Birthing is the most profound inititaion to spirituality a woman can have - Robin Lim
Srividya Kannan Ramachandran was well into her pregnancy when she considered hiring a doula for the first time. The almost 35-year-old research lead at Facebook was attending a company-organized art class (Facebook offers extra-curricular courses to its staff to help mitigate work stress), and the instructor, who was also pregnant, asked her if she had enrolled in childbirth classes. She had not. The instructor passed along a recommendation for New York-based childbirth educator and doula Mary Esther Malloy’s popular Mindful Birth classes and Ramachandran enrolled a few days later. “I didn’t realize I wanted a doula until about three weeks into the class,” she says. “That’s also when I realized how many things I didn’t know.”
One of those unknowns, of course, is the changing landscape around pregnancy that has come with COVID-19: Ramachandran is now contending with the pandemic’s effects on how she—and women across the country—must retool their birth plans while considering new variables such as single-support-person mandates. While not implemented nationwide, the common practice to protect laboring mothers, their newborns, and healthcare workers from the virus’s spread often means making a difficult choice: whether to have your partner or your doula by your side during childbirth.
If she had to make this decision right now, Ramachandran says she would consider choosing Malloy, who she hired for her own delivery. “My husband and I, neither of us know what to expect. That one day could be very traumatic,” she says. In contrast, doulas have attended many births and know exactly what to do in any number of scenarios. “Being able to have that expertise next to you is just so comforting.”
It’s also statistically proven to improve birth outcomes. In New York City, where 65% of women giving birth are on Medicaid, only 10% of women utilize doulas, which means that many people consider their services “a class thing,” says Malloy, versus a healthcare necessity. (Doula fees can range from under $1,000 to $3,000 and up, and are often an out-of-pocket expense that is not always covered by insurance.) “But doulas are not a luxury,” emphasizes Nan Strauss, a trained lawyer and the Managing Director of Policy, Advocacy, and Grantmaking for Every Mother Counts, the New York-based non-profit founded by Christy Turlington-Burns that is dedicated to raising awareness around fetal- and maternal-care safety. Strauss, who has been actively involved in making maternal healthcare policy recommendations for state and federal responses to COVID-19, has also been a vocal supporter of doula pilot programs in states such as New York, Oregon, and Minnesota.
These initiatives aim to provide doula access to underserved communities, most commonly lower income communities and communities of color, where maternal death rates are far higher than the already dismal national average. “Doula care is an evidenced-based measure that has been found to be the most successful intervention when it comes to reducing the risk of preterm birth and delivery complications—and this is according to The American College of Obstetricians and Gynecologists,” Strauss says. Perhaps most notable is that these measures can help reduce the need for C-sections by 39%—a staggering statistic considering cesarean deliveries cost 50% more than vaginal births. “So across the board, more doula support could be saving the system healthcare costs. More importantly, though,” she continues, “most women don't want to have major abdominal surgery!” It’s for all of these reasons that Strauss has made expanding access to community-based doulas a big part of the advice she is sharing with congressional leaders and the National Governors Association as she works to secure the medical care of expectant mothers during the pandemic. “There's such a need for the information, system navigation, and emotional support that doulas can provide, now more than ever,” Strauss adds.
In broad strokes, for the uninitiated, that support typically entails moment-to-moment, non-medical care before, during, and after one of life’s most intense experiences. “It sounds funny, but even just having someone by your side to anchor your faith in your own ability and your body’s ability to give birth, provides a sense of safety to allow you to go as deep as possible into the process,” says Malloy. This vaguely amorphous description is something that you truly can't begin to process until you’re, say, into your 25th hour of labor and wondering if you will in fact be able to make it to the finish line. I myself am among the converted when it comes to doula appreciation. Malloy was my doula when I gave birth to my son two years ago, a 32-hour ordeal that I have nothing but positive things to say about thanks in large part to the doula care I received.
What many first-time pregnant women and their partners often don’t understand until they are in the delivery room is that your doctor or midwife is not with you while you labor. They check in periodically to ensure things are progressing apace and return to safely deliver your baby. Having access to experienced support people throughout the process, however—to literally hold your hand, rub your back, wave a peppermint oil-soaked paper towel in front of your face to ease your nausea, help troubleshoot natural solutions to speed up dilation, and to count down every single contraction, for 25 hours straight, until you finally concede to an epidural—is another, entirely different, but no less essential service. Even the most well-intentioned partner cannot be expected to provide this kind of support. Which is why relegating doulas to FaceTime and Zoom in hospital rooms—an increasingly common new development—can be yet another harsh reality of the evolving impact of COVID-19 on pregnant women.
“There is still a tremendous opportunity for doulas to provide virtual support during birth,” insists Strauss, adding that there is an even bigger opportunity for their virtual support postpartum, especially as new families are now more isolated than ever. Malloy and many of her colleagues are adapting their models of support accordingly. “We’re encouraging partners to have a tripod so we, the virtual doula, can have a visual vantage point. But different families are doing it differently,” Malloy says. “Some are keeping their doulas just on speaker, or FaceTime. Some families want constant support, some just want periodic check-ins,” she continues. During our interview, Malloy is “attending” one such birth, and awaiting a text response from her client’s partner. She had just dropped the couple off at NYU Langone Medical center after laboring with them at home for hours. I can hear the pain in her voice as she describes the surreal nature of not being able to be with her client in person.
Ramachandran, who is due on May 22, is encouraged by the idea that some hospitals are allowing women to swap out their single support person—so a doula can be present for the active labor, and then a partner is permitted to relieve her for the actual birth, provided he our she is not symptomatic of, or has tested positive for COVID-19. But for now, she is holding out for good news in our fight against the spread of the coronavirus, and that increased containment could cause a change in many hospitals' one-support-person mandate. “I really do hope we’re in a different place by then,” she says. For her sake, and for all expectant mothers, so do I.
Source: Celia Ellenberg, Should I Choose My Doula Over My Partner? Navigating Birth Support in the Era of COVID-19, Vogue, April 15, 2020.
Previous research has shown lower rates of cesarean births, more satisfaction from mothers and better newborn Apgar scores — a measure of a baby's condition at birth — among mothers who use doula care. In fact, the American Congress of Obstetricians and Gynecologists says in guidelines for safe prevention of cesarean births that doula care is "probably underutilized."
"It’s not our bodies that are broken. We need to look at all the other external factors that are making childbirth more dangerous.”
Women have traditionally been supported by a companion during childbirth, and there is good evidence this benefits both the woman and the baby.
The World Health Organisation recommends continuous support for women during childbirth. Yet across the world, initiatives promoting health facilities as the safest place to give birth have not necessarily respected this tradition.
But now we have new evidence on the ways women are supported during childbirth by a doula or other labour companion.
In Sweden, midwives deliver babies. But doula culture interpreters act as bridges between midwives and immigrant women.
I am not a mom; however, I have been blessed to hear the fascinating birth stories of some of my closest friends. Each of these friends has one thing in common when talking about their experience of childbirth: their desire to feel in control and connected to their own body during pregnancy and childbirth.
One of these friends, in particular, worked with a doula and describes the experience she had as a completely transformative way for her to prepare for birth.
Upon finishing class, I came to realize that having a doula was like having a loving and knowledgeable friend by your side, while not overshadowing the partner nor family, but rather enhancing the entire experience altogether. Now who couldn't use that?!
Doulas are a growing force in the ever-changing culture of maternity, at once a manifestation of the growing demand for personal service (the doorman, the yoga teacher, Amazon Prime) and a backlash against the perceived overmedicalization of birth, with its high rates of cesarean sections.
Doulas -- nonmedical professionals who help women cope with childbirth and the postpartum period -- do many things. They soothe. They massage. They cheer.
And, according to new research, they may also substantially lower women's odds of having a cesarean section that isn't medically necessary.
When a baby comes, friends and families don’t always know how to help.
A new report from Choices in Childbirth and Childbirth Connection, a program of the National Partnership for Women & Families, argues that increased access to doulas would help drive down the cost of childbirth in the United States.
Studies show the calming presence and supportive reinforcement of doulas can help increase birth outcomes and reduce birth complications for the mother and the baby. Still, only a small percentage of women use doulas nationwide.
Pregnant women are hiring companions to hold their hands through labour for fear of being left without help and support by midwives.
A sweeping Cochrane review from 2011 found that when women have continuous support, whether from a spouse, friend, nurse or doula, the birth outcomes are generally better. And they are best when women are supported by someone who is not employed by the hospital and who has specific training in overseeing births -- a doula’s job description.
It takes a village to not only raise a child, but also to prepare for his or her arrival into the world.
Today, giving birth involves making a variety of important choices, many that were not available to mothers in the past. A doula can help expectant mothers and their families during this life changing event-before, during and after the arrival of their bundle of joy.
“Doula care is an evidenced-based measure that has been found to be the most successful intervention when it comes to reducing the risk of preterm birth and delivery complications—and this is according to The American College of Obstetricians and Gynecologists,” Strauss says.
Devoted to the development of doulas and our profession.
DONA International is the leader in evidence-based doula training, certification and continuing education. Our doulas are the world's best!
We are here to guide you in the right direction. Whether you are searching for a doula in your local area or looking for doula training to help women in this very important transition of their lives… becoming a mother.
This site was developed to help expectant families quickly and efficiently find doulas who are available during their due dates. It’s also a great place to get a baseline understanding of each doula’s training, certification, and experience levels.
Currently DoulaMatch only lists doulas in the US and Canada.
We believe that birth is a sacred event, and that motherhood is an anointed institution. We believe that all women need and deserve the support of other women during pregnancy and birth. We believe that the knowledge of labor support is the heritage of all women and should be shared.
Brought to you by the Institute of Somatic Therapy. We are the premier certifying organization for prenatal massage and Massage Doulas. Massage Doulas are Certified Massage Therapists who have completed advanced study in prenatal massage, postpartum massage, labor, delivery support and, optionally, infant massage.
To me, being a Radical Doula is committing to the hard work of facing issues of racism, classism, ableism, homophobia, transphobia head-on in our work with pregnant and parenting people. It means understanding birth as just one instance in a wide spectrum of pregnancy-related experiences that include abortion, miscarriage and adoption, and understanding why doula support across that spectrum makes sense.
Being a doula is the greatest profession in the world! Our goal is to celebrate the doula profession and to provide a valuable resource for everyone who calls themselves a doula. We strive to carry the best products, blog about relevant doula information and provide top quality resources.
I write about childbirth, breastfeeding, doulas, feminism, anthropology, public health, women's issues, culture, maternal and child health, childbirth education, vaginas, breasts, lactation, midwives, pregnancy, reproductive health, and more.
The diary of childbirth educator, doula, mother, & aspiring midwife.
Welcome to 'Melbourne Doula', the place where I share what birth work is teaching is me, and what I am learning from the wonderful families who have invited me to share this most special season of their lives. Here you will find information about me and the doula services I provide, birth stories from remarkable women and their loved ones, as well as all kinds of resources to enrich your own journey of discovery.
The Academy of Certified Birth Educators is dedicated to providing childbirth education classes and doula training classes.
Birth Arts International offers Certified Doula, Postpartum Doula Certification, Childbirth Educator (CBE), Breastfeeding Educator Certification (BEC) and Midwife’s Assistant certification training and education, via workshop, distance learning and online eLearning.
If you enjoyed reading Birthing From Within, your confidence and personal growth will be enhanced when you take Birthing From Within childbirth classes with a trained Mentor or Doula. Read more about Birthing From Within childbirth preparation and what to expect in a class.
CAPPA, Childbirth and Postpartum Professional Association is an international certification organization for Doulas, Childbirth Educators and Lactation Educators. Since our foundation in 1998, we have certified thousands of perinatal professionals. CAPPA is the Largest Childbirth organization in the world. CAPPA trains and certifies doulas, childbirth educators, lactation educators and more.
Founded in 1918 as the Maternity Center Association, Childbirth Connection is now a core program of the National Partnership for Women & Families.
For nearly 100 years, we have helped develop and advance many forms of care that are now critical components of the nation’s maternity care system.
Childbirth International is a unique organization. With a global outlook and a strong belief in the "education is power" philosophy, we provide training for doula, childbirth educator and breastfeeding counselor students all over the world.
Information about having an easier, more comfortable birth with hypnosis, and about pregnancy, birth, breastfeeding and newborn parenting choices!
You are at the official HypnoBirthing Institute website. If you are an expectant parent and you are looking to take a class, then you can learn about the process here: Getting Started with Mongan Method HypnoBirthing®.
The International Childbirth Education Association (ICEA) is a professional organization that supports educators and health care professionals who believe in freedom to make decisions based on knowledge of alternatives in family-centered maternity and newborn care.
International Board Certification for Doulas, Childbirth Educators, Lactations Support and Educators as well as Parent Advocates.