Doula Bag

Denise Bolds MSW, CD(DONA)

January 9, 2017

It’s a new year; 12 months of births, breasts, trainings, blogs and communications on social media. I’ve been in the doula world for over 2 years now; I possess a master’s degree in social work; I am still learning about my practice and myself as a doula. Many new doulas and seasoned doulas come to me and ask for advice and guidance. These wonderful women often feel the weight of the ‘should’ and ‘could’ resulting in some of the most, harsh and combative scenarios I have ever witnessed from my own gender. One ongoing query of angst among doulas: the doula bag. There are numerous articles on: “The must haves for the doula bag.”

Many doulas have a bag of special support tools they use with their skills in comfort techniques for a woman in labor. Everything from rebozos to squeeze balls. All too frequently, I am asked: ‘What do you have in your doula bag Denise?’

In response, my doula bag are two bags: a tote with my comfort items and a larger bag with a yoga mat, bolsters, birth ball and a peanut or two. My comfort items range from sleep mask to honey sticks to a change of socks and underwear for myself. I also carry a bluetooth speaker and an electric diffuser so mom can use her scented oils. Sometimes I feel as though I am Mary Poppins. 

December, 2016 winter solstice night, I was called to support a birth of a first time mom. Upon my arrival at her home, I witnessed mom’s labor going very well, and quickly. On her second trip to the bathroom, I accompanied her; she was in her labor zone, I didn't want to leave her unattended. As she pulled down her pants, meconium went everywhere! Mom was now grunting in her contractions, she was getting ready to push. I immediately informed the husband we had to leave for the hospital immediately, I cleaned up my laboring client quickly and explained what we must do; we got to the hospital in the darkest of night.

There was no time, we parked in the emergency room parking lot. I jumped out of my car running to support my client inside to a wheelchair. In my haste, I left my two doula bags behind. Upstairs, my client was evaluated, her baby had flipped and was now breech. Her contractions were so intense, the nursing staff could not get a vein to start an IV. My client’s birthing room was a flurry of clinical staff, obstetrician, anesthesiologist, midwife, the husband and myself. While everyone was as calm and professional as possible, an aura of urgency was dominating. My client had begun to take in some of this energy, I knew in order for her to do well with her birth, she had to focus.

I turned my laboring client focus solely upon me, my eyes and my voice while her husband answered the questions needed for admitting. I talked my client down from the high perch of instability she was heading towards. With my voice, my presence, my focus, my confidence I was able to calm her. I did Reki on her by placing my hands over her heart focusing my thoughts on the most calm, beautiful sunny day on the beach… as a result of her releasing her tension, the nurse was able to start an IV with a Hep-Loc.  I kept my client calm with her focus upon me while the clinical staff worked on her birth.

Her baby boy was born; it was an amazing birth. All of this occurred less than two hours, without my two doula bags. You are wondering what is my point?

Many doulas are so focused upon the props in the profession, all the attachments to grow their business. Most times all a doula really needs is herself. To possess a belief in herself she can empower, she can be of service and support to another without infringing upon clinical boundaries, without devaluing her work and without her doula bag.

There are times when I do have my two doula bags and I still am in need of something. Laboring at home with another client, I had her use the bathtub for hydrotherapy. The tub stopper wasn't working well, I had nothing in my bag for this.  I went to her kitchen and found a rubber jar opener to use in the tub to stop the water leaking out. I had to use my wits and improvise.  At that moment, it was about the client, not me. The doula bag is more for the doula than it is for the client.

Doulas, here’s the take-away: you do not always need a bag of items and props to support a client. Of course its nice and fun to have. At the end of the day, all a laboring woman need is you; your confidence, your compassion, your respect, your intuition, your truth that you are here for her. Don’t become so caught up in the ‘should’ in the doula world that you forget why you are a doula; because your heart calls you, because you come from an ancestry of empowerment, because you believe in what you are providing. 

I am a certified doula, I’m proud of what I do. I remain humble to witness a miracle called birth as part of my job. Each birth brings me to trust more deeply in myself, my confidence and my truth; there’s no outside bag that can hold this - only me, myself and I hold and carry these attributes. 

I still have my bags I support women with in my doula practice. There will be another time when I will not have my two bags with me; I will support my client just as well as if they were with me because of what I carry within. What’s in your doula bag? Who is it for?

Talk To The Hand: Agencies - Doula Services Are Not Free

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.