MARIPOSA, Calif. – Tynesha Bennett holds a lot of babies as a doula.
But at one Mariposa County home surrounded by acres of tall grasses, wildflowers, and farm animals, she recently found herself holding a very ripe grapefruit.
She was juicing the grapefruits that had piled up on the counter of her client, Jennifer Phipps. The smell of citrus permeated the air as the juice trickled into a metal bowl.
Phipps didn’t have time to eat the grapefruits because she has a newborn baby.
“[She’s] helping me with the project that's stacking up in my life,” Phipps, 42, said.
Bennett poured the pulpy juice into some jars, washed the dishes and wiped the counters. She said she wanted to leave the kitchen clean so Phipps could spend more time cradling her baby, Eva.
Doulas like Bennett, 43, provide support for families from the beginning stages of pregnancy to up to one year after the birth. Having a doula for someone without insurance can cost anywhere from a few hundred to a few thousand dollars.
But Phipps has Bennett. That’s because of a new state law that added coverage for doula services to Medi-Cal plans in 2023.
Phipps is among the more than one third of Mariposa residents enrolled in Medi-Cal. She said she wouldn’t have a doula at all if it weren’t covered by her insurance, and she’s immensely grateful for it now. She said it eased the process, especially being out in the rural Sierra Nevada foothills, with no prenatal care for miles.
“You have a connection that is not like any other connection because she was there at your birth,” Phipps said. “That's something that is so special and so sacred and bonding.”
Easing anxiety
Bennett began working on a birth plan with Phipps when Phipps was five months pregnant. At the time, Phipps was anxious. She had a miscarriage while living in the foothills before, and she was afraid similar challenges would make this birth go awry.
“Because of my age and my past experience having some complications, [I had a lot] of fear and anxiety,” she said.
One added fear was the drive she would need to make in order to give birth.
Phipps knew she wanted to have her baby in the nearest hospital with a maternity ward. For her, that was at Mercy Medical in Merced — the hospital is more than a 30 minute drive away from Mariposa County.
Her travel situation is not unique. Around 150 babies from Mariposa County are born annually.
Most are born at out of town hospitals because the hospital in the county has no maternity ward or prenatal care.
According to the California Department of Public Health, while at-home or freestanding birth center births have ticked up in recent years, about 93% of births still occur at out-of-county hospitals.
As a consequence, Mercy Medical Center in Merced has received the most inpatient visits from Mariposa County residents in years like 2023, even though it’s 47 miles away.
The second closest hospital with a maternity ward is 60 miles away at Adventist Health in Sonora.
Thankfully, Phipps and her husband did make it to the hospital. Bennett was by her side, and helped Phipps make decisions during labor.
For instance, Phipps wanted to have her baby naturally, without any medications used for pain or birth inducing. But Bennett helped her think of an alternative after more than 24 hours at the hospital. She decided to take Pitocin, a medication meant to intensify contractions.
“I could talk to her about it and she understood me,” Phipps said. “I wasn't just a patient… It was a relationship that helped guide me in the situation.”
Now, she and Bennett chat about breastfeeding, baby-related research, and housework. The constant change is what Bennett likes about the job.
“It's always something new,” Bennett said. “It's always an incredible experience, even the really challenging ones.”
Her work is challenging, and she says with Medi-Cal clients, it can be harder because of the time-consuming paperwork and lag between having an appointment and getting a paycheck. But, she recently received a grant that is helping with some of the challenges.
A growing resource, businesses
To help bring more doulas into the Medi-Cal space, the local agency that administers Medi-Cal, the Central California Alliance for Health, started offering a grant last year for doulas. The Alliance covers Mariposa, Merced, San Benito, Monterey, and Santa Cruz counties.
Jessica Finney, the recruiter for the agency, said the financial assistance is meant to support doulas during their first year as Medi-Cal providers.
She said some grants are made out for up to $65,000.
Jessie Dybdahl, the provider services director at the Alliance, said the move to provide these grants came from a push to help local doulas expand their services to families who need it most, but might not have known about it.
“What we found is having the existing doulas that reside in the communities or already have those partnerships with local organizations like the hospitals or different birthing networks are the best fit for the members,” Dybdahl said. “It's really those that already have those foundational relationships that exist with the community and then us coming in to help support them.”
Bennett is using one of these grants now. She said the funding covers the administrative tasks and travel costs involved in working with families. She lives in Sonora, so trips to clients in Mariposa or Merced take up significant time and money.
“It's the research,” Bennett said. “It's responding to texts for my clients many, many, many times a day that I'm not billing for.”
The extra money gave her security, and helped her grow her business. She’s currently helping four families in Mariposa and said she averages 12 to 14 families per year, but she’s not deterred from increasing her clientele.
“I just got really excited knowing that this was going to be a service that was now accessible to so many people who would not even even consider [having a doula], because it is just not within their realm of financial possibility when maybe they're going to be way more concerned about getting food on their plate day after day than having the ‘luxury’ of a doula,” she said.
Doulas give a voice and confidence to mothers
On a recent morning, Bennett met a family outside of Red Rock Inn, a hotel just off the highway in Mariposa.
Christopher Davis, Amber Caywood, and Bennett sat on the room’s bed, taking turns cradling the family’s month-old baby Astraea.
Bennett helped them through labor, too. Caywood said since her last birth was high risk and happened when she was only 18 years old, she didn’t get a chance to hold her baby the way she wished.
This time, Bennett made sure her wishes were met.
“She was able to still give me a voice when I couldn't even make a voice for myself,” Caywood said. “She was my back up.”
Caywood said Bennett is more than a doula — she’s a lifelong friend now.
Bennett believes that as long as moms are supported, she’s doing her job.
“When babies are coming into this world in a safer and more supported way and the families feel safe and supported and informed, it's just going to benefit everybody,” Bennett said.
