A week into my son’s life, he wouldn’t stop crying. I can still see his scarlet face and hear the alarm in his voice. Exhausted and new to motherhood, I was flummoxed and near panic myself.
Then my doula rang the bell. A no-nonsense woman, she swooped Malcolm up, whispered in his ear and massaged his little body. Identifying that he was hysterically hungry, she fed him a few fingers of formula — calming him down long enough to nurse.
She also asked me how I was doing and listened when I admitted: “Not great.” She was a lifeline in the chaos, and I still think of her with deep gratitude.
A doula is a woman who is trained to assist women during childbirth as well as in the pre- and postnatal period. It’s a tradition with roots around the world but a practice that has been resurrected in the U.S. as research increasingly shows doulas reduce C-section births and encourage successful breast-feeding.
But doula services, which can cost hundreds or thousands of dollars and are rarely covered by insurance, often aren’t available to the women who need them most.
“There’s a perception that doulas are something of a privilege, but we think that it’s a right,” says Dila Perera, executive director of Open Arms Perinatal Services, a nonprofit that provides doula services to low-income families in the Puget Sound region, with a focus on families of color and immigrant communities.
Perera sites recent statistics that reveal deep inequities in maternal and child-health outcomes based on race and ethnicity, including one that says Native and African-American babies in King County are twice as likely as white babies to die in the first month of birth.
“Interacting with medical staff … can be a very intimidating experience, especially with our immigrant families.”
Open Arms doulas help close those gaps — lessening unplanned C-sections, preterm labors and low birth weights, and increasing rates of breast-feeding. What’s more, they do so in culturally sensitive and relevant ways.
“Interacting with medical staff … can be a very intimidating experience, especially with our immigrant families,” says Rokea Jones, a doula with Open Arms. She explains that women can sometimes feel rushed or pressured by health-care providers who don’t speak their language or understand their culture. “English is often not their first language, and sometimes medical staff come in with medical jargon or the attitude of ‘Oh, we know, so we’re just going to do this.’”
Beyond the delivery room, Open Arms ensures that families have the support they need to get off to a healthy start.
“We focus on more than what they need during the birth. We also focus on what they need to be healthy and safe and not stressed going into birth,” says Perera. “We ask what is their housing situation? Do they have adequate food? Do they have a car seat? Do they have a safe place to bring the baby home to?”
After birth, Open Arms doulas continue their relationships with families, offering breast-feeding support and new-parent training for two years after a child is born.
It’s a holistic, community-oriented approach, and one that is both revolutionary and deeply familiar.
“We’ve always had women who helped at the birth,” says Margarita Celis, an Open Arms doula for Spanish-speakers. “They may not have been called doulas, but they were there.”
And like those diverse women in history, Open Arms doulas can also help bring important cultural traditions to labor and birth, especially when they come from the same communities they serve. That could mean anything from facilitating the attendance of multiple family members in the delivery room to providing traditional tea for the mother.
“Some Somali clients, when the new baby is born, they need to have someone say a prayer into the baby’s ear, welcoming them to Islam,” says Suad Farole, a Somali outreach doula with Open Arms, who has said the prayer herself when needed. It’s all part of what she calls a “rich culture of welcoming a new baby to the world.”
And a little piece of making sure that a baby’s family feels cared for and welcome as well.