In 2019, I delivered my last baby. As the mother of four, including one who died in utero at eight months, I have had a variety of birth experiences. This final birth was the best of my birth experiences because of support I received from doulas, lactation consultants, and my mom tribe.
I had never hired a doula before because I dismissed them as an unnecessary luxury.
Because I was over 40 with type 1 diabetes, I had a medical team that included an obstetrician, a perinatologist, an endocrinologist, and a nutritionist. They were all attentive, but their care felt compartmentalized. I also had a birth doula, who covered topics holistically that the medical team didn’t. She deeply explored my history with me, including past birth health, who was present at the births, and what did and didn’t go right. We covered religious observances, cultural practices, and home environment. We developed a stress-releasing practice for me that included meditation, movement, and mantras. We worked through how, although I appreciated my thorough medical team, I actually felt more anxious at appointments as they quoted risk factors and warning signs. We synced our hearts to the best outcome for the baby and created a birth plan.
I had never hired a doula before because I dismissed them as an unnecessary luxury. My ignorance stemmed from my lack of life experience. In my early 20s, I was healthy, bounced back quickly from birth, and had friends having babies to share the experience with. I associated doulas with hospitals—but my experiences with medical professionals led me toward distrust. I also was unaware of the data supporting the fact that black women often receive substandard medical care due to treating professionals’ unconscious biases. Instead, my experiences disconnected me from my gut, caused me to blame and shame myself, and think I was alone.
With my eldest, I was pressured into having an epidural when the doctors repeatedly insisted that, as a first-time mom, I would labor for hours and run out of energy. I felt labor progressing quickly but submitted to them as the experts. The anesthesiologist administered the epidural; I told them I felt my daughter coming, but they scoffed at the idea that I would recognize the feeling, even as my daughter was crowning—before the anesthesia took effect. Immediately after, I was again ignored when I started to have an allergic reaction to the anesthesia; they said many women itch and have trouble breathing right after birth. Lack of immediate care for the allergic reaction was the worst part of that birth experience.
Less than 24 hours after the birth of my second, I checked myself out of the hospital early when the incessant monitor beeping did not allow me to rest, nurses refused to turn the in-room volume down, and I was shamed for wanting to keep my baby in the room with me. I lived in a different state, but my friends and I helped each other with childcare and advice. When I birthed my third child after he died in utero, this was a time of mourning. The birth was induced and was traumatic. Later, I ended up readmitted to the hospital with an infection after my initial symptoms were ignored. Still, I relied on my spouse and friends for childcare and emotional support.
Fast forward more than a decade, and I’m now living in yet another state, and my good friends aren’t living nearby anymore.
With more life experience under my belt, and knowing my spouse’s temperament and inability to be emotionally present at the birth, I knew I would be on my own. Soberly aware of the weakness of my support system, I started talking to old friends and women in online forums who’d had babies in their 40s. I asked what made things go smoothly, even with older children and the complexities of real life.
Doulas are essential support for those without a “village” or for when supports aren’t physically present.
They’d hired doulas. This was my answer. I asked my mom to take care of things at home, and I read everything I could about doulas and sought recommendations. Ultimately I chose a highly recommended one and hired her for two prenatal visits, birth care, and two postnatal visits. A former hospital-affiliated doula, she was striking out into private practice. This sounded ideal, as I needed someone comfortable holding her own with medical professionals.
Additionally I wanted a woman of color like me—I valued the possession of an innate understanding of my cultural and religious beliefs and the capacity to advocate for them. By the time I hired her, I had shed my skepticism and incorrect luxury categorization. Doulas are essential support for those without a “village” or for when supports aren’t physically present. The only person ever to really ask me about the loss of my third child was my doula, and I learned from her that I had never grieved properly. She gave me specific ideas for how to intentionally grieve to avoid overshadowing this pregnancy. Talking to her revealed how much that loss had fueled a drive to persist through invasive, expensive, and ultimately disappointing infertility treatments. Amazingly, this child was conceived naturally.
She encouraged me to let myself feel the loss. People had used religious tropes to suppress my feelings, like the useless: “Let go and let God!” All that told me was who was unsafe with my vulnerabilities and shut me down. But my doula encouraged acknowledging my son’s existence, using the analogy of waves. Grief waves might crash continuously, other days, intermittently, and maybe not at all. Regardless of intensity, it’s real and worthy. This analogy has been helpful in dealing with other losses since.
Her care became even more crucial when my birth plan was jettisoned. During a regular appointment at 36.5 weeks, I was sent to the hospital for additional tests and ultimately admitted because my placenta was failing due to damage to the uterine wall. Our vital signs were discouraging. Additionally, no matter how much I ate that day and in the few preceding days, my blood sugar kept plummeting dangerously.
Honestly, I felt angry. For the first time in my life I had navigated the medical system well. Worry diluted my confidence. Originally I’d planned to travel to the hospital with my doula. Instead, I was alone when admitted. I was induced instead of starting labor spontaneously. My old medical fears resurfaced; but once I voiced them to my doula, she helped me navigate them. I didn’t get to use the birthing tub or stool that I had planned to use to mitigate the pain naturally. Because of timing and family dynamics, sometimes I was alone at the hospital. It took more than 85 hours for me to stabilize, be induced, and deliver—a marathon of exhaustion, worry, and pain. However, my doula kept me focused on what went well. My homefront was well-tended. I still used holistic supports like essential oils, music, movement, and massage. Even when physically alone, I had my doula’s emotional support. I avoided surgery and most complications. Post-delivery, my blood sugar stabilized. The baby was safe. I still stare at him in tearful amazement.
After delivery, I needed help breastfeeding: My baby latched properly about one in four times; either way he promptly slept. A baby that is not eating enough enters a vicious cycle where he won’t have enough energy to eat, and my son lost too great a percentage of his birth weight. Even though I had previously breastfed, I’d sustained a pelvic injury and I needed help with positioning. The maternity ward’s certified lactation consultants helped with the mechanics, and my doula advised me to give my son hand-expressed colostrum every two hours in addition to nursing him. Within 48 hours he improved, and I credit my doula’s commonsense solution.
Having a baby is both wonderful and difficult. The best outcomes happen when mothers are supported emotionally and logistically.
Before I was discharged, the lactation consultants provided me a flyer for two new moms groups. Gratefully, I attended both and made friends, voiced concerns, learned about community activities for new moms and babies, and formed my mom tribe.
Having a baby is both wonderful and difficult. The best outcomes happen when mothers are supported emotionally and logistically. This was never clearer to me than when we both caught the flu when the baby was six months old. Newly single, hypoglycemic, feverish, and sleep-deprived, I realized I was in trouble. Neither my family nor my birth doula were immediately available.
So I messaged my mom tribe just before dawn.
Within hours, I had food, saline spray, and throat lozenges on my doorstep, my sister offered to ship me a humidifier, a friend offered to pick my daughter up from practice, and another gave a trusted referral to a postpartum doula. I spoke with the doula that afternoon, and she came that same night. She brought a fever reducer for my son and fluids for me. I slept nearly six hours while the doula cared for the baby—the first time in a week I’d slept more than two hours in a row. Sleep turned the tide for us because my exhaustion had prevented me from rebounding, which made it hard to care for my son.
I wonder how different my previous births and surgeries would have been with someone there specifically to support and advocate for me.
Even as sick as my son was, he and the doula immediately bonded. She sang to him and rocked him so he was soothed. She monitored his temperature through the night. Most importantly, she put me at ease. We talked in-depth and she encouraged me to visualize a good night’s rest several times throughout the afternoon so that both my body and mind would be ready to rest when she next arrived.
Being supported by doulas made me realize how important their care can be for moms of newborns at birth and beyond. I wonder how different my previous births and surgeries would have been with someone there specifically to support and advocate for me. Would a support person’s presence have empowered me to insist that doctors fully consider more appropriate actions? I cannot go back, but I’ve learned what a truly supportive birth team looks like and the importance of intentionally building my support system.
Since then I have referred other moms to doulas, contributed to meal trains, and been an active member of my support groups. The support I receive and have given is vital both personally and at a communal level. It has helped me reconnect with my gut instinct and speak up for myself more. Doulas, lactation consultants, and new moms groups have been a lifesaving trifecta.
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