Something Was Wrong
S23 E6: Dignified Maternal Care with Doula Melissa Espey-Mueller
Thu, 20 Mar 2025
*Content warning: death, infant loss, pregnancy and birth trauma, medical trauma, medical neglect, racism*Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources ABC’s new show, Familicide: https://www.familicide.net/Melissa Espey-Mueller's North Dallas Doula Associates:Website: https://www.northdallasdoulas.com/ Instagram: https://www.instagram.com/northdallasdoulas/ Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texas:https://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:Best Doulahttps://bestdoulatraining.com/ CAPPAhttps://cappa.net/training-certification/ DONA Internationalhttps://www.dona.org/ Madriellahttps://madriella.org/ ProDoulahttps://www.prodoula.com/ American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ A Brief History of Midwifery in Americahttps://www.ohsu.edu/womens-health/brief-history-midwifery-america CDC, Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/maternal-mortality-rates-2023.htm CDC, Working Together to Reduce Black Maternal Mortalityhttps://www.cdc.gov/womens-health/features/maternal-mortality.html Geospatial distribution of relative cesarean section rates within the USAhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9284873/ In Mexico, Midwives Offer Care Rooted In Ancestral Traditionhttps://www.pih.org/article/mexico-midwives-offer-care-rooted-ancestral-tradition Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison?utm_source=chatgpt.com March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countrieshttps://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Racism During Pregnancy and Birthing: Experiences from Asian and Pacific Islander, Black, Latina, and Middle Eastern Womenhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9713108/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ US Has Highest Infant, Maternal Mortality Rates Despite the Most Health Care Spendinghttps://www.ajmc.com/view/us-has-highest-infant-maternal-mortality-rates-despite-the-most-health-care-spending What is a freebirth?https://www.pregnancybirthbaby.org.au/what-is-freebirth *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag’s original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Chapter 1: What is the content warning for this episode?
Something Was Wrong is intended for mature audiences. This season contains discussions of medical negligence, birth trauma, and infant loss, which may be upsetting for some listeners. For a full content warning, sources, and resources, please visit the episode notes.
Opinions shared by the guests of the show are their own and do not necessarily represent the views of myself, Broken Cycle Media, and Wondery. The podcast and any linked materials should not be misconstrued as a substitution for legal or medical advice. Origins Birth and Wellness owners and midwives, Caitlin Wages and Gina Thompson, have not responded to our requests for comment.
Music
Hey, friends. Firstly, I want to say thank you so much for your support of this season and of the survivors. We are so thankful to hear that many of you have been feeling validated by the survivors sharing their experiences.
Chapter 2: How does the podcast support survivors and nonprofits?
Last week, we had the honor of traveling to the iHeart Podcast Awards at South by Southwest, where Something Was Wrong was nominated for Best Crime Podcast for the second year in a row. To celebrate the day before, we held a small private meetup party to test these kinds of events for the future, and it went incredible.
It was so wild to meet friends in person and experience live discourse, feedback, and community. Thank you to everyone who attended. We hope to host similar events in the future to raise funds for local nonprofits that serve survivors in the cities we visit.
If you're interested in attending an event like this in your city, please let us know in a new or updated review by adding a PS at the bottom and telling us the city you'd like us to visit.
Now, before we get into the more investigative portion of Season 23, the coming together of these incredible survivors and their ongoing efforts to help others, and the ongoing legal investigations of Origen's birth and wellness, we wanted to share a doula's perspective.
A doula's perspective is unique and important because they typically work with birth clients and health practitioners in many settings. As a reminder, a doula is a birth worker, typically without formal obstetric training, who is employed to provide guidance and support to a pregnant person during labor.
We are thankful to Doula Melissa from North Dallas Doulas, who previously worked directly with survivors who were clients of Origins Birth and Wellness Center. I'd like to also thank our associate producers, Amy B. Chesler and Lily Rowe, for conducting this interview while I was unavailable.
Longtime listeners will recognize Amy's voice from season seven of Something Was Wrong, where she shared the harrowing story of her mother Hadassah's senseless murder at the hands of her now convicted brother. Amy, or ABC as we call her, is also the talented host and co-creator of our short-form docuseries show, What Came Next. ABC is an incredible interviewer, host, and human.
The Broken Cycle Media team is thankful to have her important perspective. We'd also like to celebrate and give a shout out to ABC's newest podcast, Famillicide, which she co-created with Sam Mettler, the creator of A&E's hit docuseries, Intervention. Links to ABC's new show, Famillicide, and North Dallas Doulas can be found in the episode notes. Thank you so much.
My name is Melissa S.B. Mueller. I am the owner and founder of the largest doula practice in the state of Texas.
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Chapter 3: Who is Doula Melissa Espey-Mueller and what is her expertise?
I currently serve as a certified birth doula, a certified childbirth educator, a gynecologic teaching associate for Texas A&M University, and I also work as the director of prenatal education at Baylor University Medical Center in Dallas, Baylor Scott & White McKinney, and Medical City of Las Colinas. Those are three hospitals here in the Dallas-Fort Worth area.
I have been practicing as a doula for 25 years and I have attended just over 3,500 deliveries to date. Doulas are held accountable to the highest standards by their certifying agencies. There's usually a program that they will go through to become certified doulas, and those organizations require many different things. Sometimes there's codes of ethics, there's practicing in the scope of a doula.
I certified with DONA, which stands for Doulas of North America. And Doulas of North America is an international certifying organization. That is where I certified initially. And then eight or 10 years later, I did an additional certification with ProDoula, which offered me elite doula certification, which is for people who are more experienced doulas.
So there's a list of things they want you to have in order to have that certification, which becomes a lifelong certification. I personally did both of those things, but there are many other certification agencies that are well known. But what you're looking for when you want to certify is the pathway that fits you the best.
For instance, the doulas who work here with me, many come out of the field of nursing. Perhaps they've been a labor and delivery nurse for over 10 years. And they say, Melissa, I'm really interested in shifting careers and becoming a doula. What do I need to do? I don't know that I would encourage them to go through DONA. There's many things you have to do. You have to do some reading.
You have to write some papers. You have to get signed off by doctors and nurses. That particular person has kind of done all of that and then some. So I might encourage them to go somewhere like Madrilla, which is an online certifying agency, because they don't need as comprehensive a training course per se.
Whereas somebody who's never been in the field, never walked with someone through the birth space, or maybe only walked through it with their sister or their best friend, those people really need something more comprehensive where they're going in and sitting in a classroom with other people who are asking questions. They are learning hands-on. I never sought out to become a doula.
I actually was in school at Dallas Baylor University Medical Center and at the time was a single mom. They were paying for my school and I was working as a hospice care provider. I thought that I would follow through into the nursing career, working in hospice care, which is taking care of people who are transitioning out of this life.
And then my unit closed due to funding and I found myself without a set job there, if you will. So they still employed me and I went to different floors every day, but I was finding that nothing felt quite right. I happened upon an article that was talking about this woman who was a doula. And I thought, wow, that is so interesting. Let me look into this.
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Chapter 4: What role does a doula play during birth?
birth and postpartum doulas provide informational, emotional, and physical support during pregnancy, labor, and the postpartum period. We're not offering clinical support. It's different for everyone, clearly, as far as how long their actual birth is going to take. 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.
But they're not a textbook. So just because early labor is usually more comfortable or manageable, you may not feel that and you may need your doula sooner. But usually we have helped them find ideas of things they can do through early labor.
That might look like if it starts at night, these very sporadic period like cramps that maybe you're going to take a nice warm bath, get a massage and try to sleep as long as you can. Then if you wake up, give me a call. or it might be happening during the day.
And they're like, well, I've got a few things to do at my office, then I'm gonna do a target run, then I'm gonna get a mani-pedi, and then I'll call you. Early labor a lot of times is just staying distracted, resting if you can, or staying busy if it's daytime. But we're talking every one to two hours usually, unless they're asleep. There's a lot of communication.
Once they cross over and they're having more patterned contractions that are making them pay attention and stopping them in their tracks, that's the time we'd like to be with them. The goal in joining them is to be as active as we can. Think about positions that are going to help facilitate progress. progress. We are thinking about how are they doing in their head and heart space?
Are they hydrated? When's the last time they ate? Have they emptied their bladder? How are they managing their pain? We're helping them through all of that and helping to guide them on things like, oh, now we should go to the birth center. Oh, now we should go to the hospital. And then once we get there, whether it's a birth center or the hospital, then there becomes a lot of interpretations.
We're helping them interpret some of the things that are being offered to them or or what they're signing as far as consent forms go, or what they can request as far as amenities. There's a lot going on there. So a lot of times we're joining them around that time when things start to pick up. And then we stay with them all the way through pushing.
And during pushing, we're helping them find productive pushing positions, thinking about ahead of time their recovery, what pushing positions are going to help facilitate less tearing, less drama to the perineum. Have we spoken to their chiropractor? Have we spoken to their physical therapist about best pushing positions? How can we help facilitate that?
Because we've got that knowledge ahead of time and we're all working collaboratively. So we will stay with them through pushing. And then usually about one to two hours post delivery to help initiate feeding. Especially if they're planning to breast or chest feed, like we want to make sure that we're helping them get off on the right track.
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Chapter 5: How does the Texas maternal health system affect birthing experiences?
And that was a disservice to not only the patient or the client, but also to those midwives who were doing their best to learn and receive guidance that perhaps they weren't. But again, this is us just looking through the window. We don't actually know that's true. This is just us having these roundtable discussions about what could we do and what could possibly be happening.
There's all kinds of things. And this is not exclusive to Origins. That could happen anywhere. But that was primarily what our issue was. There were doulas in my group who would say, well, Melissa, should we stop serving clients there? And then another doula was like, they need us to serve them even more. That's the truth.
And on the flip side, too, we had instances where doulas were our clients and came to us and said, we don't want you to be our doula anymore. Our midwife or someone who works at the birth center told us that we don't need you. We don't want to move forward. We were giving people information or more options on kind of questions to ask, etc.
We never, ever are in the business of shit-talking providers. That's just not who we are. So we would never do that. But we do give people questions to ask their provider. If someone comes to us and says, I'm not being heard by my provider, well, we'll talk with them about ways to communicate and things that they could ask.
Or if their provider's recommending something that they're adamantly opposed to, it's a relationship. We want them not to be afraid to have those conversations. will help them find ways to have that. And I think we might've been doing that a little too often.
I don't know, but we were getting people who had paid us and we'd been working with, and all of a sudden they would come to us and say, our midwife told us that we don't need you anymore. And that was really unusual because that isn't something that happens for us often at all, but it was happening there more and more.
To clarify at origins. Yeah. Yeah. What would you say to birthing people, even when they're empowered, they're not quite in the right mind because they're in their birthing brain, if you will. And the trust is then broken through a series of actions that was prioritizing a lower transfer rate than their own health.
You have a birth team for a reason. It's not just you and the midwife. It's not just you and the doula. You usually have also a support person. So that could look like your partner, your sister, your mother, your best friend.
That is someone who ideally is the one that might be coming to your visits with you or doing your childbirth class with you or coming to your doula visits with you and listening to all of your hopes and plans for your birth experience. That person oftentimes is the person that could also help speak up for you in times when you cannot speak for yourself.
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Chapter 6: What challenges do marginalized communities face in childbirth?
If I have to have a backup, I want you to be able to give the person all that info about me, but I want it to be seamless. I want her to take over where you left off. And for me, when I send a backup to a birth, I want them to like my backup better than they liked me so that they will use them next time. They will feel supported.
They never missed me at all because they got exactly what they needed from that backup doula. So that's very important. And then I would wanna know, do they charge money? Because you might think, well, maybe someone would love it if their doula said I'm free or $100, but it's hard to sustain being a professional doula if you don't charge money.
You have to charge money in order to keep up your credentials, to pay for insurance, to pay for gas in your car, to pay for your phone so that they can call you, to pay for your website, to pay for your continuing education hours, to pay for childcare, your food, et cetera. Those are some of the questions I personally think are important when searching for a doula.
And of course, doing your own research, taking ownership of your birth, go and read their reviews, look at their website, look at their social media, see if you align with them and their energy is something that you would want in your birth space, because that's also very important. That's a very sacred space and you want to be protective of it.
What questions would you ask prospective care providers before hiring them? Do you advise people to have a doula in the birth space? Are you a provider that works collaboratively with a doula? If that person says no, if that person says you don't need a doula, you'll just have me, that person likely doesn't want you to have more information than you need.
Because a doula is there to give you options. That provider might say, hey, let's try this plan A. And your doula might say, oh, well, that's great. You could do that. But you could also speak to them about if they would be willing to let you try B, C, and D first. And you go back to that provider and ask that. And they say, we'll give you some time to do that. I hadn't even thought of that.
But yes, we can do that. Because providers who work with doulas routinely and are accustomed to it, they are not offended by that at all. It can be helpful to bridge that gap. And then if I was asking questions to a prospective physician, I would want to know what is your personal C-section rate? What is your episiotomy rate? What is your induction rate? Do you practice evidence-based care?
And what does it look like at the facility where you deliver or where you have privileges? Are you, as the provider, telling me you're low to moderate risk? You can have intermittent fetal monitoring. You can eat during labor. You don't have to push on your back.
Yet you get to the facility and that provider is only coming at the end of your delivery and the facility's policies are you need to be monitored continuously. We don't let you eat food here. You need to be back in that bed. All of those things that you were hoping for are now changing because you didn't think about the facility. You only thought about the provider.
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Chapter 7: What is the relationship between doulas and birth centers like Origins?
I would like to add, if somebody asked me, Melissa, what do you think is the most important thing for me to do prior to giving birth? I would say that it is to become as informed as you possibly can. I tell all of my clients, you have to take ownership of this experience. remember that nobody cares about it as much as you do.
So if you're finding yourself in a situation and you think, well, you know, it's too hard to switch providers now. I don't feel comfortable. This gives me a red flag. Maybe I'll just wait until my next baby and I'll do something different. We would never do that if we were getting married and we were planning our wedding.
We'd never say, if this wedding doesn't turn out the way that I want it, with my next one, I'm going to do X, Y, or Z. We have to realize that as people giving birth, nobody else is in charge of it. We are the ones who are in charge of our birth space, our birth team. And hopefully when we get as much information as we possibly can, our experience will unfold closer to the way that we had hoped.
birth again is unpredictable. It's an initiation into parenthood. So there's surprises along the way, but they don't have to equal trauma. So I would just say, find a good childbirth class, hire a doula. So that would be my one piece of advice that I would want to leave you with.
Thank you so much. It was all vital information for the listeners.
Next time on Something Was Wrong.
I definitely heard that my situation was talked about and that it wasn't the first time that something like this has happened. This was just something that I learned after building a community and after talking to more people and hearing stories.
It was a few women that had joined first. It was a little quiet at first. Nobody was really saying their stories or anything. But then we started getting more and more people joining or trying to join our group. I messaged Markita.
I knew something terrible had happened, and I just didn't know what it was. It had to have been a couple days later. She left her review. That's when she was talking with Kristen. Kristen created a survivor's group on Facebook that has reached 40-plus women now that have all had traumatic births with origins.
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