Delivering Care

I’ve been fascinated by the topic of modern-day motherhood for a long time – both by the immense, impossible amount of pressure & work involved (and lack of any sort of structural support) for women with children, and by this essentially being the first generation of women with enough money and agency to really think through and choose if they want to be mothers or not.

A study recently came out that 45% of women are expected to be single and childless by 2030, but a ton of women are still having children – in a country where that choice gets increasingly politicized and policed by the day, as healthcare – particularly for women – continues to decline.

To think through what a different path forward might look like for American mothers from the very first step of having a child, I talked to a doula who’s deeply focused on safety & encouraging women to trust their bodies. 

– mw

How would you describe what a doula does? 

When people hear the word “doula,” most of the time it’s assumed to be related to pregnancy. However, to some people’s surprise, there are actually many different types of doulas, including birth doulas, abortion doulas, postpartum doulas, and end-of-life/death doulas. My particular experience has been as a full-spectrum birth doula (though I would love to translate those skills to end of life doula work down the line!). 

The main responsibilities of a birth doula are to provide emotional, spiritual, physical, and informational support to birthing people. In addition to the physical care that a doula might provide through comfort positions, breathing techniques, massage therapy, etc., another significant component of birth doula work is to encourage the birthing person to consider their needs for their pregnancy and empower them to communicate those things to their care team.

 A doula can act as an advocate for the person they are supporting, and ultimately, the role is intended to complement the care provided by doctors, midwives, and/or nurses rather than work against it. 

Why did you want to become one – and what was your journey like? 

I’ve been interested in reproductive health issues for a long time, and when I realized that doulas can play an important role in the health and wellbeing of someone experiencing childbirth, I wanted to participate in a training to learn more. When I took my first training in 2020, I realized that the skills needed to be a doula actually came quite naturally to me. In a way, I had already been playing this doula role as a caregiver for many of my friends and family. I was also excited about the prospect of being able to support someone in feeling comfortable and cared for while they bring new life into the world. Once I finally committed to the idea of getting trained as a doula, I began to research all of the organizations that were providing certifications and training. Over the past couple of years, I’ve trained with Mama Glow and Ancient Song—two amazing organizations based out of Brooklyn that are both committed to creating more opportunities for people to engage in doula work. My process of practicing as a doula has been incredibly meaningful and at times slow-paced. Since I’ve had other jobs while working as a doula, I typically only support clients a few times a year when I’m able to be fully present and available to provide them the proper amount of care. 

Who are your typical clients? What are they seeking? 

I’ve seen a range of clients who all vary in age, socioeconomic background, race, and location. Some of my clients include first-time parents looking for guidance and support through the challenges of childbirth, individuals with high-risk pregnancies or prior traumatic birth experiences who want extra support, and/or people planning both non medicated and medicated births who want pain management techniques and informational support. 

People who opt for home births often hire doulas to provide additional support in a non-hospital setting, but it’s a common misconception that all doulas only support home births! Overall, clients seek doulas for personalized, emotional support, evidence-based information, advocacy, comfort measures, and the potential to reduce unwanted medical interventions.

What’s your role in childbirth? 

One of my primary roles during childbirth is to be a continuous presence for the birthing person. In the two weeks leading up to their due date, I am on call 24/7 to ensure that I could be available to the client when they start to experience contractions. If the person is experiencing physical or emotional stress, I offer comfort, encouragement, and reassurance to help them navigate any intensities of labor. I can also offer physical support through various comfort measures like massage, positioning suggestions, and breathing techniques to help manage pain and discomfort. 

Another part of my role is acting as an advocate to make sure the birthing person’s preferences and wishes are effectively communicated to the medical team. I always try to work in collaboration with that person’s care team—my goal is to create a sense of safety and trust for my client, while not getting in the way of any other interventions. 

What’s been your biggest surprise about women’s bodies? 

One of my biggest surprises has been the intuitive nature of women’s bodies. As a woman myself, it’s not uncommon for me to fall into a place where I’m questioning my own emotional and physical sensations when something seems out of sort in my body. I see this similar sense of tension between intuition vs. logic come up in birth space. 

While I absolutely think healthcare expertise is incredibly important when it comes to ensuring that people can give birth safely, I also think that women know their bodies better than anything else and that wisdom needs to be acknowledged in healthcare settings. 

What are the major conversations you see happening around the topic of motherhood today?

One of the most pressing discussions I’ve seen in the birth space revolves around health disparities for Black mothers—particularly the alarming fact that the maternal mortality rate for Black women is 3x higher than white women. There’s also a growing awareness of postpartum depression and anxiety, and more people are recognizing the crucial need for mental health support for new mothers. Lastly, I’ve noticed a surge in conversations surrounding fertility treatments and assisted reproductive technologies, as medical interventions become more advanced and create new opportunities for people to have children.

Are there any big changes or trends happening in your field? What do you think is behind them? 

One of the big trends is the increasing collaboration between doulas and healthcare providers, and I think this shift is related to the ongoing research that has shown the positive impact of doula support on birth outcomes and maternal care. Additionally, there is a rising demand for doula services as more expectant parents recognize the value of continuous emotional and physical support during childbirth. There’s also a heightened emphasis on diversity and inclusivity within the doula profession, with efforts to train doulas from various backgrounds to better serve more diverse communities. For example,  New York City launched the Citywide Doula Initiative last year which is focused on providing free or low-cost doula services to birthing people and families. I’ve participated in the program and think that it’s a really unique and exciting model for other cities.

In your dream future – what would you change about the way we treat women & motherhood, particularly when it comes to the topic of the body? 

Sadly, so much. One that’s very much top of mind for me is the current, devastating state of reproductive health in a post Roe v. Wade era. 

My desire is for the healthcare of women, mothers, and birthing people to be respected and taken seriously politically, legally, and socially. 

In my dream future, there would be no stigma attached to women’s choices, and there would be universal access to safe and affordable reproductive healthcare.