I became a doula because of an exciting idea from Ms. Tamiko Ralston to support black and brown mothers through the birth process while also mitigating the disparities in the maternal death rate and infant mortality rate, as expressed by the community. When I first began my journey, it was to do something new and innovative to give back to my community. But what I learned about birth work in the black community from a historical context, this initiative evolved from an innovative way to give back to my community into a passion and a calling. I began to understand the history, the need, and the legacy of the many birth workers who began this work in our community before they arrived on this continent from Africa, and how it evolved, and the struggle to keep it going once enslaved Africans arrived in America.

A doula has a vital role in supporting maternal health. In many ways, especially in African American communities, doulas have been a sole source of support for birthing mothers and potentially the sole lifesaving force behind those mothers. I see my work as equally important as a primary caregiver, and the main advocate and liaison between mothers and the health care system. Doulas are every bit as important to the birthing families as healthcare providers. Doulas and healthcare providers should work as complementary partners for families with the unified goal of making sure all are happy, healthy, and their needs are met. They should be working in a fashion where information is shared freely (as legally appropriate) and leverage each other to fill in gaps that the other has.

The role that doulas play is that of a liaison. An individual who is both comfortable with and experienced with the healthcare system, who can translate the concerns and needs to the provider that the family may not feel yet comfortable expressing, and someone who can help the families navigate the complexities and language of the healthcare system. A doula’s job is to be very attentive, aware of the family’s needs, fears, and desires, and able to remain a person of peace and someone who can hold peaceful space for the family when it’s needed. The role of the Doula is to be the ultimate resource of stability and a confidant for the families in the birthing space.

It is a delicate balance of building a strong relationship with the families while also building a strong relationship with the healthcare team so that they can begin to see you as a friend instead of foe, but also a vital piece of that team which can be used as an asset in the space as someone who understand the patients emotional needs and has the trust of a patient that they may not have. As a doula, many times we have intimate knowledge of the families and their support systems that aren’t shared with the healthcare team. It is then that we step in to provide context for certain needs and supports. And it’s important to acknowledge that just as much effort that is put into building relationships with the family, a doula should try to equally do so with the healthcare team.

I help clients feel heard and empowered by developing relationships with them grounded in trust, encouraging them to express to me what their thoughts and perceptions are every step along the way. This is important because not only does it allow me to develop a clear sense of what they are experiencing, but how best I can support them. It enables me to communicate the best way possible to communicate with the family. It’s important to check in with clients and allow them to even question you as a doula, allowing space for them to explore and overcome misconceptions or perceived power dynamics that they may feel exist between themselves as clients and myself as a professional. Talking “with” a client establishes a very different tone and environment than talking “at” a client.

Doula’s can mitigate the impact of bias during the birthing process, by being intentional about pay attention to the wants and needs of their clients, being perceptive of the care they are receiving, being receptive of how their clients feel they are being treated while in the care of healthcare provider and themselves and being very clear and outspoken in their advocacy when they see clients’ needs are not being met because of unconscious or conscious bias.

This is done with relationship building during prenatal visits and conversations with providers regarding how you see your role and gaining clarity on how they see your role and areas of opportunity to collaborate rather than just existing in the same space. It’s important to level set with one another, establish clear lines of communication and be intentional about sharing working styles, best ways to communicate, and ways in which you see how you can both provide optimal service to families.

We may all have a plan, even the family, but the number one goal is that the mother, child, and partner deliver and thrive. Never let a plan or preconceived expectation keep you from being flexible during the process, as every birth is different and has its own challenges and variables. Never let your own agenda or that of a provider get in the way of the priorities and safety of a family, and remember to center and take care of yourselves before, during and after the process. Self-care is essential.