The Importance of Doulas Today: Background information when reading We Are a Haunting

The Importance of Doulas Today

This article relates to We Are a Haunting

Despite its original ancient Greek definition of "a woman who serves," the word "doula" has come to mean "one who mothers the mother." In caring for mothers and their newborns, doulas advocate, listen, advise and comfort. They are professionally trained to provide emotional and informational support during pregnancy and labor as well as after birth, sometimes specializing in one of these periods. Doulas also manage anxiety, depression and fear.

In earlier generations in many parts of the world, women were not part of the workforce. When a new mother came home with her baby, or when she delivered the baby at home, she was typically cared for by her own mother, and perhaps her sister and a couple of aunties, who helped her manage the needs of an infant until she was able to get her bearings. But with women working, families spread out across the world and some people estranged from their families, doulas arguably fill an important need more than ever. They empower and champion those going through pregnancy and who have given birth.

In the novel We Are a Haunting, birth doula Key is driven to the profession because she wants to make an impact in the lives of pregnant black women who suffer negative birth outcomes. Racism plays a part in the black healthcare experience and doulas have been shown to mitigate these outcomes by emotionally connecting with their marginalized and socially isolated clients.

When looking at people giving birth in general, regardless of race or income, one study found that a doula in the birthing room increases the odds of a spontaneous vaginal delivery by 15% and decreases the likelihood of a cesarean section by 39%. When patients are given continuous support throughout the childbirth process, such as that provided by doulas, they tend to feel less pain and are less likely to request an epidural.

Birth doulas often meet their clients months before the baby is born to establish an understanding of their wishes. Do they want a home birth? A birth in water? Or in a clinical setting? Do they have a history of birth trauma? A stillbirth or medical complication? Or a bad labor experience? This information helps the doula extend specific support so the client and their partner can have an uplifting birth experience.

It's important to note that doulas do not directly offer medical care. Many doulas work alongside a midwife; Key works with a midwife named Carrie. Their client Treasure is specific about her needs: "She wanted what most people thought of as natural birth, didn't want to be shot up with drugs that felt like rising mercury, forced to make decisions about another life as well as her own while high as a kite. She had said after her first child she'd been traumatized by her experience, said it made the space between her hips feel flooded, a phantom chill."

During delivery, the doula is in close proximity to the client, walking her through techniques to deal with the pain, comforting her, perhaps giving her massages, which can stimulate the production of the hormone oxytocin to encourage uterine contractions and bring about a feeling of well-being. As Key explains, "Our job was to listen. To be sensitive to habits and women's bodies and try to be preventative."

When a medicated birth is required, birth doulas communicate with physicians and provide the patient and partner informational support to alleviate fear. Doulas explain procedures, the side effects of medications and how much discomfort is the norm. Their responsibility is to ensure a healthy labor, newborn and family.

Treasure's son Cameron is born during a messy, painful and remarkable labor. White writes that Treasure "kissed his ear as she whispered to him. Within an hour, she breastfed her son for the first time, in her home, surrounded by her family." And her birth doula.

Gray scale photo of a pregnant woman, via Pexels

Filed under Medicine, Science and Tech

This "beyond the book article" relates to We Are a Haunting. It originally ran in May 2023 and has been updated for the April 2024 paperback edition. Go to magazine.