Denise
Bolds MSW, CD(DONA)
December 15,
2015
The question above of doula services remains a heated
debate and is a chronic occurrence… The scenario: low income women who are also
without resources are pregnant… Agencies repeatedly and mistakenly request the
intervention of a doula for ‘free’.
This request is a blatant hypocrisy in reducing
maternal health disparities involving low-income women; mainly women of
color/culture. In the USA there are evidence-based models verifying the
benefits of birth doula intervention during labor and birth. Many believe doula
support is a luxury; this is possible in some cases. For low-income women of
color/culture the support of a doula can be a matter of life and death.
Black women and their black babies have the highest
rate of infant mortality, fetal demise, low birth weight, maternal death, and
poor breastfeeding rates than any other ethnicity/race. The majority of
grievances about 'free' doula services are from white women. Many who
gripe have no concept or education of the history of the chronic decimation of
women of color/culture when it comes to maternal health outcomes. People are
certainly entitled to their opinion. However, it's a matter of life and death
when agencies knowingly request ‘student’, free or volunteer doulas when
evidence shows the benefits of having a certified professional doula support a
birth.
Low-income women of color/culture have higher
incidences of birth trauma, experience epigenetic inheritance as well as
medical care disparities. Period.
Agencies requesting student, free or volunteer doulas
repeatedly commit acts of exploitation: to call upon uncompensated, unsalaried
services of doulas when the solution is as evident as the evidence agencies
utilize to obtain funding to operate is a form of prostitution. Agencies have
the capability to request funding, the doula and the mother do not. Physicians,
nurses and midwives are not approached in this manor; why are doulas? Doulas
are certified, follow a professional model and many possess advanced college
degrees. Doulas are on call 24 hours, 7 days a week for their clients, they use
gas in their transportation, they invest in education that is not free, they
pay for liability insurance; in a nutshell – doula support is not free. There
was and is a sacrifice either monetarily or otherwise made by a doula to
support a woman in childbirth. It maybe a surprise to many, but doulas pay
mortgages/rent, utility bills, car payments, gas, food, childcare and more.
Agencies possess grant writers, as well as
designations that can result in the allocation of budgets offering
compensation, salaries and adequate stipends to doula providers. Continuing to
request ‘free’, volunteer, student doula services devalues the doula
profession. By offering the pregnant woman (client) ‘free’ student, volunteer
doula services results in the client being further stigmatized and reluctant to
engage in this empowering service. It also breeds suspicion and mistrust as
well as perpetuates the stigma of learned helplessness. Many of these agencies
are directed or managed by white women who have had supported births
themselves. The knowledge is present; the congruence is not.
The intervention of a birth doula with a low-income
woman of color/culture is a life saving action: advocacy, education, support
and awareness supports both mother and baby to bond, for mother to be able to
feed her baby and to heal from birth; to alleviate oppression that can result
in life threatening depression. Imagine how many lives can be saved if mother
and baby did not give up in the medical system that can be maternally hostile.
One solution is very simple: agencies, put in an
adequate budget for professional doulas. Evidence shows how invaluable this
service is. The outcomes are diversely positive across all spectrums of
maternal health. Until the education of maternal health disparity is
universally and correctly disseminated, until agencies incorporate appropriate
funding that adequately compensates doula services; the mis-education,
mis-direction, and mis-allocation of services will redundantly continue with
women and babies dying in the United States of America.
Agencies know better, it’s time to do better. In order
for negative statistics to decrease such as high cesarean section rates, poor
breastfeeding rates and stronger families; funders must include proper
allocation of doula services to agencies requesting funds. Talk to the hand agencies. Let the revolution
begin.
As for the term ‘student’ doula, I don’t know what the
hell that is. Once a doula receives proper training, she can support births and
be compensated accordingly. Is this done with ‘student’ lawyers, doctors and
nurses? I don’t think so.
