Tasha Allen Story Transcript

My name is Tasha Allen. I am a registered nurse. I currently am a case manager for high risk pregnancies, I have worked with Duke midwives for many years, ever since maybe 2004-2005.

From food insecurities, to domestic violence, to a bad experience at the doctor’s visit, to having a problem with DSS [Division of Social Services] and not being able to reach somebody. I mean, every day, we’re constantly putting out fires and problem-solving. I was a staff nurse in the prenatal clinic, or the OB clinic, as an employee of the Durham County Health Department, and our providers were the midwives.

But we at Lincoln at that time were a small group, with very few resources and support. And I don’t say that to undermine the Health Department, but we weren’t located right there with everybody else. So, we only had each other as a team. And for the most part, we were like family. So everybody capitalized on each other’s strengths, and we knew what buttons to push, what not to push. The midwives were totally awesome in not having the “big I”, “little you” perception of a staff.

Midwives don’t stop with the medication. They [say], “Hey, this lady said she doesn’t have diapers.” Or, “She mentioned that she missed a couple of meals because she wanted to feed her kids.” They were very in-tune when listening to the ladies, listening to the clients. And they typically would take it to another level of – how can we refer this person to get more help? Is there anybody in Lincoln that can provide a service to help them?

So in clinic we worked with midwives, and in Centering we worked with midwives, we co-facilitated with them. Unless you’ve got some really, really serious complications with your pregnancy, it’s the way to go. Because it’s empowering. It’s informative. It gives the moms some autonomy. And I feel like the nutrition information, all of the information that they received during their Centering [curriculum] is life-changing information. So after you have your kid, you still have that information about nutrition, you still have that information about normal blood pressure. It’s ongoing. And so for that mom – a lot of our moms are single moms, so I’m just gonna say they’re the head of the household – it could potentially change how they’re parenting their kids, what they feed their kids, and things of that nature. So then you’ve got a healthier family. Then the snowball effect is that if we have healthier families, we have healthier communities. So in terms of Centering, I think it’s an ongoing benefit.

They get to spend time with the nurse-midwife individually to talk about private concerns. But then we have this moment of circle time, I guess you could call it. And we talked about things that are relevant to the pregnancy as a group discussion. So if it’s early on we may talk about some do’s and some don’ts in regard to foods, hot tub baths, [and] things of that nature. And then as we progressed we have a curriculum but we let the clients – it’s their group. We have women that come in that are from different cultures, different ages, and different geographic locations. So there are oftentimes discussions that give way to appreciating somebody who looks different [or] talks different, in that sharing between the group creates a rapport where the women actually start being concerned for one another and keeping in touch with one another. It’s amazing to me.

In a regular clinic setting the fathers of babies would come and accompany the moms. They sit in a room – this is just my observation, and this is a blanket observation, not everybody all the time – and they’re there. But it’s almost like they’re invisible. Some of the Hispanic men, I think they, and black men, tend to feel more invisible when it comes to prenatal care. The provider comes in, they focus on the woman. And the guy is just sitting there. It’s not really inclusive. So what we learned is they’re a team. In Centering they’re a team, this is their support person. So they have feelings, too. They have questions, too. They’re being affected by this, just as much as the mom. It may be [affecting them] financially, physically, [or] emotionally. So working with the partners was great.

Having a second set of ears and eyes, so when you go home, you and your partner both have a good understanding of what this pregnancy looks like, and the progression thereof. That was a big plus, because it was very inclusive of a support person. We did a lot of fun activities, like we would have the support person come in when the moms are good and round and say, “Okay, paint a picture on the belly.” We had paints that were sensitive to skin. And you would have, like if it was a boy, the father of the baby’s got this big ol’ blue UNC basketball on there. If it was a girl you’d see flowers and ballet slippers. And so they get to use their imaginations, and kind of bond with the baby before the baby even gets here. So there’s lots of activities, lots of education, rapport, and trust and consistency between the providers and the patients and the nurses. It’s amazing.

Read a transcript of the full interview here.