Child Care 101

Chris Morley and her husband planned for three years, but nothing prepared them for the upheaval that arrived with the birth of their daughter in 1986.

“I was completely unraveled,” said Chris, 41. “I had an avalanche of questions, but there was nobody to help.”

In times past, relatives and friends usually helped new mothers with cooking, cleaning and child-care advice. But with society more mobile and families living farther apart, many new mothers today have little such support. Lack of assistance after birth is a common complaint among mothers, health-care providers say.

Morley began searching for a solution and discovered the concept of the “doula,” the Greek word for “laborer” that has come to mean “a mother’s helper.”

She founded Tender Care, a Valencia-based doula service that recently began selling a $25,000 training-and-curriculum package to hospitals around the country. Included in the fee are Morley’s consulting services. The one-year contract gives the hospital exclusive use of the Tender Care program in its geographical area.

In a move applauded by maternity educators, five Southland hospitals recently began offering the program. Two other local hospitals are negotiating with Morley.

“My goal in life is to change maternity care as we know it,” said Morley, Tender Care’s president. “I want to make doulas available to every woman who wants one.”

Although Morley worked hands-on as a doula for nearly a decade, switching to consulting enabled her to broaden her outreach, she said. Her one-woman company is the first to sell the concept to hospitals in Southern California.

Doulas are not nannies, who care specifically for children. Instead, they focus on the mother, enabling her to attend to her newborn. They instruct her in breast-feeding, run errands, cook and clean--all to ease the transition to motherhood. Labor doulas, who offer support during delivery, are a related profession.

Doula services are booming. The Doula Organization of North America, which refers clients to labor and postpartum doulas, has seen its membership skyrocket from 85 in 1992 to 1,800 this year. The National Assn. of Postpartum Care Services, a doula trade group, lists 250 doula agencies nationwide.

Although there are no estimates on how many of these mothers’ helpers work in California, representatives from the national organizations said the East and West coasts have the highest concentrations of them.

Doulas work with families from one to four weeks, about four hours a day, and generally charge $16 to $25 an hour, plus a $25 initial consultation fee. Morley said 15 hours of care over five days averages $300 for the hospital-based and independent doulas.

Typically, doula agencies are small operations--five to 30 employees--and are not affiliated with hospitals. In most states, insurance companies do not cover doula care and no states currently license the agencies. The national organizations investigate grievances but lack policing power.

The desire for accountability motivated Morley to create hospital-based programs. Tender Care sells its program to the institutions, which then recruit, train and hire the doulas. The hospitals also certify them and monitor performance, Morley said, and run criminal background checks on prospective employees.

The one-week Tender Care program includes instruction on cardiopulmonary resuscitation, breast-feeding, detection of warning signs and other child-care issues.

This fall, five hospitals--Hoag Hospital in Newport Beach, Santa Monica-UCLA Medical Center and Little Company of Mary in Torrance, plus its affiliates, San Pedro Peninsula and Bay Harbor hospitals--rolled out Tender Care programs. They joined hospitals with Tender Care programs in Cleveland and Bowling Green, Ky.

The hospitals added doula services as part of a trend in expanding home-based care. Little Company of Mary and its affiliates already offer one free visit by a registered nurse to mothers. Santa Monica-UCLA gives eight free hours of doula service.

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Despite a state law passed Aug. 27 that requires medical insurers to provide a 48-hour stay after childbirth, mothers often go home exhausted.

“They need someone to help with the basics, to help build confidence,” said Lori Fernandez, program manager for obstetric education at Hoag Hospital.

Irma Essick, 42, found her doula invaluable. Although husband Benny Sommerfeld, 37, took a three-month leave from work, both first-time parents were overwhelmed after the birth of daughter Naomi on Oct. 12.

“I didn’t know that recovery would be so draining. I thought, ‘Within a week, I’ll be managing.’ Two weeks later, I was still sore,” said Essick, of Thousand Oaks.

For two weeks, Sharon Campion, a Tender Care graduate from Santa Monica-UCLA, taught Essick breast-feeding and postpartum care. Campion also cooked and shopped, freeing the parents to bond with the newborn.

“We called her a mom with no issues,” Essick said, chuckling. She said Campion could offer her objective advice without the hindrance of often-emotional family dynamics.

“It’s a way of giving back, using my life experiences and perspective,” Campion said. The 53-year-old Los Angeles mother of two had been intrigued by the help-wanted ad placed by Santa Monica-UCLA: “Women interested in educating and nurturing new mothers.”

Santa Monica-UCLA, which delivers 175 babies a month, hopes that mothers will extend service past the free period. The hospital also wants to provide services to patients who delivered at other hospitals, said Dana Refano, director of maternal child health services at the hospital.

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Tender Care’s Morley hopes to expand her programs further. The company is negotiating a contract with Columbia/HCA, the nation’s largest hospital company. To meet training demands, Tender Care will open a Los Angeles center in the spring, enabling Morley to train up to 10 hospital staffs per month.

Morley is proud of her success.

After the 1994 Northridge earthquake, she almost gave up. When business slowed, she had to close Tender Care, and she considered switching to a teaching career. Then she reconsidered and reorganized her company.

“I thought, ‘I can’t walk away from this. I live and breathe this every day,’ ” Morley said. “I paved the way.”