Meet the Labor & Delivery nurse leaving the hospital to serve families in Fort Wayne

Most of my life, I’ve planned on having children “someday” and thought I had a somewhat realistic picture of what those early weeks of newborn care might look like. I pictured the late-night and early-morning feedings, the coffee-fueled slog through the afternoon and rocking a crying baby to sleep. What I didn’t picture was doing it all while trying to recover from abdominal surgery.

When my son was born by an unplanned C-section in the wee morning hours of January 7, my picture of what this "postpartum" period would look like was turned upside down. I was barely able to walk or sit up straight, let alone help my partner with mounting household chores and baby care. (How do single mothers do it?)

When I talked with friends who delivered babies vaginally (and were even athletes before giving birth), they expressed similar challenges. “I was so much more sore and physically restricted than I imagined,” was the general consensus.  

This common refrain inspired my husband and I to start asking questions about a lack of postpartum care for women and families in the U.S. In other cultures — even primitive societies — there seems to be more of an “it takes a village” mentality when it comes to raising children and families. In some hunter-gatherer societies, as many as 14 people (not including the parents) look after a single newborn each day. And in modern, communal societies, like the Netherlands, a kraamverzorgster, or home maternity nurse, comes home with the newborn for eight to 10 days after birth.

When my husband and I were leaving the hospital on our fourth day post-partum, he remarked how nice it would be if we could take a member of the nursing staff home with us to help. So when I saw a press release for a new small business in Fort Wayne started by a BSN-RN, seeking to help families make that daunting transition to parenthood via private consultations, I was curious to know more.

It’s called Empowering Families, LLC, and it works not only with inexperienced young families like ours, but with parents and families of all types in Fort Wayne, providing non-judgemental, evidence-based education on family planning, pregnancy, postpartum, childcare and more. In fact, Owner-Founder Donielle Krempel, BSN-RN, of Fort Wayne says providing this type of inclusive, universal support — without restrictions on what types of families can participate — is a core reason she started Empowering Families LLC in the first place.

“Too many programs limit or decline families based on income requirements, visit volumes and gestation dates you must sign up by to participate, etc.,” Krempel says. “Empowering Families has no restrictions on how much or little a family’s income is, or how many visits families can choose when they choose to sign up. We don’t just serve mothers and fathers; we serve families of all kinds. For example: Grandparents parenting for a second time, single parents, teenage parents, childless families, adoptive families, the highly educated, foster families, stepfamilies and any other family structure you can think of.”

In other words: If you have, or are planning to have, a child in Fort Wayne and have questions, or want to make sure you are secure in your knowledge, Empowering Families might be able to help you. What’s more, data from 2022 indicates this type of support is desperately needed in Indiana. In fact, our state has the 7th highest infant mortality rate in the U.S. at 7.16 and the 3rd highest maternal mortality rate at 44 deaths per 100,000 live births. 

So what's contributing to these statistics, and how can an organization, like Empowering Families, help? We sat down with Krempel to find out.

Tell us more about yourself: How long have you lived in Fort Wayne, and what was your experience like as a nurse and mother here prior to launching Empowering Families LLC? 

DK: I moved from a small southeast Ohio town called Coolville to Fort Wayne in 2009 for nursing school. I started out at Ivy Tech Community College, where I obtained my associate degree in medical assisting and my phlebotomy certificate while taking my prerequisites for my nursing degree. I transferred to the University of Saint Francis and graduated in 2015 with my Applied Science in Nursing Degree. I began my nursing career at Parkview Hospital in the ICU and then transitioned into Labor & Delivery, as it had always been my goal to become a maternal health nurse. 

As a nurse, I saw many gaps in our healthcare systems in labor and delivery and knew that working within the hospital would not fulfill my need to do and prevent more. I met my husband in 2010; only a year after moving to Indiana. As a mother, I felt similar gaps when my daughter was admitted to the NICU after birth and continued concerns I had with breastfeeding.  

Tell us more about some of the challenges you ran into as a young mother – even with experience working in Labor & Delivery. 

DK: I moved to Indiana without knowing a single person. I was and continue to be relatively good at making friends, so I knew I would not be alone for long. I was a college student, and I was up for the adventure. I honestly did not think Indiana would become my home. I also was attempting to separate from unhealthy family relationships that had caused me much distress since I was a young child myself. Indiana felt like the right place to distance myself from unhealthy family relationships, so I moved in May of 2009. I met my husband through mutual friends at the University of Saint Francis, and we married in 2013. We were young and had a lot to learn about ourselves and of course, our to-be children. My husband had not had much experience with babies, and other than my Labor & Delivery experience and nursing education with children, I did not have the slightest clue what life may look like or what to expect with having a baby and having children.  

My husband’s family and I became very close over the years. Without their understanding and support, I can honestly say I would not be the mother and wife I am today. Not all daughters-in-law can say that, but I was lucky enough to gain a wonderful supportive husband and in-laws who supported, guided, and loved me for who I was. A year after my husband and I married, my mother passed away, leaving me without the person that I expected to help me with all the questions I had about becoming a mother prior to having my first child. I was devastated, but again, my husband’s family jumped right in and helped me through all my stages of grief. 

In January 2015, I went in for my annual exam to my gynecologist to talk about preparation for conceiving a family. I got a call a week later that something was wrong with my exams and that I would need to come in for more testing. I was still in nursing school and the thought of more testing placed a financial strain on our already modest family income. I contemplated not going. “It can’t be that bad, right?” is what I thought to myself. 

My nursing brain, husband, and friends all urged me to just go get the testing, to not worry about the money, and to just do it to make sure I was fine. I got a call a few days after my testing and I had to sit down. I was diagnosed with adenoma-carcinoma inside my cervix. I was 25 and just on the brink of starting my career and possibly a family. I was devastated. My obstetrician at the time recommended a surgery. After the surgery, I still had positive margins, meaning I still had the cancerous-causing cells. My OB referred me to an oncology specialist, they were trying to preserve my fertility while still removing the cancer. My oncologist performed another surgery and felt we had cleared the margins. However, I had minimal cervical tissue left and still ran a high incidence of the cancerous cells growing back and spreading. They performed one more surgery to double-check that it was eradicated before telling my husband and me that time was of the essence to conceive our first child. This was not our timing. We had plans — plans to save; plans to establish ourselves; and plans to prepare for a child. However, the risk was my life, and we decided that, although we were not “ready,” we would become “ready.”  

I had to have one more surgery due to not having much of a cervix, which is vital to carry a viable pregnancy to term. I had what is called a TAC (Transabdominal Cerclage). A cervical band that is permanently placed through my abdomen to be able to keep my potential pregnancies inside my womb. The only doctors at the time who performed this very rare surgery that were close were in Chicago and Indianapolis. However, I was introduced to my wonderful and skilled Obstetrician Dr. Steven Tanner, who vowed he could perform this surgery to the best of his ability and get us in sooner than what Chicago and Indianapolis experts were able. We chose him, and the surgery was performed in November 2016. We found out we were pregnant with our daughter in January 2017. 

How did your first pregnancy go?

DK: The pregnancy, I felt at the time, was so stressful. “Would the TAC hold? Do I have cancer growing? Will I make it to term?” 

My anxiety got the best of me during this pregnancy. I was on many restrictions. I did not go out much. I was only able to work so many hours, no strenuous activities, contractions were dangerous, etc. I did not realize it at the time, but I had depression during pregnancy. It was difficult and isolating. My family was so supportive, but I did not realize I could become depressed during pregnancy. That only happened after, right? 

I never discussed it with anyone, I just kept it inside, and it ate at me. I set small goals, and every time another week passed, my anxiety lessened a little more. I needed someone to come alongside me and say “Hey, you know what? You are a rare case. This can be hard. You are a risk for pregnancy-related depression. There are things you can do to help this. If you have limitations for those things, we will do something to help improve it for you.” I needed an Empowering Families nurse. Just that little bit of non-judgmental confidence and expertise would have saved me so much silent suffering. 

Our daughter was born at 35-weeks gestation. This made her be considered premature. She was 6 lbs 4 oz via urgent C-section. She was swooped away by NICU without me ever getting to hold her. I spent all this time attempting to “make it this far,” to not be able to see her more than 10 seconds. I was panicked: Where was she going? Was she okay? Someone tell me what’s going on. Can my husband go with her? We were not prepared. 

I worked in Labor & Delivery at this time, and I was still not prepared. We spent an agonizing week battling with doctors over what we wanted for our daughter versus what was required by the “hospital protocols.” (Many of these protocols have changed for the better, but not all of them.) Seven long days, and our daughter was able to go home, which brought with it a whole new set of questions: Is our car seat right? What do we do when we get home? How do I best introduce her to the dogs? Will she ever latch? 

There were so many barriers to the things I needed. I needed a nurse to come to my home to help me with lactation. I needed someone to come and allow me to catch up on rest. I barely slept in the hospital due to being separated from our daughter and worrying about her being alone in NICU. I did not want my husband to leave her or me, but he could not be in both places at once. 

We were at home, and the Googling and friend asking started. We muddled our way through parenting, but it could have been so much better, had I known I had the most updated and informed information to know we were making the best choices for our family. 

How did your second pregnancy go?

DK: Everyone remembers, and will always remember the year 2020, as the day the world stopped. I remember it for the wonderful pregnancy I had! We were told we needed to have another baby if that’s what we desired, as a hysterectomy was recommended for me as soon as possible to prevent the cancer from growing and spreading. I had become knowledgeable in lactation, car seats, perinatal mood disorders, newborn care, childcare, family leave, partner support, doulas, many resources, and ways to prevent unwanted health outcomes. We had our son, and we were armed with all the information and power Fort Wayne had to offer and more. The pregnancy, the postpartum and the newborn period all went smoother, and I was feeling really good about the decisions we had made.

However, not all those decisions came easy. There were still many gaps in receiving knowledgeable medical care from many medical staff, still being a high-risk pregnancy and reaching out to places to see if what they provided was what we were looking for. It was very time-consuming, considering my husband and I were both working full-time and helping take care of our small family. I know that we did it; we can all do it. As parents, we have an innate want to protect our children, and we will do whatever it takes. Empowering Families, LLC was born to help us all do it all a bit easier.  

Tell us more about some of the strain on the current healthcare system that makes it hard to meet challenges for pregnant women and young families. 

DK: I have seen and heard many people say that the medical system is failing them. I hear it time and time again. Pregnant women and young families find that the medical systems in place in the U.S. and Indiana fail them, as well. Although the healthcare systems have many facets that need improving, the biggest concerns and complaints I have and continue to see are:  

1. Quantity of providers: We are pretty lucky in Fort Wayne; a lot of rural counties do not have as many options for providers as we do. However, we still don’t have enough. We have offices pushing out many months to be able to see a provider, and if you miss an appointment because you are a busy parent, you may have to wait even longer. 
2. Time: Time is an interesting concept. It is so powerful. The most important thing in life is time, and it’s the one thing you can never get back once it’s gone. (My dad taught me that right before he passed.) Most healthcare providers are still receiving payment for the quantity of patients they see, not the quality of care patients are receiving, causing depersonalization of care and discoordination of care for many patients and families. Evidence has shown that the more time a provider spends listening and discussing with patients, the better understanding between the two will be, and the better outcomes will be as the provider assesses more than just the initial issue. However, the majority of our systems do not allow for enough time for providers to fully assess all needs and questions during visits to them, leaving families with many questions unanswered, having to call back in and sometimes not getting a timely answer, and then utilizing Google to get answers that may not be accurate or helpful. 
3. Childcare: For young, working families, childcare is a huge stressor. Most of the time, this is just a quick question at the doctor’s office: "Do you have childcare? Where do they go?” And a box is checked. But many parents have many questions on initial searches throughout their young child’s life, such as: How to find reliable childcare, what type of childcare options are there, where to look, what are average prices, how to find a person who jives with your family, how many hours you need childcare, what should you expect, what types of questions should you ask, etc. These are all great questions. It may take you multiple hours to Google and read through each article, blog, etc. Is the information you looked at correct? How can you be sure? Now, after parents spend all that time researching, they need to contact some of the places they looked at. 

These are just a few topics an Empowering Families nurse can assist you with by helping you determine your needs, giving you trusted information, local resources, and guiding you to help ask the right questions. 

What are some other differentiators of Empowering Families services?

DK: I like to think of myself not just as a nurse, but as a social and medical worker who utilizes prevention and her resources to best provide care. I may not know the answer to everyone’s questions, but I will make sure I find the answer for them, or get them pointed in the right direction to make their parenting journey that much easier. I am a human, just like anyone else, but I have a grand amount of knowledge and insight to share with our local families to prevent and improve pregnancy and childhood outcomes. If something is not working for my clients in my practice, you can guarantee I will be changing it to fit the need. 

You offer 60-90 minute consults on a variety of topics, from pre-birth planning to newborn care and mental health. Can you walk us through how a consult might go?

DK: Initially, the client is referred or signs up themselves through Empowering Families LLC website under “Bookings.” They choose their generalized consult, package, or class.  

1. The client signs up for virtual (phone or video) or in-person at the client's home or a place of the client's choosing as well as the date and time that works for them and their nurse. 
2. They pay their deposit.
3. They receive an email and text confirmation. 
4. They then receive their agreement form, which they fill out and agree to receive services and verify what consults they have signed up for. 
5. They then receive an “Intake form.” This is where the visit becomes specific to the family’s needs. Clients get to choose a more specific topic within their consult option to discuss during their visit with their nurse. I take clients time very seriously and want to make sure they get exactly what they are looking for. 
6. On the day of their visit: The nurse either sends an invite or shows up to the agreed-upon place for the visit. 
7. Their nurse asks a few questions, but most importantly listens to them. Their nurse wants to know what is most important to them. Based on this assessment, the nurse may assess their blood pressure, weight, and or their child’s weight; discuss recommendations; or offer reassurance, practical help and referrals based on the consult topic and what was discussed during the visit. 
8. The client receives curriculum resources and referrals and is able to continue with their normal routines and implementing what they feel is best for them and their family.  

The internet can make it both easier and harder to care for babies with so much information available online. How does your business help families find reliable information and avoid misinformation? 

DK: I am a bachelors-prepared nurse and can say that there is a lot of great information out there for families. I love to Google! However, families need to know what information actually has research behind it versus someone just telling them something that could be harmful for them or their family. Sometimes, something that appears so simple to try can be very mentally or physically unwell for families. Empowering Families helps you understand the information gained from Google and verify, or make other recommendations, so families feel secure in their choices. 

Being a new mother myself, I was surprised by the lack of postpartum care compared to pre-birth care I received. Before I had my baby, I was going to my provider for weekly checkups. But after having my baby and being discharged from the hospital, I was told to “self-monitor” at home for surgical and mental health issues until my six-week checkup. Six weeks feels like a long time. Is this a response you typically see from new mothers/parents about that post-partum period? What are things you commonly see new parents saying and experiencing? 

DK: I have been fighting for better postpartum care for as long as I can remember being interested in maternal health! Postpartum care has standard recommendations from ACOG, but it is mostly up to the provider on what they feel is “best,” which, again, if you are getting paid for quantity versus quality, most providers don’t see a need for it, as most of the time, post-postpartum care is making sure the parents are taken care of so that the baby is taken care of (which is SO important though right?!) But how would they bill for that?

Our community's cultures have changed so much over the years, and this leaves many parents feeling overwhelmed and not as cared for when it comes to postpartum care. New parents are experiencing exactly what you experienced. Personally, I hired a postpartum doula for the birth of our second child, and it was the best thing we ever did for ourselves. However, many parents don’t know about the change in care after having a baby and issues that can ensue until after going through it at least once. Extra support is necessary for most families during this fourth trimester, and we need systems that reflect our community’s needs.

My husband and I have talked about other countries, like the Netherlands, that send new parents home with a nurse from the hospital after having a baby. What do you think of other systems for newborn/family care, and how do they compare to our local models?

DK: I am all about sending families home with a nurse! Wow, how great that would be? Honestly, I think as a society, we think parents of multiple children have their stuff together, which is not always the case. Information is ever-changing, and parents of multiple children can use support, reassurance, updated education and resources as much as the first-time parents, as well. I am all about prevention. Prevention is health. Many healthcare and social issues are preventable, or at minimum, intervenable to prevent long-term complications. Families in the U.S. need more people to support them, to tell them they are doing a great job. One of the key components of Empowering Families is to come alongside families and support and encourage them when they need it. I feel the implementation of sending a nurse home with parents after birth could reduce many of Indiana’s poor maternal and infant statistics, along with decreasing cost in the long run for healthcare systems.

As you alluded to, Indiana has the 7th highest infant mortality rate and the 3rd highest maternal mortality rate in the U.S. What factors have you seen that might contribute to these statistics, and along with your business, what broader healthcare changes are needed to reverse some of these trends? 

DK: These statistics weigh heavy on my heart and mind. Each one of these statistics was someone’s child. Many of these stats reflect our fractured healthcare system, as previously discussed. It all comes down to quality and prevention. If we have quality, then prevention can take place in many instances. If we lack quality in time, understanding, listening and unbiased personalized care, then we are going to see these numbers continue to climb. Government officials and administrators of healthcare systems know they can improve these statistics; I feel they are not asking their providers (those seeing the patients) the right questions. 

In my opinion, we have made some improvements, but a huge step in the right direction would be if providers had a stronger voice than those currently making the healthcare decisions. Then changes would reflect the idea that most providers get into healthcare to make a difference in others’ lives, and we would see an increase in quality, if providers were able to be given what is necessary, which is time. 

Speaking of time, many working parents have limited or no paid leave after having children. How does this contribute to challenges with postpartum care, and how does your business serve working parents?                    

DK: I recall educating families in my community health position (prior to beginning Empowering Families LLC), that they should look for positions that offer paid maternity leave. Families don’t realize it’s importance until it is necessary. We need to consider that our local and American culture is changing. For many reasons, many families have moved away from family values where new families were supported from previous generations that had gone before them in having and parenting children. Families do need support. Many starting families do not have the support that our previous generations had. But society has not changed much to reflect this decrease in support many are feeling. The saying “it takes a village” is still true, but that village just may look different. This gap in guidance leads families to tangible, internal and financial struggles between work and family.

I have seen many families request to go back to work prior to their six week recommendation to return to work, due to their needing the money. I have also seen families decide not to go back to work at all to not have to deal with the stressors, which crushes our economy. The support system for working families is broken. It is, and has continued to be, slow to change. Some progress has been made, but not enough. 

Empowering Families LLC works with working families to make the ability to meet with a qualified nurse as hassle-free as it can be. The nurse can do a virtual call with you over your lunch break, at your work, or in your home at a time that works best with your schedule. We also make sure to vet resources, either by using themselves or knowing as much about the resources as possible, to ensure they are good resources for families prior to referring them. 

Maternal mental health is an important topic, and it doesn’t seem like there are many local resources for women in the postpartum period. Tell us more about your mental health services. 

DK: Once a child’s arrival date is announced, communities tend to focus on the child and not on the parents. Parents are what drive the entire family's being. Parents are a child’s first relationship, and if they are not well, then the child is also not going to be well. Maternal mental health is an important topic, but both parents are equally important. Unwell moms are not as well supported by unwell partners and vice versa. I personally received mental health services during and after my second child’s birth, and without these services, I would not be the strong, healed individual I am today. Everyone has mental health — whether it is well or poor.

Many think that postpartum depression is all there is to talk about when discussing mental health for parents, but there are many other diagnoses that are important to know about and to know what can be done and where to get assistance. For instance, many people are not familiar with OCD, PTSD, and Postpartum Psychosis. These are just a few of the many perinatal mood disorders that can arise during pregnancy and early childhood years that parents should be informed about, as well as postpartum depression. Our goal is to assess, discuss, refer and empower families to know that they can become (and stay) well if they are struggling with their own mental health. 

Last, but not least: What has it been like taking your business from concept to reality? Any advice you’d give other healthcare professionals (or anyone) seeing a gap they’d like to address with a small business of their own? 

DK: Follow your heart. I attempted to talk myself out of my business many times. It took me about two years to finally accept that the weight was too much to bear without doing more. I personally had to and continue to learn everything there is about running a business. The easy part is knowing what I am good at; the hard part is allowing others to assist me with what I am not an expert at. My friends and family have been excellent support during the process and have cheered me on since the moment I mentioned I was interested in beginning my business. The Small Business Development Center (SBDC) has been an amazing resource, too, and assisted me with many of my questions to help me keep moving forward and understand what was needed to make Empowering Families LLC a reality.