Summary of "Something Was Wrong"
Episode: S23 E6 – Dignified Maternal Care with Doula Melissa Espey-Mueller
Released: March 20, 2025
Host/Author: Broken Cycle Media | Wondery
Introduction
In Season 23, Episode 6 of Something Was Wrong, titled "Dignified Maternal Care with Doula Melissa Espey-Mueller", host Tiffany Reiss delves into the critical role of doulas in maternal care, particularly within the Texas healthcare system. This episode features an in-depth conversation with Melissa Espy Mueller, a seasoned doula with over 25 years of experience, who sheds light on the challenges and systemic issues faced by birthing individuals, especially those from marginalized communities.
Meet Melissa Espy Mueller
[06:04]
Melissa Espy Mueller introduces herself as the owner and founder of North Dallas Doulas, the largest doula practice in Texas. She holds multiple certifications, including Certified Birth Doula and Certified Childbirth Educator, and serves in various educational roles at institutions like Texas A&M University and Baylor University Medical Center. With over 3,500 deliveries attended, Melissa emphasizes the high standards and ethical responsibilities doulas uphold.
Melissa Espy Mueller: "Doulas are held accountable to the highest standards by their certifying agencies." [06:04]
The Role and Responsibilities of a Doula
Melissa elaborates on the multifaceted role of doulas, which includes providing informational, emotional, and physical support during pregnancy, labor, and the postpartum period. Unlike clinical support, doulas focus on guiding clients through the birthing process, offering comfort measures, and advocating for the birthing person's wishes.
Key Points:
- Support During Labor: Doulas assist with pain management techniques, hydration, and positioning during labor.
- Advocacy: They help interpret medical information and consent forms, ensuring clients understand their options.
- Postpartum Care: Doulas support the initiation of breastfeeding and early bonding between mother and baby.
Melissa Espy Mueller: "We spend a lot of time with people on the front end, guiding them through what the phases and stages of labor might look like..." [14:30]
Challenges in the Texas Maternal Health System
Melissa discusses the broader systemic issues within Texas's maternal health landscape, highlighting racism, inadequate oversight, and the dismissal of Black and Brown women in birthing spaces. She shares personal anecdotes of facing blatant racism and the consequent need for doulas to be extra protective and supportive of their clients.
Key Points:
- Racism in Healthcare: Melissa recounts instances where racial biases adversely affect the care and treatment of birthing individuals.
- Lack of Accountability: There is a significant gap in regulatory oversight, leading to inconsistent care standards.
- Midwifery Challenges: While midwives play a crucial role, they often face systemic barriers, including unfair wages and lack of support.
Melissa Espy Mueller: "Black women are dying at an unimaginable rate. It's something that no one person can take care of alone..." [20:26]
Relationship with Origins, Birth and Wellness
The episode delves into Melissa's professional relationship with Origins, Birth and Wellness, a birth center that has undergone ownership changes affecting the quality of care. Melissa notes a shift from an intimate, training-focused environment to one prioritizing higher volume, which has led to increased transfers and suboptimal outcomes for clients.
Key Points:
- Shift in Ownership: Transition to new management altered the center’s dynamics and care quality.
- Increased Transfers: Pressure on midwives to reduce transfer rates compromised client care.
- Community Response: Doulas organized roundtables to discuss and address these issues collectively.
Melissa Espy Mueller: "We are having these issues where there's this care that people are not at bare minimum practicing standardized care as midwives, it's kind of ruining it..." [27:46]
Advocacy and Client Empowerment
Melissa emphasizes the importance of empowering birthing individuals to take ownership of their birth experience. She advises clients to become well-informed, ask critical questions, and ensure their birth team—including doulas and midwives—supports their wishes.
Key Points:
- Informed Decision-Making: Clients should be educated about their options and potential interventions.
- Communication with Providers: Effective dialogue between birthing individuals, doulas, and medical providers is crucial.
- Backup Support: Ensuring that there are backup doulas available to maintain continuity of care.
Melissa Espy Mueller: "You have every right to ask any and all of these questions, and you should." [38:34]
Advice for Hiring Doulas and Midwives
Melissa provides practical guidance for prospective parents on selecting qualified doulas and midwives. She highlights the importance of verifying certifications, experience, and the ability to collaborate effectively with other birth team members.
Key Points:
- Certification and Training: Confirm the doula’s training background and ongoing education.
- Experience: Inquire about the number and variety of births attended.
- Backup Plans: Understand the procedures if the primary doula or midwife is unavailable.
- Philosophical Alignment: Ensure the providers’ approaches align with the client’s birth preferences.
Melissa Espy Mueller: "What does that look like for you? What have you attended in the past?..." [38:34]
Conclusion
The episode wraps up with a heartfelt reflection on the need for standardized, dignified care in maternal health. Melissa underscores that improving birth experiences requires collective accountability and a commitment to honoring the voices and autonomy of birthing individuals.
Melissa Espy Mueller: "If we are in the middle of the birth space and we are hopeful for a normal natural vaginal delivery with no trauma and drama, but the body or the baby is telling us something different, then we have to listen." [52:15]
Final Thoughts
"Something Was Wrong" effectively highlights the indispensable role of doulas like Melissa Espy Mueller in advocating for better maternal care. Through her experiences and insights, listeners gain a deeper understanding of the systemic challenges in the Texas maternal health system and the critical need for compassionate, informed, and equitable birthing practices.
Notable Quotes:
- Melissa Espy Mueller: "Doulas are held accountable to the highest standards by their certifying agencies." [06:04]
- Melissa Espy Mueller: "Black women are dying at an unimaginable rate. It's something that no one person can take care of alone..." [20:26]
- Melissa Espy Mueller: "You have every right to ask any and all of these questions, and you should." [38:34]
- Melissa Espy Mueller: "If we are in the middle of the birth space and we are hopeful for a normal natural vaginal delivery with no trauma and drama, but the body or the baby is telling us something different, then we have to listen." [52:15]
This episode serves as a crucial resource for anyone interested in understanding the intricacies of maternal care, the importance of doula support, and the ongoing efforts to create a more equitable birthing environment.