When 18-year-old Maria Alarcon found out she was pregnant, she was scared and nervous about giving birth.
“This was my first kid and I didn’t know anything,” recalls Alarcon, a senior at Roosevelt High in Albany Park. “I wanted to be more informed.”
So when Alarcon found out about a support program for pregnant teens run by the Ounce of Prevention Fund, she signed up and was paired with a doula, a paraprofessional who is trained to help expectant mothers while they are pregnant, during labor and after the baby’s birth. The doula program is part of the Ounce of Prevention Fund’s long-term strategy to promote early learning and increase preschool enrollment by teaching teen moms about child development and the importance of early childhood education.
In mid-December, with a couple of weeks to go before she was scheduled to deliver, Alarcon reported that she learned a lot from her doula, not just about pregnancy and birth but, more importantly, about interacting with her baby. On Jan. 2, Alarcon gave birth to a daughter, Daniela.
Helping young moms bond and build a healthy relationship with their baby before it is born are the first steps that, down the road, foster school readiness and better performance in school, say early childhood experts.
“When you bond with your baby, you want what’s best for them,” says Bridget Lally, Alarcon’s doula. Even in infancy, the interaction between parent and child sets the stage for school readiness, she adds. “You talk to them and play music and games with them. We know that from birth to 3, the brain is a sponge. It makes a huge impact.”
Lally is with Christopher House, one of the 24 social service agencies that work with Ounce of Prevention, serving teen moms from Chicago Public Schools in Albany Park, Humboldt Park, Logan Square, West Town, the Near North Side, Uptown and Edgewater.
The program, now publicly funded, is the offshoot of a privately-funded pilot that was launched in the 1990s and also spawned a similar national network. And the concept of using doulas to help teen moms, low-income moms and other at-risk mothers-to-be has support on a national level: Last year, the federal government appropriated $1.5 million for these community-based doula programs.
Lally walked Alarcon though the steps of pregnancy and labor, the changes she could expect in her body and the choices she had for her delivery. And Lally, Alarcon’s mother and boyfriend and a host of other relatives were there for the birth.
“Bridget made me comfortable. She talked to me and coached me through my breathing,” says Alarcon, two days after her daughter’s birth. Because of Lally’s prenatal training and support, Alarcon adds, “I knew what to expect.”
The Ounce of Prevention’s network gives young, lower-income moms-to-be the benefits of support that was once available solely to middle- and upper-class women who hired private doulas. The network pairs a doula with a teen in her 7th month of pregnancy, and the doula will continue to provide support until the baby is two to three months old. The expectant teens are also paired with a home health aide, who works with them until they turn 21 years old or their child turns 5.
Alarcon found out about the program at her school’s clinic, when she suspected she was pregnant and wanted to get a free pregnancy test. She met Lally, who visits the clinics at Roosevelt and at Senn High in Edgewater to promote the program.
“I thought it would be good to sign up when Bridget told me about coming to the house and the prenatal classes I could take,” says Alarcon. She had support from her mother and boyfriend, and read books about pregnancy and motherhood, but she felt the need for more help and took advantage of Lally’s guidance.
When Alarcon was worried because she had not felt the baby move in a while, she called Lally. When she felt the baby was having hiccups and wondered what to do about it, she reached out to her again. The two discussed the stages of pregnancy and labor, what happens during birth and breast-feeding. In turn, Lally reached out to Alarcon for serious conversations about birth control and sex, topics Alarcon was not comfortable talking about with her mom, even though they are close.
“She’s a teenager,” says Lally, who visited Alarcon weekly at home beginning last September and also saw her at a weekly prenatal class at Christopher House. “[Teens] don’t talk to parents about some things. They read a book but still don’t know what certain things mean. With teens, you may have to ask, ‘Do you know how you got pregnant?’ ”
Other teens served by the network face more challenges, she adds. “We’ve had some pretty tough girls,” says Lally. “Some don’t have trusting relationships. Some of have been sexually abused. Some don’t have relationship with their parents or they are homeless.”
Alarcon is quiet and reserved but notes that she and Lally had no problems forming a close relationship. “It was kind of shocking that I warmed up to a person that quickly,” she says.
That is Lally’s intention: Moms are more likely to build a healthy, trusting relationship with their babies when they build one with adults, she says.
Lally included Alarcon’s boyfriend, Oscar Roman, in parenting discussions, where the two learned to talk to their baby while still in the womb. “Bridget told us that the baby can listen to you, so I talk to her and Oscar talked to her, too,” Alarcon says.
To show the two how hard it is for babies to communicate, and how important it is for parents to be patient, Lally asked them to take turns pretending to be infants who wanted to let a parent know that they are hungry, tired and uncomfortable. The session showed them that babies cry to communicate because they have no other options.
“If Maria stays in our program, she will be ready for motherhood,” says Lally.
Going national
In 1995, Ounce of Prevention teamed up with the Chicago Health Connection, the Harris Foundation and the Robert Wood Johnson Foundation to launch a pilot doula program.
Nick Wechsler, assistant director of program development at the Ounce of Prevention, says organizers theorized that, if doulas worked for adult, middle-class women, “why not teen mothers?”
The pilot was launched at three sites—Alivio Medical Center in Pilsen, Christopher House in Lincoln Park and Marillac House on the West Side—with seven doulas. Since then, the network has grown to 24 sites throughout Illinois, with 54 doulas. Eight of those sites serve school-aged young women in 39 CPS schools. The $1.8 million program is funded by the Illinois Department of Human Services, the Illinois State Board of Education and Chicago Public Schools.
The Chicago Health Connection, now called HealthConnect One, now has 20 programs across the country serving teen mothers and minority, low-income and immigrant moms-to-be. HealthConnect One received a two-year, $575,000 federal grant last year to launch a doula leadership institute and to evaluate six federally funded programs around the nation, including one in Chicago run by Access Community Health Network (the only other publicly funded doula program in the area).
Research conducted by the Ounce of Prevention in 2006 and 2007 found that 69 percent of doula program participants improved their skills in such areas as understanding their baby’s needs and paying attention to their baby. Participants were also more likely to read to their child, take the child to monthly doctor visits and use birth control after the baby is born.
Angela Ewing Boyd, a social worker and program manager at Developing Families Center in Washington, D.C., says doulas reconstruct some connections that have been lost in minority communities, particularly in African American neighborhoods.
Doulas provide the hand-holding and social reinforcement missing in some minority neighborhoods, Boyd points out. “Doulas also help them discover that they have the capacity and power to made choices about their births and the capacity to mother,” she adds.
Now that Alarcon’s baby has arrived, the conversation with Lally will shift to include more discussions about how a baby’s brain works, and how a baby sees, feels and explores its world. Teen moms also must learn how to balance school with being up all night with a crying baby, how to accept that they are more likely to lose friendships because their lives are changing, and how to handle frustration without taking out their feelings on their baby.
“These are things I will talk to Maria about,” says Lally, whose sister was a teen mom. Lally says remembering what her sister experienced helps her do her job.
In the meantime, Alarcon says she’d recommend a doula to other young expectant moms,
“They make you feel comfortable,” she says. “They listen to you and help you. It’s like having another friend.”
UP NEXT: Venturing into motherhood