A Conversation w/ A Doula

Interview by Jefferson Ellison, done in Partnership w/ AVLtoday.

Label me a feminist if you must, but I tend to think that our human capabilities aren’t limited by gender. In fact, the only thing I can think of that is exclusive to the capacity of women, is childbirth. Men - hard as they may try - will never understand the physical labor of the act and as of today, modern science has not been able to give those who were assigned male at birth, the option to go through the process.

In a big city/small town like Asheville - where the healthcare industry is one of the biggest employers in the city - this topic is incredibly relevant. Tack on the propensity of Ashevillians to seek alternative approaches to everything, and having a conversation with a Doula, is essentially a requirement. Zipporah Stevens is a young, ambitious, and impressive professional whose passion for women's health and autonomy is unmatched. I must admit that while she isn’t my doula, she is my friend. And I can personally vouch for her ability to provide care, nurture, and offer unwavering support.

What is a doula?

A birth doula is someone who provides emotional, physical, and informational support to as an individual before, during, and after childbirth. We help solidify a birth vision, point you to evidence-based information, and help facilitate communication with your care providers throughout your pregnancy and labor.

How does it differ from a traditional OB/GYN?

An OB/GYN is a doctor who specializes in women's health. They will oversee all the medical aspects of your pregnancy. A doula is a trained professional who is non-medical. We do not give medical advice or perform medical tasks.

What is your training like?

In order to become a trained doula I attended several childbirth and breastfeeding classes, participated in DONA doula training workshops (Doulas of North America) and did a six-month mentorship program at Homegrown Families.

Isn’t it true that some people decide to have a traditional OB/GYN and a doula?

It's quite common that people have an OB/GYN as well as a doula. While medical care providers are occupied by making sure the mother and baby's clinical needs are being met, a doula is the only nonmedical person on the birth team that is solely there to provide emotional and physical support to those in labor.

Why did you decide to become a Doula?

During my childhood, my family and I lived in Puerto Viejo, Costa Rica. This was before Costa Rica became a burgeoning bustling country. We lived in a small village with no paved roads and minimal electricity. My mother was the unofficial midwife of this town so I was able to witness and became fascinated with the wonder of childbirth. There is no other experience in life that can be equated to this. It is such a transformative, significant, and multidimensional time in a mother's life. It's incredible to have the opportunity to be a part of this experience and help make it as positive as possible.

What surprised you the most about the process?

The realization that so many women aren't aware of their rights and options during pregnancy and childbirth.

What has the process been like finding clients?

At Homegrown Families we hold Meet the Doula date nights every other week. Since the pandemic these meetings are now virtual. There is also the Homegrown Families website where potential clients can reach out.

What is your understanding of America’s issue with maternal mortality - specifically in Black women?

The U.S maternal mortality rate is abysmal, in 2018 it was 17.4 maternal deaths per 100,000 live births. The U.S is last in the rank amongst similarly wealthy countries. This maternal health crisis disproportionately affects black women the most. Black women are three to four times more likely to experience a pregnancy-related death than white women. They have the highest infant mortality rate of any racial or ethnic group in this country. These disparities are firmly rooted in racism.

How has that affected how you approach your work?

It is evident in our country that black women's voices are too often not being heard in the health care system. Advocacy, support, and understanding, are essential in having a positive birthing experience for any mother. I believe all women should have doulas, however, due to racial bias in the health care system, black women have a greater need. My role as a doula is particularly important for women who have trouble questioning authority or find themselves deferring in situations even though they may not want to. A doula can be an essential advocate and help to make sure that a woman's needs are being met.

Has being a women’s healthcare provider changed how you view womanhood, motherhood, etc.?

Being a women's healthcare provider has given me a more in-depth understanding on the importance of a support system. As we go through our journeys of pregnancy, motherhood, and womanhood it's vital that we have people in our life who can uplift, encourage, motivate and support us. Since becoming a doula I've realized that when/if I do give birth it is essential for me to have a birth team who I can count on and help guide me through pregnancy and labor.

As someone in healthcare, do you find that your experiences at the doctors or hospital can be “Activating” because it isn’t the same way you’d approach a medical client?

It can be infuriating to witness or hear stories about negative experiences one has at the hospital. Listening tends to be the common factor in these events. Oftentimes as patients in a hospital we can feel vulnerable, powerless, and at times voiceless. All too often there seems to be a lack of space where patients feel they can express their fears, hopes, and opinions. When there is open communication between doctor and patient it dismantles the harmful hierarchy, creates a connection, conveys respect, and builds trust.

What’s the biggest thing we should change about how we approach healthcare and childbirth?

The U.S healthcare system is failing to meet women's health needs in a multitude of ways. One of the ways to help improve the healthcare system is to provide a doula for every delivery. Statistics prove that women who have a doula during labor and delivery are more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, Cesareans, and negative feelings about childbirth.

What is the biggest surprise to people when they are learning about the doula process?

People are surprised to learn that doulas are one of the only professions that provide full wraparound care. We are not only there during labor but are also present before and after the baby is born. We have several prenatal meetings to solidify a connection and a postpartum meeting to discuss the birth experience, ask questions, and to see how things at home are with the new baby.

What’s the biggest misconception?

I think a common misconception about doulas is that we only participate in all natural births. Doulas provide support in all types of environments whether it be a hospital, birth center, or home birth. Interested in speaking with Zipporah about your maternal needs/future? You can email her at zipporahthedoula@gmail.com!