November 17, 2023 • 33 mins
This episode we are joined by Marli Mayon, Training Projects Coordinator at PCAR, to learn about doulas. Marli tells us what doulas are, the different types of doulas, and how they can provide a trauma informed approach to the birthing experience. Marli also discusses the connect between doulas, reproductive justice, and the sexual violence movement.
DONA International -- https://www.dona.org/ and Dauphin County Doulas -- https://www.dauphincountydoulas.com/
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Episode Transcript
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(00:08):
Welcome to PA Centered, a podcast designed to help listeners be a part
of the solution to end sexual harassment, abuse, and assault.
Each episode, we will take on a topic or current event to help
spark conversation and break down barriers to building communities free
from sexual violence. Hi, I'm Mallory Michael. I use she/her pronouns and
(00:35):
I am the Prevention and Evaluation Coordinator at the Pennsylvania Coalition
Against Rape. I'll be your host today as we're joined by Marlee Mayon to
learn and talk about being a doula. Hi, I'm Marlee Mayon. I use
she/her pronouns and I also work at the Pennsylvania Coalition Against Rape
as the Training Projects Coordinator. I'm a newly trained birth doula and
(00:55):
a reproductive justice advocate. And I really want to live in a world
where every birthing person has access to a doula. So I'm excited to
talk more about what they are and why I think they're so important.
Thank you so much for being here with us, Marlee. I'm super excited
to have this conversation with you. So to start, can you tell us
what a doula is and how it's different from a medical provider that
(01:17):
most folks are probably thinking about? Yeah, so a doula is someone who
is not at all medically trained. They're someone who's really going to provide
physical, emotional, informational support on pregnancy, birth, to people
during their prenatal, so while they're pregnant kind of period, the labor
(01:39):
and birth process, and then also the postpartum process. So they provide
that support in all those different ways during all those different stages.
It looks a little different depending on which type of doula you are,
but you can think of it as someone who isn't a medical professional,
who is someone there to support, provide information, who is someone who
acts very similar to that of an advocate who we might be more
(02:02):
familiar with in this movement, who is specifically kind of there to provide
that information to the birthing person and help them navigate a really
life changing process. Thank you so much, and I love that connection and
comparison to a doula being very much like an advocate. I think for
all of us in the sexual violence movement, we're like, oh yeah,
(02:24):
I know what that is. They definitely help a lot in the process
with survivors, and having that connection makes sense to me, at least about
what a doula is and what their role can be.
Yeah, we think about advocates are people who know the language,
know the lingo, know the systems, know how to navigate all that survivors
(02:45):
have to navigate, who, when we think about survivors, people who are experiencing
something really traumatic or maybe in a state of crisis sometimes,
all the things who need that person who can kind of explain things
to them, connect them to resources, walk them through what to expect.
Doulas serve a very similar function. And I think in a dream world,
I love the idea of pairing survivors in the same way we pair survivors
(03:09):
with an advocate, being able to pair birthing people with a doula just kind
of inherent to that process of being pregnant and having a baby.
Thank you. You mentioned that there are different types of doulas. Can you
tell us a bit more about that? Yeah, so there's a lot of
different types of doulas, probably more than I'm even going to cover,
(03:29):
but as like a quick, here are a couple examples. Birth doula, so that's
kind of what I'm trained in. These are folks who specifically help the
pregnancy and birth experience. So they provide support to pregnant people
and their families specifically for navigating pregnancy and then labor
and birth. Postpartum doulas, kind of like the name suggests, are folks
(03:52):
who support families after the baby is born.
And that support can look a lot of different ways. There are people
who support the transition into parenthood, maybe for people who are becoming
parents for the first time, or even people who already have children just
supporting that addition of a new life and the way routine and things
are adjusted because of that. Postpartum doulas can support things like
(04:16):
chest feeding or breastfeeding, meal preparation, just care for the baby.
It can look a lot of different ways, but really those people who
are there in those weeks to months following birth.
We also have abortion doulas. So these are folks who provide information
and companionship to people who are accessing abortion.
(04:37):
A lot of the things that they might do
are dispelling a lot of myths and harmful rhetoric associated with people
who choose to access abortion, and being someone there who's once again
able to provide information and compassion and advocacy in preparation for
and during abortion. There's also death doulas. So these are people who
(04:59):
work with folks who are maybe at the end of life who are
dying or their families to support them through that grief process.
So they might be able to support families in coordinating things like end
of life care and end of life plans.
They also are people who create space to deal with,
I shouldn't say deal with, but to discuss and
(05:22):
talk about the taboo of death in a more kind of meaningful and
ideally healing way. And then some type of doula I've more recently learned
of are transition doulas or trans doulas. So these are people who support
queer, trans, non binary people in the process of seeking gender affirming
care. Once again, providing that information, companionship, dispelling
(05:44):
harmful rhetoric that's especially prevalent I think in the media and in
policy right now. And so, so many of these different forms of doula
all go back to information, education sharing, compassion, validation.
Once again, very much the things we think of as advocates in the
victim service realm. These are people specialized to help people during
(06:05):
major life stages with information and support. Thank you so much.
And I love that you talked about information and support being really key
components here. And I think all the doulas that you mentioned are available
to people are all during those big life moments where most people don't
(06:25):
know how to connect with their loved ones or how to support a
family member or a friend or what to say, what to do,
how to best help them navigate. And it sounds like a doula can
really be that person for them and help them navigate those changes in
that different season or, or really just allowing them to be
(06:47):
where they are. I'm thinking especially with like a death doula for the
grief and having them feel comfortable to sit in that grief if they
need to. Exactly, yeah. This person who creates space and learning and
safety for people to navigate, you're saying these major life changes that
(07:08):
make sense are tough and challenging to navigate. It's why we have things
like postpartum depression and anxiety. When we think about the birth and
pregnancy space specifically, it makes sense to have a person to
support us through that process. And I think a lot of times when
we think about birth and labor doulas, we put so much of that
expectation on the partner. And that's especially challenging if someone's
(07:30):
navigating this solo, who is that partner to support them? And also what
unrealistic expectations to put on a partner who's also
likely new to this space and learning. It allows some of that pressure
to be taken off and have a real kind of expert in this
space come in and support not only that pregnant person, but the potential
partner who's there too. So yeah, just that support all around to that
(07:51):
person, but also the support system around them. It sounds a lot like
having that community there too. I think when we experience big life changes,
you can cut people out whether you want to or not,
or maybe not cut people out is the right word, but really push
them away because of the stress and just not knowing how to ask
(08:13):
for help or how to be like, I need you out of my
house for like just 10 minutes, please. And it sounds like a doula can
really have those conversations or really support the person that needs
that extra support and love during that time.
Can you tell us when someone would contact a doula? So like, especially
(08:37):
with like birthing or they're pregnant, when would someone contact them?
This can look different for different people. Certainly,
I've heard colleagues in the doula space kind of the best practice they
provide for folks is if you're looking for a birth doula,
trying to coordinate that by the time you're 20 weeks. So,
(09:00):
40 weeks is like full term pregnancy, 20 weeks is at that midway
mark. So ideally by then having a sense of who your birth doula is,
just especially when you think about it gets more challenging, the more
pregnant you are, the more things that are coming. So having that lined
up, I think is just helpful for you.
When it comes to postpartum doulas, those people who are specifically there
(09:20):
after you've had that baby, looking at the 30 week mark as a
time where you'd want to coordinate that care.
But some people go earlier, some different doulas have policies around when
they'll kind of start service, sometimes as late as like 32 weeks.
Doulas also have different policies as far as how many kind of prenatal
appointments they'll have versus how much time they'll be there during the
(09:44):
actual labor and delivery. So a lot of it is different by doula, but getting
a sense of for you, maybe before you start having those conversations and
checking in with doulas, what you want, what you expect,
being clear on those expectations with your doulas is a big part of
it. And also a big part of the information a doula is to
provide you, that information on what you can access, what kind of things
(10:08):
you have an option in. So yeah, being able to kind of synthesize
the information folks are providing and then make a care plan and birth
plan that is best for you. Great. Thank you.
It sounds like there's a lot of different options a bit and kind of how
involved you want them to be, which I think is something that we
(10:29):
don't always think about, especially with like medical providers, when you're
giving birth, like you're told to do something one way
and then, you just don't know until someone provides you
with other information. Exactly. Great. So can you tell us a bit about
what it takes to become a doula or what training doulas have?
(10:54):
Yeah. So there's definitely different schools of thought here, different
trainings that different doulas kind of have under their belt. The most
kind of prevalent kind of mainstream doula training entity that I'm familiar
with, that I went through is called DONA International.
And so the way that training process works is they have a pretty
(11:15):
intensive three day training that covers a variety of...
Now this was specific, they have birth training opportunities and postpartum
doula training opportunities. And so I did the birth training experience
and that also includes information on lactation, just understanding of different
(11:35):
pain management techniques that we would want to use,
ways that we include potential partners in the process,
just a lot of the information we'd want to share with people who
are navigating pregnancy. So that's kind of what you learn in that training
space. Part of the kind of credentials with DONA is
(11:56):
being able to like supervise so many births. I think it's like two
to three for that accreditation or those credentials, I guess.
And then you have a process where the doctor or the midwife,
whoever's in that process, some nurses will sign off on the care you
were able to provide. There's also a lot of doulas or doula collectives,
(12:16):
kind of grassroots efforts who push back on this idea of having a
really regimented, credentials required process because of the history of
doulas and just the way this... This really came out of
mostly women being like a nurturing space for people who are giving birth.
And so different states also have different requirements. Some states require
(12:39):
you to have that certification from entities like DONA. Some do not require
that. Some people have the experience of having pregnancy and birth themselves
and that's really great learning to take into their work as a doula.
So there isn't kind of one specific process. It can look different and
it can look different based on what you plan to do with that
(13:01):
learning. If you plan to join a doula collective, if you plan to
do some kind of like occasional work yourself.
So yeah, that's kind of some of what's needed to be a doula. Thank
you and thank you for the information on how each state has their
own accreditation for it or certification or just process in general for
(13:24):
being a doula. I feel like it's one of those things that you
don't know until someone's like, oh, there is this thing. And also,
it varies from what state you're giving birth in or where you want
to give birth or, different things like that. And I think that can
be really helpful for folks when they're having these conversations or doing
(13:44):
a planning process for a doula kind of things to be aware of
and what they want or what they would prefer not to have,
sticking with like the grassroots that you said and/or, just going forward
with what they want in general and what makes them feel comfortable.
Yeah. And some people also, I think, confuse doula care with like midwifery
(14:08):
care or midwives. And that goes back to understanding doulas are trained
on that emotional, physical, informational support. So, there's no
medical anything happening with doulas. Midwives are folks who we can also
think of as being a little bit more removed from kind of the
strict medical process sometimes. Not to say that there aren't midwives
(14:31):
within hospital settings, but we think of those as being more kind of
natural, I guess, for lack of a better word. We don't always like
to use that word in the doula space because it's like everything is
natural, right? There's not like, you're not better if you have a natural
birth versus not. What does that even mean?
But yeah, I think sometimes midwife care and doula care are considered similar.
(14:52):
You can certainly have a midwife and a doula. But a lot of
what I learned in my training is that
hospital birth settings are an especially important place to have a doula
because of the way that advocacy is so needed and required in that
systems space where there's a clear way of doing things. There are people
who know what they're supposed to do. And so, having that doula care
(15:13):
to know what you have options in, what you can say no to,
all of those things helps you to have a more empowered birth within
that kind of medical system. I'm also just thinking about how
intense childbirth can be for folks and how
you forget what you want or the plan changes. And it's a very
(15:35):
quick change. So, you're forced to make a decision without
having someone to provide you with the background information or
in the case of survival of the person giving birth or of the
child, you really need to take well, you don't take time,
but you really need to have that immediate reaction. And it sounds like
(15:58):
having a doula there can really help with that
information for the understanding of what's happening, having a better idea
of what decision is best for you. Exactly. Being able to meet outside
of what can sometimes feel like crisis, which is like giving birth.
That can feel like a really stressful time, understandably. So, being able
(16:20):
to make those decisions ahead of time, understanding what things you even
have to decide on, having a doula there to enforce those things because
you are likely in a state of crisis.
Yeah, it's just such an important time and can be really overwhelming to
navigate alone without the advocacy of a doula or a partner or
to, like I said, put those expectations on a partner to
(16:44):
it's just not in everyone's nature, it's not in everyone's personality to
be an advocate, to be someone who's like, no, she said she didn't
want that. They said they didn't want that, right? And so,
to have a doula who's just trained to
really enforce your wishes as much as they can. I mean, things happen
that are certainly out of our control, but to be able to go
in with a plan, be able to really create the birth that we
(17:05):
want is such a useful, empowering tool that I think doulas provide.
Yeah, I'm thinking a lot how some people are really totally fine with
confrontation. And then there are other people who
are like, I don't know what's happening. There is chaos around me.
I need to take a step back. But then
(17:26):
if they're the partner or, if they're a family member or someone who
is there to support the birthing person, how that can really impact
the experience, the health, a lot of different things.
Yes. Yeah, it's a super, like, sensitive, important, vulnerable time.
And something that we learned also in my doula training is just the
(17:48):
way people who've had babies remember their birth story, their birth experience
so distinctly, good, bad, ugly, traumatic, all the things. It's such a core
memory, obviously. And so to be able to make that a special core
memory, not even special, but just not harmful, not traumatic. There's so
many stories of traumatic births of just care for pregnant people after
(18:12):
the fact or complications or like the maternal mortality rates we talked
about. I mean, there's so much that shouldn't happen in the United States
that unfortunately does happen. And so once again, just having that support
and advocacy of a doula is so incredibly important. In the Aftershock documentary,
I think I mentioned that in this space, but that's a documentary that
(18:34):
talks about black maternal mortality rates. The pregnant woman in that documentary
talks about, black pregnant women in hospitals are very similar to black
men at traffic stops who are interacting with police and how
the advocacy that's required, just inherently being on the defense when
(18:56):
you're in this vulnerable, special place. I mean, I just, I can't even
imagine. And so all the more reason why having a doula in that
space is important. I think learning from people and recognizing that's
a really valid experience people are having is why we have to have
these conversations, why we have to talk about making doulas kind of a required
(19:17):
thing for the just prenatal care in general for people. I just thought
that was like a really interesting and useful way to frame it and
make the case for why it's so important.
Yeah. Yeah. And you talked about essentially how we have normalized childbirth
to be traumatic and for folks to kind of look for those
(19:41):
terrible stories that they encountered during their birthing time
and their birthing experience. Whereas it doesn't have to be that way.
And there is that norm, like, well, you know, you never know what
you're gonna get with your childbirth. You can plan and plan and plan,
and it's like, well, yeah, you can plan, but you can also have
(20:02):
someone there to make sure plan A, B, C, and D.
All the things that you feel comfortable doing still go into effect.
Thank you. We talked a little bit about well, we talked a lot
about how doulas can be really beneficial. How can doulas be beneficial
for folks who are survivors of sexual violence and
(20:26):
really just in the sexual violence movement, how can they be really beneficial
for folks? Yeah, so I think birth and pregnancy has such an inherent
kind of invasive non consensual touch nature to it, right? Not that it
should be like that, but that does just feel so inherent to
what people can expect from those medical appointments leading up to birth
(20:51):
and the actual birth itself. I mean, this is a time
where, likely one of the most life changing experiences is happening to
you, right? You're in labor, you're in delivery, and you have strangers
in the room with you. You have people looking at your body in
a really vulnerable way. That bodily autonomy that we talk about being so
(21:11):
fundamental to survivors being something that we as advocates support survivors
in regaining after things like sexual violence have occurred, and that bodily
autonomy has been taken away from a person that can really feel triggering,
as you can imagine, for people who are
going through this inherently traumatic experience and then have all these
(21:32):
new people and touches and things happening, a lot of times what feels
like without their consent. And so I think
having a doula there is once again, having that advocate, having a person
who you already talked through, this is how I want this,
this, and this to go. And I think once again, an expectation doulas set
is we'll try within, we'll try as much as we can to make
(21:55):
that possible, but also recognizing emergencies happening, crisis happens
and this is how we'll navigate that if that should happen.
And so I think when we think about advocacy and best practices and
supporting survivors, we think a lot about trauma informed care and
a way that doulas are inherently trauma informed is explaining the process
(22:15):
of what to expect in the labor and delivery room to a survivor,
here's what you can expect. Here's who will be there, here are the
options you're gonna be presented with. We talk so much about
voice and choice and empowerment. There's so many opportunities to create
that with pregnant and birthing people in the context of
birth. So yeah I think allowing survivors access to doulas during that period
(22:42):
is so important to a survivor's continued healing the way they can continue
to heal and feel safe within this really important wild life stage of
having a baby. An experience I had with a birthing person I supported
around this time a year ago, she really did not want to have
an IV. And that was something we talked about as being an option,
(23:03):
something she did not have to have. And I remember being in the
space and the nurses and the medical professionals really wanted her to
be hooked up to an IV and wanted these things that we had
already talked about she did not want. And so
that was a time for me to really
enforce kind of what she wanted and it can feel uncomfortable just being
(23:23):
in that position. I think we can think of that as advocates too.
Like it can be uncomfortable when we're up against these systems advocating
for the folks we're serving. But how important that I could do that
and she didn't have to worry about that, right?
And so, yeah, I think it's just really important when it comes to
planning for making those choices and then really enforcing those in the
(23:45):
moment. Yeah. Yeah. It sounds really beneficial for
folks who need things kind of laid out for them.
I'm thinking a lot with survivors of sexual violence needing to know what's
happening next what's going... Like what's the next process and that being
really outlined for them and knowing that someone is going to be there
(24:06):
to make sure as best they can that those things still happen for
them. I know last time we had you on the podcast,
you talked about Reproductive Justice and you talked a little bit about
it here. But can you tell us how Reproductive Justice and doulas are
connected? How they might go hand in hand with each other
(24:30):
and can you tell us a little bit about that?
Yeah, I mean, I think doulas, whether it be abortion doulas, birth doulas,
postpartum doulas, any doula is just an extension of a Reproductive Justice
model framework we talked about, of people who are there to support
pregnant birthing people and having that bodily autonomy and exercising
(24:52):
that bodily autonomy in a variety of settings, whether it be
medical appointments leading up to birth or the birth setting itself.
So I think in a world, in a country that really prioritizes Reproductive
Justice, it would be a world where we see
states like New York, states like Illinois, who have programs to ensure
(25:16):
marginalized low income folks have access to doula care, recognizing this
disproportionate statistic of maternal mortality broadly, and then black
maternal mortality more specifically. Part of Reproductive Justice is looking
at those social justice factors. And so we have to take an intersectional
approach to understanding who are people who are most at harm when they
(25:39):
have a baby? How are we ensuring they have services and support.
When it comes to black maternal mortality rates, a lot of what they
find and why those rates of death are so disproportionate is because it's
a lot of time doctors, medical professionals who are learning,
who are supporting black pregnant people in birth. And it goes back to
(26:01):
just the formation of gynecology, right? They treated black bodies as a
space for learning, and we're still doing that, and we're still seeing the
harm of it. And so changing up the way we do this,
changing up the way people learn. A big thing that doulas share with
pregnant people is you don't have to have any folks aside from the
medical professionals who are required to be there in that space with you.
(26:22):
You don't have to have people who are learning
be... You don't have to be a guinea pig with your birth.
Like, you don't have to be someone who people are learning from.
And that can be something that feels really uncomfortable to mention,
but that's another reason why a doula can be the one to say
it like, you don't need to be in this space. Why are you
here? And so, yeah, I think doula care is so fundamental to Reproductive
(26:45):
Justice. It talks about the way Reproductive Justice explores that prenatal
birth and postpartum. Having doulas for all those stages,
really speaks to how we can enforce and see Reproductive Justice in action.
And so yeah, I think that's kind of the relationship between the two
and yeah. Yeah. Thank you. And it sounds like going back to that
(27:08):
information sharing and the community around it and having
the support and understanding that you need in these big times of change,
of adjusting to a new way of life, of adjusting to the trauma
that was impacted to your body. I mean, childbirth is not an easy
(27:29):
thing no matter how you give birth. And
I really love that doulas can really support you in all of those
seasons of change and really be that person to
guide you through that, help you, support you, be there with information
(27:50):
and also just that knowledge of like, "Hey, things are new and that's
okay, and this is what's going to happen with your body,
or this is what you might be experiencing and there's no reason to
be afraid or be scared or start freaking out. Like this is a
big change for you." And I feel like that's just something that we
all need to hear in a lot of different spaces, not just with
(28:14):
birthing or reproduction or anything like that, but in a lot of different
spaces as a nice reminder, like changes are going to happen and they
can be big and scary, but you can also have people support you
through that. Yeah, let's walk through this together. And so many of the
different doulas I mentioned, death doulas, abortion doulas, trans doulas,
(28:35):
like it's all information and support a lot of times within the context
of systems, medical systems. And so I think there's something to be examined
there. Yes doulas, but also what's going on with these systems that
we need these people in these positions to ensure harm is not happening
or to ensure families and people feel supported, right? There's more to
(28:57):
uncover there, there's more of a root cause of
why these systems are harming people. And so I think
Reproductive Justice allows for those conversations to happen, happen in
a trauma informed intersectional way that hopefully gets us at both continuing
to have individualized support for people while also
(29:17):
mitigating the harm caused by systems. Yeah. Yeah. Thank you.
If someone was looking for a doula on a wide variety,
right? We talked about birth doulas, death doulas, abortion doulas, trans
doulas. If someone was looking for a doula, where could they find
one? Is there a resource for that? Yeah, so I mean, it definitely
(29:41):
goes back to what I said before of thinking about for yourself what
context of doula care is best for you? Are you someone who wants
to ensure you're having someone who's credentialed, who's been through the
process? Or are you someone who's more open to more of a grassroots
doula collective approach? DONA International, the organization I mentioned
(30:02):
as being a major trainer of doulas, they have information on their website.
We can definitely link on finding a doula. And so those are folks
who would have those credentials. But I also think social media is a
really great resource for finding doulas in your area.
I think you can also in general kind of look up what doula collectives
are around. I know in Dauphin County where we are, there's a,
(30:25):
I think it's called Dauphin Doulas Collective. And the cool thing with the
collective is they operate on kind of a rotating basis. Folks are on
call, but that also means that they may not be the person,
they might be someone you've been working with your whole pregnancy perhaps,
but they may not be the person there actually during your birth,
which is also similar to doctors and midwives. And
(30:47):
so there's perks of different... There's pros and cons I think,
to all of it. But I think first deciding for yourself what do
you want that care to look like, and then also what your budget
is. There's a lot of different prices for doulas depending on if they're
new, if they've been more seasoned in this role.
But it is something that can be expensive. And
(31:07):
like I said, in states like New York and Illinois where they're making
that as part of a inherent low cost access for people is ideally
the goal, I think across the country for all states.
But thinking through, I think first, like I said, your budget,
what you want in that person is a really good starting place to
kind of research from there. Great. Thank you so much. And I had
(31:29):
no clue that there was a collective in Dauphin County, so that's really
awesome to know. And I love that you talked about social media 'cause
I feel like people can be very honest on social media whether they
had a great experience or not, so great experience and also sharing that
experience, whether that was with a doula or their birth experience or,
(31:51):
you know, a lot of different things that I think that could definitely
be really helpful for folks to look into. Like,
"Was this great? Do I know someone who might have, you know, worked
with them? Can I chat with them?" Having those background checks that make
people feel sometimes more comfortable just going through a new experience
(32:12):
or something that isn't really widely known. Yeah, certainly. And yeah,
and like you're saying, a lot of doulas will have websites that have
kind of feedback and testimonies from past clients, folks who utilize their
doula services. And so I think doing your research on that just as
much as you would on finding your actual like medical professional
(32:34):
for your birth, that's just as important as like doing the vetting and
research on the doula care you look for. So.
Yeah. Great. Well, Marley, thank you so much for joining us today to
talk about being a doula and the work that it can help with
survivors and just all the options that doulas can provide us.
(32:55):
Thank you so much. Yeah, thanks Mallory. Thanks for having me.
Yeah. That's all the time we have today, but thanks for listening to
this episode of PA Centered. You can learn more at www.pcar.org. Any views
(33:15):
or opinions expressed on PA Centered by staff or their guests are solely
their own and do not necessarily reflect the opinions of PCAR or PCARs funders.
Welcome to PA Centered, a podcast designed to help listeners be a part
of the solution to end sexual harassment, abuse, and assault.
Each episode, we will take on a topic or current event to help
spark conversation and break down barriers to building communities free
from sexual violence. Hi, I'm Mallory Michael. I use she/her pronouns and
(00:35):
I am the Prevention and Evaluation Coordinator at the Pennsylvania Coalition
Against Rape. I'll be your host today as we're joined by Marlee Mayon to
learn and talk about being a doula. Hi, I'm Marlee Mayon. I use
she/her pronouns and I also work at the Pennsylvania Coalition Against Rape
as the Training Projects Coordinator. I'm a newly trained birth doula and
(00:55):
a reproductive justice advocate. And I really want to live in a world
where every birthing person has access to a doula. So I'm excited to
talk more about what they are and why I think they're so important.
Thank you so much for being here with us, Marlee. I'm super excited
to have this conversation with you. So to start, can you tell us
what a doula is and how it's different from a medical provider that
(01:17):
most folks are probably thinking about? Yeah, so a doula is someone who
is not at all medically trained. They're someone who's really going to provide
physical, emotional, informational support on pregnancy, birth, to people
during their prenatal, so while they're pregnant kind of period, the labor
(01:39):
and birth process, and then also the postpartum process. So they provide
that support in all those different ways during all those different stages.
It looks a little different depending on which type of doula you are,
but you can think of it as someone who isn't a medical professional,
who is someone there to support, provide information, who is someone who
acts very similar to that of an advocate who we might be more
(02:02):
familiar with in this movement, who is specifically kind of there to provide
that information to the birthing person and help them navigate a really
life changing process. Thank you so much, and I love that connection and
comparison to a doula being very much like an advocate. I think for
all of us in the sexual violence movement, we're like, oh yeah,
(02:24):
I know what that is. They definitely help a lot in the process
with survivors, and having that connection makes sense to me, at least about
what a doula is and what their role can be.
Yeah, we think about advocates are people who know the language,
know the lingo, know the systems, know how to navigate all that survivors
(02:45):
have to navigate, who, when we think about survivors, people who are experiencing
something really traumatic or maybe in a state of crisis sometimes,
all the things who need that person who can kind of explain things
to them, connect them to resources, walk them through what to expect.
Doulas serve a very similar function. And I think in a dream world,
I love the idea of pairing survivors in the same way we pair survivors
(03:09):
with an advocate, being able to pair birthing people with a doula just kind
of inherent to that process of being pregnant and having a baby.
Thank you. You mentioned that there are different types of doulas. Can you
tell us a bit more about that? Yeah, so there's a lot of
different types of doulas, probably more than I'm even going to cover,
(03:29):
but as like a quick, here are a couple examples. Birth doula, so that's
kind of what I'm trained in. These are folks who specifically help the
pregnancy and birth experience. So they provide support to pregnant people
and their families specifically for navigating pregnancy and then labor
and birth. Postpartum doulas, kind of like the name suggests, are folks
(03:52):
who support families after the baby is born.
And that support can look a lot of different ways. There are people
who support the transition into parenthood, maybe for people who are becoming
parents for the first time, or even people who already have children just
supporting that addition of a new life and the way routine and things
are adjusted because of that. Postpartum doulas can support things like
(04:16):
chest feeding or breastfeeding, meal preparation, just care for the baby.
It can look a lot of different ways, but really those people who
are there in those weeks to months following birth.
We also have abortion doulas. So these are folks who provide information
and companionship to people who are accessing abortion.
(04:37):
A lot of the things that they might do
are dispelling a lot of myths and harmful rhetoric associated with people
who choose to access abortion, and being someone there who's once again
able to provide information and compassion and advocacy in preparation for
and during abortion. There's also death doulas. So these are people who
(04:59):
work with folks who are maybe at the end of life who are
dying or their families to support them through that grief process.
So they might be able to support families in coordinating things like end
of life care and end of life plans.
They also are people who create space to deal with,
I shouldn't say deal with, but to discuss and
(05:22):
talk about the taboo of death in a more kind of meaningful and
ideally healing way. And then some type of doula I've more recently learned
of are transition doulas or trans doulas. So these are people who support
queer, trans, non binary people in the process of seeking gender affirming
care. Once again, providing that information, companionship, dispelling
(05:44):
harmful rhetoric that's especially prevalent I think in the media and in
policy right now. And so, so many of these different forms of doula
all go back to information, education sharing, compassion, validation.
Once again, very much the things we think of as advocates in the
victim service realm. These are people specialized to help people during
(06:05):
major life stages with information and support. Thank you so much.
And I love that you talked about information and support being really key
components here. And I think all the doulas that you mentioned are available
to people are all during those big life moments where most people don't
(06:25):
know how to connect with their loved ones or how to support a
family member or a friend or what to say, what to do,
how to best help them navigate. And it sounds like a doula can
really be that person for them and help them navigate those changes in
that different season or, or really just allowing them to be
(06:47):
where they are. I'm thinking especially with like a death doula for the
grief and having them feel comfortable to sit in that grief if they
need to. Exactly, yeah. This person who creates space and learning and
safety for people to navigate, you're saying these major life changes that
(07:08):
make sense are tough and challenging to navigate. It's why we have things
like postpartum depression and anxiety. When we think about the birth and
pregnancy space specifically, it makes sense to have a person to
support us through that process. And I think a lot of times when
we think about birth and labor doulas, we put so much of that
expectation on the partner. And that's especially challenging if someone's
(07:30):
navigating this solo, who is that partner to support them? And also what
unrealistic expectations to put on a partner who's also
likely new to this space and learning. It allows some of that pressure
to be taken off and have a real kind of expert in this
space come in and support not only that pregnant person, but the potential
partner who's there too. So yeah, just that support all around to that
(07:51):
person, but also the support system around them. It sounds a lot like
having that community there too. I think when we experience big life changes,
you can cut people out whether you want to or not,
or maybe not cut people out is the right word, but really push
them away because of the stress and just not knowing how to ask
(08:13):
for help or how to be like, I need you out of my
house for like just 10 minutes, please. And it sounds like a doula can
really have those conversations or really support the person that needs
that extra support and love during that time.
Can you tell us when someone would contact a doula? So like, especially
(08:37):
with like birthing or they're pregnant, when would someone contact them?
This can look different for different people. Certainly,
I've heard colleagues in the doula space kind of the best practice they
provide for folks is if you're looking for a birth doula,
trying to coordinate that by the time you're 20 weeks. So,
(09:00):
40 weeks is like full term pregnancy, 20 weeks is at that midway
mark. So ideally by then having a sense of who your birth doula is,
just especially when you think about it gets more challenging, the more
pregnant you are, the more things that are coming. So having that lined
up, I think is just helpful for you.
When it comes to postpartum doulas, those people who are specifically there
(09:20):
after you've had that baby, looking at the 30 week mark as a
time where you'd want to coordinate that care.
But some people go earlier, some different doulas have policies around when
they'll kind of start service, sometimes as late as like 32 weeks.
Doulas also have different policies as far as how many kind of prenatal
appointments they'll have versus how much time they'll be there during the
(09:44):
actual labor and delivery. So a lot of it is different by doula, but getting
a sense of for you, maybe before you start having those conversations and
checking in with doulas, what you want, what you expect,
being clear on those expectations with your doulas is a big part of
it. And also a big part of the information a doula is to
provide you, that information on what you can access, what kind of things
(10:08):
you have an option in. So yeah, being able to kind of synthesize
the information folks are providing and then make a care plan and birth
plan that is best for you. Great. Thank you.
It sounds like there's a lot of different options a bit and kind of how
involved you want them to be, which I think is something that we
(10:29):
don't always think about, especially with like medical providers, when you're
giving birth, like you're told to do something one way
and then, you just don't know until someone provides you
with other information. Exactly. Great. So can you tell us a bit about
what it takes to become a doula or what training doulas have?
(10:54):
Yeah. So there's definitely different schools of thought here, different
trainings that different doulas kind of have under their belt. The most
kind of prevalent kind of mainstream doula training entity that I'm familiar
with, that I went through is called DONA International.
And so the way that training process works is they have a pretty
(11:15):
intensive three day training that covers a variety of...
Now this was specific, they have birth training opportunities and postpartum
doula training opportunities. And so I did the birth training experience
and that also includes information on lactation, just understanding of different
(11:35):
pain management techniques that we would want to use,
ways that we include potential partners in the process,
just a lot of the information we'd want to share with people who
are navigating pregnancy. So that's kind of what you learn in that training
space. Part of the kind of credentials with DONA is
(11:56):
being able to like supervise so many births. I think it's like two
to three for that accreditation or those credentials, I guess.
And then you have a process where the doctor or the midwife,
whoever's in that process, some nurses will sign off on the care you
were able to provide. There's also a lot of doulas or doula collectives,
(12:16):
kind of grassroots efforts who push back on this idea of having a
really regimented, credentials required process because of the history of
doulas and just the way this... This really came out of
mostly women being like a nurturing space for people who are giving birth.
And so different states also have different requirements. Some states require
(12:39):
you to have that certification from entities like DONA. Some do not require
that. Some people have the experience of having pregnancy and birth themselves
and that's really great learning to take into their work as a doula.
So there isn't kind of one specific process. It can look different and
it can look different based on what you plan to do with that
(13:01):
learning. If you plan to join a doula collective, if you plan to
do some kind of like occasional work yourself.
So yeah, that's kind of some of what's needed to be a doula. Thank
you and thank you for the information on how each state has their
own accreditation for it or certification or just process in general for
(13:24):
being a doula. I feel like it's one of those things that you
don't know until someone's like, oh, there is this thing. And also,
it varies from what state you're giving birth in or where you want
to give birth or, different things like that. And I think that can
be really helpful for folks when they're having these conversations or doing
(13:44):
a planning process for a doula kind of things to be aware of
and what they want or what they would prefer not to have,
sticking with like the grassroots that you said and/or, just going forward
with what they want in general and what makes them feel comfortable.
Yeah. And some people also, I think, confuse doula care with like midwifery
(14:08):
care or midwives. And that goes back to understanding doulas are trained
on that emotional, physical, informational support. So, there's no
medical anything happening with doulas. Midwives are folks who we can also
think of as being a little bit more removed from kind of the
strict medical process sometimes. Not to say that there aren't midwives
(14:31):
within hospital settings, but we think of those as being more kind of
natural, I guess, for lack of a better word. We don't always like
to use that word in the doula space because it's like everything is
natural, right? There's not like, you're not better if you have a natural
birth versus not. What does that even mean?
But yeah, I think sometimes midwife care and doula care are considered similar.
(14:52):
You can certainly have a midwife and a doula. But a lot of
what I learned in my training is that
hospital birth settings are an especially important place to have a doula
because of the way that advocacy is so needed and required in that
systems space where there's a clear way of doing things. There are people
who know what they're supposed to do. And so, having that doula care
(15:13):
to know what you have options in, what you can say no to,
all of those things helps you to have a more empowered birth within
that kind of medical system. I'm also just thinking about how
intense childbirth can be for folks and how
you forget what you want or the plan changes. And it's a very
(15:35):
quick change. So, you're forced to make a decision without
having someone to provide you with the background information or
in the case of survival of the person giving birth or of the
child, you really need to take well, you don't take time,
but you really need to have that immediate reaction. And it sounds like
(15:58):
having a doula there can really help with that
information for the understanding of what's happening, having a better idea
of what decision is best for you. Exactly. Being able to meet outside
of what can sometimes feel like crisis, which is like giving birth.
That can feel like a really stressful time, understandably. So, being able
(16:20):
to make those decisions ahead of time, understanding what things you even
have to decide on, having a doula there to enforce those things because
you are likely in a state of crisis.
Yeah, it's just such an important time and can be really overwhelming to
navigate alone without the advocacy of a doula or a partner or
to, like I said, put those expectations on a partner to
(16:44):
it's just not in everyone's nature, it's not in everyone's personality to
be an advocate, to be someone who's like, no, she said she didn't
want that. They said they didn't want that, right? And so,
to have a doula who's just trained to
really enforce your wishes as much as they can. I mean, things happen
that are certainly out of our control, but to be able to go
in with a plan, be able to really create the birth that we
(17:05):
want is such a useful, empowering tool that I think doulas provide.
Yeah, I'm thinking a lot how some people are really totally fine with
confrontation. And then there are other people who
are like, I don't know what's happening. There is chaos around me.
I need to take a step back. But then
(17:26):
if they're the partner or, if they're a family member or someone who
is there to support the birthing person, how that can really impact
the experience, the health, a lot of different things.
Yes. Yeah, it's a super, like, sensitive, important, vulnerable time.
And something that we learned also in my doula training is just the
(17:48):
way people who've had babies remember their birth story, their birth experience
so distinctly, good, bad, ugly, traumatic, all the things. It's such a core
memory, obviously. And so to be able to make that a special core
memory, not even special, but just not harmful, not traumatic. There's so
many stories of traumatic births of just care for pregnant people after
(18:12):
the fact or complications or like the maternal mortality rates we talked
about. I mean, there's so much that shouldn't happen in the United States
that unfortunately does happen. And so once again, just having that support
and advocacy of a doula is so incredibly important. In the Aftershock documentary,
I think I mentioned that in this space, but that's a documentary that
(18:34):
talks about black maternal mortality rates. The pregnant woman in that documentary
talks about, black pregnant women in hospitals are very similar to black
men at traffic stops who are interacting with police and how
the advocacy that's required, just inherently being on the defense when
(18:56):
you're in this vulnerable, special place. I mean, I just, I can't even
imagine. And so all the more reason why having a doula in that
space is important. I think learning from people and recognizing that's
a really valid experience people are having is why we have to have
these conversations, why we have to talk about making doulas kind of a required
(19:17):
thing for the just prenatal care in general for people. I just thought
that was like a really interesting and useful way to frame it and
make the case for why it's so important.
Yeah. Yeah. And you talked about essentially how we have normalized childbirth
to be traumatic and for folks to kind of look for those
(19:41):
terrible stories that they encountered during their birthing time
and their birthing experience. Whereas it doesn't have to be that way.
And there is that norm, like, well, you know, you never know what
you're gonna get with your childbirth. You can plan and plan and plan,
and it's like, well, yeah, you can plan, but you can also have
(20:02):
someone there to make sure plan A, B, C, and D.
All the things that you feel comfortable doing still go into effect.
Thank you. We talked a little bit about well, we talked a lot
about how doulas can be really beneficial. How can doulas be beneficial
for folks who are survivors of sexual violence and
(20:26):
really just in the sexual violence movement, how can they be really beneficial
for folks? Yeah, so I think birth and pregnancy has such an inherent
kind of invasive non consensual touch nature to it, right? Not that it
should be like that, but that does just feel so inherent to
what people can expect from those medical appointments leading up to birth
(20:51):
and the actual birth itself. I mean, this is a time
where, likely one of the most life changing experiences is happening to
you, right? You're in labor, you're in delivery, and you have strangers
in the room with you. You have people looking at your body in
a really vulnerable way. That bodily autonomy that we talk about being so
(21:11):
fundamental to survivors being something that we as advocates support survivors
in regaining after things like sexual violence have occurred, and that bodily
autonomy has been taken away from a person that can really feel triggering,
as you can imagine, for people who are
going through this inherently traumatic experience and then have all these
(21:32):
new people and touches and things happening, a lot of times what feels
like without their consent. And so I think
having a doula there is once again, having that advocate, having a person
who you already talked through, this is how I want this,
this, and this to go. And I think once again, an expectation doulas set
is we'll try within, we'll try as much as we can to make
(21:55):
that possible, but also recognizing emergencies happening, crisis happens
and this is how we'll navigate that if that should happen.
And so I think when we think about advocacy and best practices and
supporting survivors, we think a lot about trauma informed care and
a way that doulas are inherently trauma informed is explaining the process
(22:15):
of what to expect in the labor and delivery room to a survivor,
here's what you can expect. Here's who will be there, here are the
options you're gonna be presented with. We talk so much about
voice and choice and empowerment. There's so many opportunities to create
that with pregnant and birthing people in the context of
birth. So yeah I think allowing survivors access to doulas during that period
(22:42):
is so important to a survivor's continued healing the way they can continue
to heal and feel safe within this really important wild life stage of
having a baby. An experience I had with a birthing person I supported
around this time a year ago, she really did not want to have
an IV. And that was something we talked about as being an option,
(23:03):
something she did not have to have. And I remember being in the
space and the nurses and the medical professionals really wanted her to
be hooked up to an IV and wanted these things that we had
already talked about she did not want. And so
that was a time for me to really
enforce kind of what she wanted and it can feel uncomfortable just being
(23:23):
in that position. I think we can think of that as advocates too.
Like it can be uncomfortable when we're up against these systems advocating
for the folks we're serving. But how important that I could do that
and she didn't have to worry about that, right?
And so, yeah, I think it's just really important when it comes to
planning for making those choices and then really enforcing those in the
(23:45):
moment. Yeah. Yeah. It sounds really beneficial for
folks who need things kind of laid out for them.
I'm thinking a lot with survivors of sexual violence needing to know what's
happening next what's going... Like what's the next process and that being
really outlined for them and knowing that someone is going to be there
(24:06):
to make sure as best they can that those things still happen for
them. I know last time we had you on the podcast,
you talked about Reproductive Justice and you talked a little bit about
it here. But can you tell us how Reproductive Justice and doulas are
connected? How they might go hand in hand with each other
(24:30):
and can you tell us a little bit about that?
Yeah, I mean, I think doulas, whether it be abortion doulas, birth doulas,
postpartum doulas, any doula is just an extension of a Reproductive Justice
model framework we talked about, of people who are there to support
pregnant birthing people and having that bodily autonomy and exercising
(24:52):
that bodily autonomy in a variety of settings, whether it be
medical appointments leading up to birth or the birth setting itself.
So I think in a world, in a country that really prioritizes Reproductive
Justice, it would be a world where we see
states like New York, states like Illinois, who have programs to ensure
(25:16):
marginalized low income folks have access to doula care, recognizing this
disproportionate statistic of maternal mortality broadly, and then black
maternal mortality more specifically. Part of Reproductive Justice is looking
at those social justice factors. And so we have to take an intersectional
approach to understanding who are people who are most at harm when they
(25:39):
have a baby? How are we ensuring they have services and support.
When it comes to black maternal mortality rates, a lot of what they
find and why those rates of death are so disproportionate is because it's
a lot of time doctors, medical professionals who are learning,
who are supporting black pregnant people in birth. And it goes back to
(26:01):
just the formation of gynecology, right? They treated black bodies as a
space for learning, and we're still doing that, and we're still seeing the
harm of it. And so changing up the way we do this,
changing up the way people learn. A big thing that doulas share with
pregnant people is you don't have to have any folks aside from the
medical professionals who are required to be there in that space with you.
(26:22):
You don't have to have people who are learning
be... You don't have to be a guinea pig with your birth.
Like, you don't have to be someone who people are learning from.
And that can be something that feels really uncomfortable to mention,
but that's another reason why a doula can be the one to say
it like, you don't need to be in this space. Why are you
here? And so, yeah, I think doula care is so fundamental to Reproductive
(26:45):
Justice. It talks about the way Reproductive Justice explores that prenatal
birth and postpartum. Having doulas for all those stages,
really speaks to how we can enforce and see Reproductive Justice in action.
And so yeah, I think that's kind of the relationship between the two
and yeah. Yeah. Thank you. And it sounds like going back to that
(27:08):
information sharing and the community around it and having
the support and understanding that you need in these big times of change,
of adjusting to a new way of life, of adjusting to the trauma
that was impacted to your body. I mean, childbirth is not an easy
(27:29):
thing no matter how you give birth. And
I really love that doulas can really support you in all of those
seasons of change and really be that person to
guide you through that, help you, support you, be there with information
(27:50):
and also just that knowledge of like, "Hey, things are new and that's
okay, and this is what's going to happen with your body,
or this is what you might be experiencing and there's no reason to
be afraid or be scared or start freaking out. Like this is a
big change for you." And I feel like that's just something that we
all need to hear in a lot of different spaces, not just with
(28:14):
birthing or reproduction or anything like that, but in a lot of different
spaces as a nice reminder, like changes are going to happen and they
can be big and scary, but you can also have people support you
through that. Yeah, let's walk through this together. And so many of the
different doulas I mentioned, death doulas, abortion doulas, trans doulas,
(28:35):
like it's all information and support a lot of times within the context
of systems, medical systems. And so I think there's something to be examined
there. Yes doulas, but also what's going on with these systems that
we need these people in these positions to ensure harm is not happening
or to ensure families and people feel supported, right? There's more to
(28:57):
uncover there, there's more of a root cause of
why these systems are harming people. And so I think
Reproductive Justice allows for those conversations to happen, happen in
a trauma informed intersectional way that hopefully gets us at both continuing
to have individualized support for people while also
(29:17):
mitigating the harm caused by systems. Yeah. Yeah. Thank you.
If someone was looking for a doula on a wide variety,
right? We talked about birth doulas, death doulas, abortion doulas, trans
doulas. If someone was looking for a doula, where could they find
one? Is there a resource for that? Yeah, so I mean, it definitely
(29:41):
goes back to what I said before of thinking about for yourself what
context of doula care is best for you? Are you someone who wants
to ensure you're having someone who's credentialed, who's been through the
process? Or are you someone who's more open to more of a grassroots
doula collective approach? DONA International, the organization I mentioned
(30:02):
as being a major trainer of doulas, they have information on their website.
We can definitely link on finding a doula. And so those are folks
who would have those credentials. But I also think social media is a
really great resource for finding doulas in your area.
I think you can also in general kind of look up what doula collectives
are around. I know in Dauphin County where we are, there's a,
(30:25):
I think it's called Dauphin Doulas Collective. And the cool thing with the
collective is they operate on kind of a rotating basis. Folks are on
call, but that also means that they may not be the person,
they might be someone you've been working with your whole pregnancy perhaps,
but they may not be the person there actually during your birth,
which is also similar to doctors and midwives. And
(30:47):
so there's perks of different... There's pros and cons I think,
to all of it. But I think first deciding for yourself what do
you want that care to look like, and then also what your budget
is. There's a lot of different prices for doulas depending on if they're
new, if they've been more seasoned in this role.
But it is something that can be expensive. And
(31:07):
like I said, in states like New York and Illinois where they're making
that as part of a inherent low cost access for people is ideally
the goal, I think across the country for all states.
But thinking through, I think first, like I said, your budget,
what you want in that person is a really good starting place to
kind of research from there. Great. Thank you so much. And I had
(31:29):
no clue that there was a collective in Dauphin County, so that's really
awesome to know. And I love that you talked about social media 'cause
I feel like people can be very honest on social media whether they
had a great experience or not, so great experience and also sharing that
experience, whether that was with a doula or their birth experience or,
(31:51):
you know, a lot of different things that I think that could definitely
be really helpful for folks to look into. Like,
"Was this great? Do I know someone who might have, you know, worked
with them? Can I chat with them?" Having those background checks that make
people feel sometimes more comfortable just going through a new experience
(32:12):
or something that isn't really widely known. Yeah, certainly. And yeah,
and like you're saying, a lot of doulas will have websites that have
kind of feedback and testimonies from past clients, folks who utilize their
doula services. And so I think doing your research on that just as
much as you would on finding your actual like medical professional
(32:34):
for your birth, that's just as important as like doing the vetting and
research on the doula care you look for. So.
Yeah. Great. Well, Marley, thank you so much for joining us today to
talk about being a doula and the work that it can help with
survivors and just all the options that doulas can provide us.
(32:55):
Thank you so much. Yeah, thanks Mallory. Thanks for having me.
Yeah. That's all the time we have today, but thanks for listening to
this episode of PA Centered. You can learn more at www.pcar.org. Any views
(33:15):
or opinions expressed on PA Centered by staff or their guests are solely
their own and do not necessarily reflect the opinions of PCAR or PCARs funders.
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