewing obese or midwives, you’re probably not even having a home birth because.

Your insurance won’t cover it. You are going to the base to have your baby. So depending on where, is there a hospital at the base? Yes. All of the clients go to like Nebraska Med, U N M C. Okay. But their doctors work at Erling Bequest. And so those are the people that you are seeing. And if you work in the medical field, potentially you run the risk of only your coworker being able to.

Your provider, and for some people that might be awkward. Yeah. This is super limited. Yeah, and I’ve actually had the honor of serving two service members through their births, and that was a big thing for both of them was they said that they felt like their birth choice had been taken from them. They’re both, you know, amazing.

They love their jobs, they’re not leaving their jobs over it. But they wish that they had gotten to interview. They wish that they had gotten to choose their birth location, and I think that’s very valid. And so for both of them, the only choice they got was me. And depending on what clinic you’re seeing at, you can see a family medicine residency doctor, or you can see the Women’s Health Clinic.

So you go to one of those, they all have a couple providers and you get who you get unless you schedule an induction during that provider’s opening or a cesarean. If you go into spontaneous labor, you are not guaranteed the person that you’ve been seeing that has been your primary ob. You’re kind of just getting one of the three or one of the two.

So just so I understand, so these doctors that are at the base, They also have privileges at the hospital. Yes, yes. So they, they have privileges. They will be seeing either they’re at a main city hospital. Mm-hmm. , it’s a really great hospital, but they’re seeing base doctors at this city hospital. They’re seeing base doctors at the base hospital and then they are driving to Nebraska Med to have their babies and one of the base doctors will be on call there.

They have privileges. Got it, got it. Awesome. So what if there’s a high risk pregnancy? So then they’re referred to mfm. They have to get a referral. Typically a referral only has a couple providers available and then they will still be seen at U N M C with whatever provider takes their insurance and was written out on that, that referral.

But they will work in collaboration with their base doctor. Wow. I know that just having choices made a big deal for me in my planning. Mm-hmm. , oh man. That makes my heart break for them, so, okay. Is there some kind of plan within TRICARE that makes, that gives them the office to go off base or is it everyone that has TRICARE goes only, you mentioned active.

Is there other things where they can go else? If you’re active duty, no, you have active duty TRICARE Prime. If you are a dependent, meaning you are a child or spouse of the service member, you can opt to pay for Tricare. Select Tricare Prime is what is referred to as free. It means your service members dedication and their time in.

Is paying for your health insurance and you will go on base and they will not bill you. Typically with Tricare Prime, you will almost never see a bill, but Tricare Select you have copays. So you have to be able to switch during open enrollment. I dunno what that is off the top of my head. Or a qualifying life event, which means moving, they no longer consider birth a qualifying life event.

Oh. So you can’t even change insurance plans just because you’re pregnant. So if you can’t afford your copays, and I think the cap, um, is around a thousand dollars. But if you can’t afford a thousand dollars, if you can’t budget that in any copays or any, that you may owe out, then you would have to stay with Tricare Prime.

So I just Googled it. , that’s open, Susan, because just from corporate America, like typically October to December. Yeah. Is open enrollment. Yeah. In corporate. I know this just because I had super long corporate career. So I Googled Tricare Prime Open enrollment 2022. It’s December 14th through December 13th.

Check with your local officer for further updates. That was a joke.

Anyway, so like, so if it’s not during that month mm-hmm. , then you’re screwed like to, and if you don’t have the extra money mm-hmm. , and that’s, you know, some pregnancies are planned, some pregnancies are not. And financially, You are where you’re at. You know, we can’t pretend that these, that these service members all have choice or that they have the financial means to make that choice.

Another thing to think about is the, the Erling Bequest Clinic, where you go for all of your prenatal postpartum care, that doctor that goes with you to birth, they are also Air Force doctors, so they are finishing out their commitments with like they are service members themselves. Oh, so they move, they deploy Sense, they PCs.

What is PCs? Permanent at change of station. So that would be like a, so that’s when they move? Yeah, you move the location for dui, which is a temporary duty assignment. Um, and how long is temporary duty assignment? I feel like I’m learning. Like just depends. It just depends. And there, short, short, all this, there are so many acronyms, but there’s all this stuff.

Oh yeah. That makes. So you go into the base clinic, you, you choose women’s clinic, you meet one of the three providers and you say, I love this person. I wanna work with this person. You go in in a month, I have no idea how long they’re gonna be there. Yeah. They, they give their clients, they give everybody a, he as much of a heads up as the Air Force will let them.

But life happens. And so there’s a lot of turnover and there’s a lot of change. Like I know for the majority of this year, there have been two providers and women’s that I’ve worked with and they just added a third. I will say, and this is nothing against those providers, but they’re all men. Oh. So if you are active duty or if you are Prime, you’re seeing a male OB in women’s clinic, I think FMR might have.

Female providers, but it just, it depends, and it depends on which side you are comfortable at. You may have to be in women’s, and so for some people there is a lot of discomfort knowing that a man is gonna be the person providing your cervical checks. A man is gonna be the person giving you your groupy strep swab.

There are just some people who they, they’re in a rock and a hard place, they can’t afford to switch. This is their only option, and. They’re fearful and rightfully so. We come with the trauma we come with, we come with the comfort level we come with. And to be limited to just male providers can be really debilitating for some people.

So having a doula, wow. Like they may have their husband, their provider, and then their doula. And most of the nurses I’ve met identify as women, but knowing that they’ll have one. in their space consistently that works just for them, can sometimes be that bridge they need to stay present in their body when their provider’s in the room.

Wow. Yeah. I have had sexual trauma, so I’ve had a very difficult time getting pap smear done since all I was born, and I cannot. See a male doctor. Mm-hmm. for my gynecological visits, you know, and that’s my trauma, that’s my story. Mm-hmm. . But, you know, everything you stated like that is so hard to process, you know?

I understand like the deployments and things like that, but not to have a choice. So like, do they have choices to decline cervical tracts? Yes. Like, so if they’re in like, like how much rights then do they have in labor? As much as they want. You can even ask when you’re there. I mean, the nurses are incredible.

You can say, Hey, I’m not comfortable with a male provider checking me. I want it to be a female provider or a nurse. They typically like while they’re in labor at the U M C, They can decline cervical checks until they’re in labor, and that’s something that, you know, is recommended for a number of reasons.

But some people wanna know. They wanna know, especially if they’re planning using their family’s gonna come visit. They wanna know if they’re dilating at all or if they’re which. And again, dilation doesn’t mean you’re gonna have your baby anytime soon, but, Sometimes people want that information and so that’s, that’s what you’re getting.

Or if you’re at the hospital, you can ask for a resident to come in and check you, or a midwife that’s on call and hopefully there is one that is a woman to provide that service to you. But it is very brave and it’s very. They are very brave. It is hard seeing people not have choice. Yes, I am a big believer.

If I don’t know my options, I don’t have any. And the fewer options you have at, at a certain point, choice is no longer a choice if there’s only one option. Wow. For the people in the back. Can you say that again please? Choice is no longer a choice if you only have one option. in the context of our conversation that applies to military families and the ways they have access to care and birth.

But that statement can apply to so much to re women’s reproductive health. Mm-hmm. , this might be the single most important conversation I’ve had in my entire season of recording. Oh, I just adore you, . I have goosebumps everywhere. So. Can you say it again please? Can you just say it again? , I, I’m soaking up.

Can you say it again? In all seriousness, choice, can you know how profound that that is? A profound statement and applies to so much? Say it again. Choice is no longer a choice. If you only have one option.

Gosh, you know I had an abortion in my twenties and I used to be scared to say that out loud. I gotten myself into a situation, and I won’t go into detail cuz that’s not relevant, but I used to be super ashamed that I had an abortion and I also had other wound trauma and. I used to think that I was a terrible person because of that, but I worked really hard to work through that trauma, understand the decisions that I had made, and to come to terms with that decision and to make peace with it.

I don’t think that necessarily I’ll ever make a hundred percent peace with it, but I don’t regret it. Mm-hmm. and choice. is something I’m super grateful for and my husband knew and knows all of that. I’m a hundred percent an open buck. But when it came to this year, and you know, women’s reproductive health and having choices and the whole abortion thing, like having choices, is so important.

And if you have only one choice, that is. So dangerous. So I don’t know, it just makes me think of the overturn. So I know that we’re talking specifically about military families and what they do have access to in relation to their prenatal care, their pregnancy, and their. Birth options specifically to Nebraska.

We don’t know what it’s like in other states or you know, I’m sure that there’s, and also Nebraska State laws . Yeah. Very restrictive. Yeah. It’s just that choices matter. So, I mean, there’s so much that these military families, you know, I’ve been with families who have, this is their first. Pregnancy that they’ve been able to carry the term, or this is their first pregnancy at the right time, after abortions or after Right.

Termination. For medical reasons. I’ve been with active duty members. I’ve been with spouses whose husbands are deployed, so they do not have the father of their child able to meet their baby. There is so much sacrifice that goes into this lifestyle, and obviously I will never know what it’s like to be a service member, but I do know what it’s like to sacrifice as the dependent, and I see my husband make these choices every day for his family and to know that that includes when he is needed, he.

And to see that playing out during other people’s births or when other people’s babies are still in the nicu, or, you know, and the Air Force here off the squadron, my husband’s in, they do everything they can to get you back. If there’s an emergency, they’re, they’re getting you back as much as they can.

But the reality is that’s not a choice for everybody. That’s not an option. And, um, Getting to be the option. Getting to be the choice is something that I really value and I, it’s my sincere hope that more birth workers will apply for the program. I mean, I’ve written an e guide. I’ve written blog articles about how to become a TRICARE approved doula.

I so desperately want other people doing this because for me, This is not, it makes me wanna go apply to the program, do it. Let me save the pay. And that’s . This program is not going to save you. This program is not gonna save your birth. This program is not going to save, you know, the maternal morbidity rates that we have in this country.

It’s a hundred percent true, but it’s giving you one choice. And now, unfortunately, sometimes I’m still the only choice. And. I don’t want to be the person capitalizing on this market. For me, it’s not a numbers game, it’s not a financial game. For me, it’s people’s lives. I know what it’s like to not have a voice.

I know what it’s like to give birth, especially during the pandemic, and not have that support. And so for me, if I can get as many people into this work as. If you can just have somebody hold that space for you, it transforms everything. And my ultimate goal is never to be the sounding or the mouthpiece for somebody.

I wanna be the sounding board. I wanna be the person making sure that you are heard. But I don’t want to be the person holding the mic during your birth. And I just think the more we can push people into this program, the more we can utilize birth workers, even if it’s just prenatal care or postpartum care.

It really does transform your. You just have given us so much to ponder and think, and I’m super grateful for you sharing all of this. This has been one of the most enjoyable podcasts I’ve ever, ever filmed and recorded. So I’m indebted to you for your, for expertise, for your time, for your stories that you’ve shared, and.

I promise you that people will be impacted by this episode, so I am just so thankful for you. Thank you so much for having me. Until next time, my friends may, you know you’re loved. It was an honor to connect and serve you this week. If you were a spiritually curious person wanting to conceive and heal blockages in your fertility, click the link in the episode description to learn more about the Fertility Foundation collective.

Until next time, my friend know you are.

Serving Military Families as A Birth Worker with Kayla Kohl

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