By Molly Sprecher
In movies, pregnancy is a supportive pep talk from the partner, a tough-love nurse and kindly doctor chanting, “one more push,” a first cry and ensuing happy montage. Off-screen: stretch marks map stomachs, afterbirths seep, nipples crack, limbs swell, distended stomachs cramp, hair thins, postpartum hits.
“I think there is a movement now for women to reclaim their bodies and their birth experiences,” Spencer Tackett, a junior at UNC-Chapel Hill seeking her doula certification, said. “And a large part of that is having a doula to help a patient advocate for themselves and calm them down when they are in a stressful and vulnerable position, or help women give birth with fewer medical interventions.”
What is a doula?
It’s hard to define what a doula is. Doulas aren’t medical professionals. Yet they are more than just emotional support humans who hold hands in the hospital. They are trained, largely through DONA, Doulas of North America, to support their clients throughout their pregnancy. Doulas offer physical, emotional, mental and educational support. . They answer questions and offer tips. In a time of emotional and physical vulnerability, doulas stand up for clients who cannot stand up for themselves — sometimes literally, seeing them balancing on the medicine ball, deep-breathing in the bed, pacing the floor with one hand dragging their IV.
Robin Rennells has been practicing as a birth doula for 11 years. She attended her first birth at the Women’s Birth and Wellness Center in Chapel Hill. She’s stood at the side of a woman, whose husband was out of town, getting a cesarean section. She’s scheduled her own family around being able to help grow others. She’s delivered all four of one woman’s children and been the doula for women who have struggled with infertility for years. She’s watched women mouth, “I did it,” through their tears and sweat. She’s left her home for a labor not knowing if she will be gone a few hours or a few days.
Doctors come in and out of the room, but Rennells stays, answering questions, holding hands, empowering clients and watching their confidence and courage grow. She’s emotionally and physically exhausted, but she keeps coming back.
“It’s like coaching someone through a marathon,” Rennells said. “Watching a miracle take place, believing in someone more than they believe in themselves, seeing a couple at their worst and best and seeing God answer many prayers.”
Why be a doula?
Joelle Schantz’s first birth lasted an hour and a half, and she stood in the corner watching her mentor coax the mother through. She’d thought she might cry. She didn’t.
Schantz completed her training to become a volunteer doula through the UNC-CH Birth Partners program. She’d first heard of doulas in a sociology class. She spent the rest of the day with friends joking that they would never have children.
“There’s this fear around birth for a lot of girls or women,” Schantz said. “Even though I was taking this reproductive sociology class, I think I still had that fear of it and thought that it wasn’t my cup of tea to be in the position to help someone. But the more you learn about something, the less fear is involved.”
Schantz has stood alone by the side of a teenage girl giving birth with no one to help her. She’s watched a father lean over the side of the tub holding his pregnant wife with pictures of their toddler. She’s hoped Spanish-speaking clients would understand her presence when they can’t understand her. She’s moved women into different positions, massaging pressure points and lowering them to the birth ball to facilitate shorter labors. She’s directed fathers away from televisions, reassured frantic women that the beeping on the electronic fetal monitor is normal and talked to people she’s only just met throughout the night. She’s wished she could be in 20 places at once, a doula for everyone who needs but can’t afford one.
Who needs a doula?
“There’s a huge disparity between maternal morbidity and mortality outcomes by racial divide, by income divide,” Schantz said. “The people who need doulas don’t have access to doulas. Everyone should be able to have a doula.”
Black, American Indian and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.
“Doulas are expensive and not everyone can afford them,” Schantz said. “The people who have doulas are typically high-income, educated, typically white women.”
Women with insurance still pay an average of $3,400 in hospital fees during pregnancy, according to a survey by Childbirth Connection, a program run by the National Partnership for Women and Families. Without insurance, prices range from $30,000 for vaginal delivery to $50,000 for a cesarean section. Many women who would benefit from having an additional support system cannot afford to hire a $1,200 doula. Although doctors help ensure the physical well-being of the mother and child, clinical settings limit women’s ability to take control of their pregnancy.
“Women in society often aren’t as assertive, and that’s just because of social norms that are put on them,” Schantz said. “And when you’re in labor, especially in a hospital setting, those norms are perpetuated. And when you’re in pain and confused and don’t know what’s going on, giving a person the space to speak and making sure a person knows their options is a huge part.”
How does it feel to be a doula?
Fariha Rahman and Spencer Tackett are both students at UNC-CH. Rahman has seen five births. Tackett has seen none. All the same, both are beginning their journeys as doulas.
“The first time I was a doula, it was a 12-hour shift, and by the end of it, I was exhausted,” Rahman said. “When I went into the client’s room, within an hour or so, I was holding one of her legs, and next thing you know, the baby’s born.”
Rahman doesn’t know what to feel each time she sees a birth. They’re all different. She laughs with new mothers cradling their child. She tenses with mothers who’ve been told something’s gone wrong.
Tackett studies high-risk births, medical paternalism and the struggles of black motherhood in secret during her Celtic studies class. She sets notifications on her phone for doula trainings and checks her Facebook messages for information on the new UNC-CH Doula Project. While filling her schedule with classes on cesarean sections and social work, she worries that not having had a child herself will limit her ability to help clients.
“It would mean everything to experience a birth with a family,” Tackett said, “The birth of a child is one of the most memorable moments in a person’s life, and knowing that a family trusted me enough to have me present for that moment, and trust me enough to advocate for their wishes, would be really special for me as well.”
Rahman’s favorite part of the job is interacting with the mothers, watching their faces transform from screams to smiles and sharing the intimacy she’s been allowed into. She sees bodies contort and triumph over impossible pain.
“I’m Humbled,” Rahman said. “Honored and humbled.”
Edited by Maddie Fetsko