Ajira: You're listening to Doula Stories, a podcast where we use storytelling to encourage, inform, and love on doulas.
Keelia: Each episode we’ll hear a story about what happens in the birth room from the doula’s perspective. I’m Keelia, she/they…
Ajira: And I’m Ajira, shey/they…
Keelia: And we’re so glad you could join us for today's intro episode.
So welcome to the first episode! Like I said I'm Keelia, and Ajira and I are going to take this first episode to tell you about who we are and the kinds of stories we’re going to hear on this podcast. So Ajira, would you like to introduce yourself?
Ajira: My name is Ajira, my pronouns are she/they. I'm what they call a third-culture kid although I'm not—I mean, am I a kid? I don't know—but I grew up all over the world, essentially. I was born in Tanzania, that's where my mother's people are from—Nyasa and Yao—and my father is British, his people are Welsh and English I think. And yeah, we just traveled everywhere my whole life. And I like to think I’ve been a doula since my mother had my sister. So I was three years old and I thought the baby was for me, and I also knew that my mother had worked really hard to give birth, and she wanted me to just bring her tea immediately because tea solves everything. From then on I was always the person who is most interested in how our bodies function, how reproduction works, what the function of the period is, and all of those things. I was always the person in my group of friends who knew how those things worked and how you could engage with them, basically.
Around the time of my first child's birth I started just offering way more postpartum support, initially. So lots of breastfeeding counseling, lots of milk sharing counseling, and just supporting folks to find ways to feed their babies. I was the person who had the recipe for homemade formula and all that kind of stuff. And then supporting friends and family with birth virtually because most of my family lives far away from where I do. And then, you know, started building more community here in the Bay Area, and then after a few years finally thought, “You know what, my kid is old enough now I can actually go support people at the hospital to give birth.” So then I’ve been doing that. But it's just felt like one version of the things that I do, you know what I mean? Like I've always been supporting people giving birth and just in different ways and in different places and at different times. And I've always I've always been supporting people with their reproductive milestones just in different ways and at different times.
What else about me? I'm black, I'm fat, I'm Queer I have two children. I'm always hoping for about 15 more.
Ajira: We'll see if that happens.
Keelia: The twins!
Ajira: That would be amazing, yeah, my children are both cheering for twins. That’s what they’re manifesting. They’re like, “Just two and then you'll be done, we’ll be four, and it'll be great,” and I'm like, “One of you can be responsible for one sibling, it’ll work out fine.” Yeah.
Keelia: Thank you!
Ajira: What about you? Tell us about you.
Keelia: Sure! I love how so many people who end up doing birth work have this background of having done it their entire lives, or often finding themselves ending up in the position of their community coming to them with questions about their reproductive experience, you know? That by the time someone actually learns what a doula is they’re like, “Oh is that what what I've been doing my entire life is called, or one word for it?” So I totally relate to that too.
I’m Keelia, I use she/they pronouns. I’m a Queer, mixed race, Asian American doula. I am like Ajira in that I'm also a “third culture kid.” I was born in the US, I lived in Chicago for a long time and then my family and I moved to Mombasa in Kenya for a little while, and then the rest of my upbringing was in Kampala Uganda. So also from all over.
And I’ve been a full-time, full-spectrum doula for the last few years which means I help people through the whole range of reproductive experiences, like what Ajira was saying. So infertility birth, pregnancy loss, adoption, foster care, surrogacy etcetera etcetera, and I've done that full time in Boston, a little bit in Gulu in Northern Uganda, and I currently do this in Oakland in the Bay area where I live with my marvelous partner. And I have a 6 month old baby.
My story of how I got into the work is also very similar which is that my mom had a bunch of other kids and I was obsessed with all these babies. But to go back a little bit further, my mom, who’s a Chinese American woman, had me and my older brother in hospitals and had really difficult experiences. So without being part of any kind of, I don't know like hippie commune, she just decided to look at these other options for how she could have her babies and ended up having her last three kids at home. And I remember being called in in the middle of the night to meet my new sibling in my parents room and watching the midwife cut the umbilical cord and all that stuff. And I was fascinated and also tried to educate all my little friends about how birth worked from a very young age. I remember acting it out with stuffed animals to this one friend of mine when I was—I must have been five or six—and she could not believe it, she was like, “That is not how the baby comes out,” and I was like, “Oh yes it is! Now you’re going to catch the baby and blah blah blah.”
So I've been fascinated by it my whole life, I've been telling people I want to be a midwife my entire life. And it wasn’t until I was older when I found out what a doula was, and I thought, “That would be a good thing to try first before I start going to Midwifery school. I should try this out full time for at least a year and make sure I still am as passionate about it as I've always been.” And as soon as I attended my first birth as a doula I knew this was it. I didn't want to go on and become a midwife or a social worker or an OB or a lot of the other things that I was juggling that a lot of doulas tend to juggle. This is all I want to be doing right now.
And the way that I actually got into this work once I did decide to become a doula was also a big part of the story. It was learning from the amazing Shafia Monroe at ICTC, the International Center for Traditional Childbearing. And then later I was also trained by Roots of Labor Birth Collective which is based out of Oakland in the Bay Area. And this was with all BIPOC cohorts (that's Black, Indigenous and other people of color cohorts) learning ancestral wisdom and tradition alongside the birthing techniques and the typical, you know, evidence-based information that you kind of expect at a doula training. So that is a really big part of my practice today and why I'm doing this work.
Ajira: I would like the name that it's really not unusual for birth workers to have, like you said, that experience of, “Oh this is what, you know, what I've always been doing is called,” and also that it's very very common as far as I can tell for birth workers to take multiple trainings. I find that BIPOC birth workers tend to, if they've taken one of the more conventional big-name trainings, they tend to feel as though there's something missing. Because that ancestral wisdom aspect or that part that really speaks to the fact that, you know, supporting birth has been an intrinsic part of -- I want to say most just because I have not researched every single indigenous culture…
Keelia: You haven’t?
Ajira: Not yet! But, you know, that [of the cultures] we know of, that this is not new. This is something that has always been that there's always been someone who was there to support birthing people. And sometimes that looks like, you know, a sibling or a parent or a grandparent or an auntie or an uncle in the village or in the community, who was obsessed with birth and had observed many many births, and had learned through experience, through paying attention and through practicing and supporting person after person after person who was giving birth to distill and discern, like, you know, these are the things that are helpful, these are the things that are not. These are the things that are normal or common, or these are the things that are unusual but not an issue, or unusual and can be an issue. And you know these are the signs of that and these are the signs… so this is not new. And I think that sometimes conventional trainings, you know, that have not been decolonized consciously and with intention can present a lot of this information as though it was, you know, some scientist who discovered it all.
Keelia: Yeah, or like it started in the 50s with a few white women.
Ajira: Yeah. And we're lucky that they’re deigning to share it with us.
Ajira: And that can feel very… that can feel very painful. Just because there's that, you know, immediate recognition in your whole body that this is not new.
Keelia: Exactly. Yeah, so if you are here and you don't have that “conventional background” of having attended some kind of doula training and checked all the boxes and gotten certified, we are so glad you're here. You belong here just as much as anybody else.
Keelia: And we also, for anybody who's here who does not come from any kind of having supportive people through birth or through any part of the reproductive experience, Ajira, do you mind telling us what a doula even is?
Ajira: Yes! Doula is an unfortunate word.
Ajira: But it is one that we continue to use with some naming of the historical context and why it's problematic, because it's the word that more people know of now. But doula is a Greek word that means slave or servant woman depending on who is telling you. And the idea is that it was coined as an appropriate term to refer to birth companions because the feeling is that, you know, we’re there to serve. However of course for BIPOC that just feels inherently wrong, I think. But because it is the word that people are most familiar with now I think I tend to use it interchangeably with birthworker or birth companion…
Keelia: Support person…
Ajira: Support person, birthkeeper, yeah. But essentially it’s that person who is in the room that is not medically trained, typically, and their purpose is not medically driven. So they're there to provide emotional, spiritual, physical support and really walk alongside the birthing person and create a space or a container for them to have their experience. And sometimes when I say that folks ask me, like, what do I mean by a container? And what I mean by that is that I don't have any preconceived notions of what your birth needs to look like. I'm coming into that space purely to be present and grounded and to not have any of my own judgments or preferences or ideas about what an ideal birth looks like. None of that is relevant when I'm supporting your birth experience because I want you to have your experience.
So all I'm focused on is being completely grounded and present so if you need someone to, you know, offer some suggestions on comfort measures, I have a bag of those. If you need some conversation around different options or choices that are facing you, I have lots of information about that. If you want to just meditate, I can support you with that. If you want to just breathe, I can do that. If you want someone to stand at the door and tell everyone that you're in the toilet so you can have a moment alone, I can do that. But basically I’m not trying to save you, and I'm not trying to tell you what’s right or wrong. I'm not trying to tell you that you shouldn't do this or you shouldn't do that. I'm not doing any of those things. All I'm doing is supporting you, reminding you to trust your body, reminding you to trust your experience and your knowledge and reminding you that you only need to choose what's best for you and your family, and nobody else is relevant in that moment, you know?
Keelia: Yes! I'm so glad you phrased it that way because one of the common misconceptions that I hear about what we do as doulas is this assumption that we are bringing an agenda. That we want everyone to have a home birth, or we want you to have your baby in a tub, or you shouldn't use any pain medication, and that's not it. It's that we are there to provide you with the information to help you make an informed decision, and then we are behind you a hundred percent no matter what you choose. And that role can be tricky because at the same time we do know the history of birth in this country, and we do know how unnecessary all of these common interventions are, so what often ends up happening is that the people we’re supporting choose not to have the unnecessary interventions or they realize they have the option to give birth safely at home or any of those examples. But if we come in with an agenda saying, “This is how we think you should give birth,” it is just as disempowering as somebody’s who’s saying, “Alright, you have to have a c-section and you don’t have a say in it,” you know?
Ajira: Absolutely. And I mean another thing that I think happens is that we see home births and unmedicated births and uninterrupted births being celebrated as the ideal. And I think that's a very romantic idea, and yes, in an ideal world that would be amazing for everybody to have. And also there are people who, for whatever reason, that's not a fit. And I think that it's very disempowering for us to have this idea that like if you do it this way then your birth is valid or good or whatever. But if you do it this way it's not. Like, I am not at all concerned, like if my client wants to choose to have an epidural, and they made that decision free and clear like they weren’t coerced into it, they weren't pressured or manipulated into it, they chose that of their own volition because that was what was best for them? Then I think that's a birth worth celebrating. Because in my experience it matters more that a person feels safe, that a person feels like they got to make their own decisions about what happened, they had that autonomy, and that a person feels like they were respected, they had a consensual experience. Those are the three things that I actually have my clients say whether their birth was good or bad, you know what I mean? Like I’ve had clients who have had the uninterrupted, un-intervened birth experience. But they definitely didn't feel good about it because they were pressured and guilted into resisting this or that or the other thing. And I've had folks, you know, who have chosen to have a surgical birth and they feel good about it because they had the time to integrate and to get grounded and to make that choice from a place of really understanding what the potential impact was, what the risks and benefits were. And I think that piece just matters so much more. So I hope that I hope that we will continue to celebrate people having autonomy over their birthing experience because I think that when we get there then we're going to see more reduction in the potential harm that can happen.
Keelia: Yeah, and that also speaks to the kinds of stories will be sharing on this podcast. They're not all going to be home birth stories with middle-aged white women, cis white women, there are going to be a huge range of people and backgrounds and twists and turns along the birth journey. One other thing I wanted to bring up is what a midwife is because the terms doula and midwife can be used interchangeably by accident if you don't understand what a midwife is. So do you mind explaining what that is?
Ajira: Yeah! A midwife is a medical provider. The midwifery model of care is typically less medicalized than an OBGYN. And essentially they are a birth professional who is licensed to check on you physically and administer certain aids like pitocin, for example, which is a drug that is used to induce contractions essentially. But they are somebody who is going to support you to have a birth experience, look after you and the baby medically and ensure that you're both safe. There is quite a spectrum of how much they will interfere with the process depending on their training essentially, and also a little bit on licensing in my experience, you know, state to state in the US. So the most traditional midwife is probably going to look like they're doing the least, because they’re essentially just going to observe you and then, should a need arise, they will intervene. But for the most part they will trust the process because that's what that training typically looks like. I think hospitals just require their staff to engage with and manipulate the process way more so a hospital--
Keelia: They’re working for different people, they have different pressures, right.
Ajira: Exactly, exactly. So they’re juggling multiple people, they have timelines, they have averages, and they are very, you know, often trying to keep you to that average in the sense that they're saying, like, “Typically at this point we're expecting to see this, and if we're not then we would like to manipulate what's happening so that we can get it as close to this as possible,” right? So, you know, they're more likely to be talking around things like, “Well, you know, but after twelve hours of labor we are expecting to see this, and if we're not seeing it then we can use this method or that method of that method to try and do it.” Where as a traditionally trained midwife is more likely to just be like, “Okay. This is what’s happening.”
Keelia: Yeah, yeah, the tool kits are so different. Well and this is also the difference between having your baby with care from an OBGYN versus having your care from a midwife: if the labor is going “too slow,” then what are the solutions that they turn to? Is it, “Why don't we try getting into a different position or going for a walk,” or is it, “Here is a medication that we think can help.” So that's also a big difference between how a midwife might help you have your baby versus how a doctor might.
And there's one other difference between a midwife and doula that I wanted to bring up, which is the continuity of care. And that is basically saying that when you're having a baby you are -- unless you're having a homebirth—you're probably going to be supported by whoever is on call at the hospital or at the birth center. So that's one piece that helps doulas provide such great comprehensive care, because when we're seeing our client in labor we already have sat for so many hours in their living room. Or if it's providing virtual support then we've had hours of conversation with them ahead of time learning their story so we can often -- well, I’ll speak for myself -- when I show up and I see that person's expression then I am able to gauge really quickly what it is that they need and how I can support them. I’m not having to build trust with them within the first five minutes of seeing them on the day that they're giving birth. And then we're keeping in touch with them afterwards.
So this isn't every doula, everyone will do it a little bit differently, but the way many doulas will work is they provide prenatal care ahead of time, so that’s having the living room conversations with the families and with the birthing person asking, “How can I support you really well? Is it going over what different birthing positions you might want to try out on the big day?” Or maybe it's something really far away from the actual physiology of birth. Maybe it's [them saying], “I'm really afraid that I'm going to repeat the mistakes that my parents made with me when I have my child,” or, “I am just so excited to have a baby and I want someone to celebrate with me. Can we just talk about how exciting it is?” you know? So that's the kind of care that we're giving ahead of time. Then the birth comes, and then we're doing the whole host of things that Ajira was describing: we’re massaging, we’re coaching through breathing, sometimes we're just sitting there and being that container. And then afterwards we're supporting them as they're starting off their parenting journey.
So we are seeing these families grow over a long period of time. And when they're struggling with breastfeeding a week after the baby is born, we have the context of “This is something they were really anxious about. As soon as they got pregnant they were worried they wouldn't be able to,” you know? We just know that any point of their birthing and then parenting journey has this story of the background and we can understand them that way. And then sometimes we get to go to the baby's first birthday party, or we end up getting to help them have their other kids. So it's much more of a relationship where we have the ability to really become a part of their story in a way that many hospital staff can't because they have to work on a shift. So that's the other big piece of what we do as doulas.
So the last thing we wanted to cover today is just talking about why we see the need for this podcast. Why do we want to hear birth stories that are told from the doula’s perspective? And I think the answer is pretty obvious. If you're here, then you know, which is just that if you get any two birth workers together then birth stories will abound automatically, you know? You’re in line at the grocery store and you happen to hear that the person behind you is a midwife, and you’re like, “Oh, I’m a doula!” and then suddenly you’re standing there an hour later and you're still talking about all the different birth stories that you've experienced. And I love that about this work.
Ajira: Yeah, I’ve barely managed to resist telling like three birth stories just in this intro alone.
Keelia: I know! I know, I can think of dozens and dozens and it's so good, it's so juicy. But at the same time, like when I first became a birth worker I was eating these stories up. Anywhere I could find birth stories, I was listening to them. And there are lots of other great podcasts that have an abundance of birth stories. But the vast majority of them, rightfully, are told from the parents’ perspective. It is their birth and it is their version of the story that matters and that many people want to hear. But at the same time we are there having our own experience. And the way that I found this is best described is a short excerpt from the book, “The Doulas: Radical Care for Pregnant People” by Mary Mahoney and Lauren Mitchell. So I’m just going to read this paragraph because it says far more eloquently than I ever could why we’re doing this podcast.
“Why is it important that we tell the stories of doulas? Because doulas are caregivers, and caregiving takes a toll. Stories from the caregiver perspective are often left out of conversations; we are supporting actors to the client's leading role. When we sign on to be caregivers, we are giving up a part of our identities for the sake of another person. Our work means that we are engaged in a deep intimacy with other people daily—the grief and joy of our clients, the doctors we work with, and each other. ...Doing doula work all day, every day, means that we become filled with stories. At the end of the day, we do not just bear witness to someone else's story, we become a part of that story and that story becomes a part of us. We try to receive emotional burden for as long as we can, but the relief of that burden comes with our own sharing.”
I just love that, and I also highly recommend that book if you haven't read it before. So one way that we can share that burden and that we can grow as doulas and sustain ourselves is just by storytelling and listening. And oftentimes what do we do when we leave a really difficult or really beautiful or really beautiful and difficult birth is we call somebody else who understands, another birthworker, and process while trying to preserve the dignity and anonymity of our clients. We’re looking for ideas for next time, you know? “This was a challenge I faced, and I’m really Struggling with like maybe if I'd known as other birthing position I could have supported that family better.” And then we’re hearing the correct response which is, “You did everything you could. Your presence was invaluable.” And also we can learn from this, it's okay!
So we are adding to our tool boxes, we are maintaining our own emotional and mental health, we're building community so that then we can support that person on the other side of the phone call when they need us. This podcast is an extension of that energy. And it’ll also just be, like I said, it'll be really helpful to hear tips from other doulas. For example in many birth worker trainings you’ll hear the instructors say something like, “Make sure the birthing person feel safe and supported,” or maybe you heard what Ajira said earlier about trying to be a container for these people's experiences, and it can be hard to really understand what that looks like if you haven't been in the birthing room before. And here we’re going to seek to give you really concrete examples. This is what it felt like in the room. The energy was so strong it felt like it was sparking, and I locked eyes with the birthing person, and I said this thing, and I don't know where it came from but I said it and this is how they responded to it and this is how the story ended up unfolding.” That's what we're here to do.
Ajira: That’s beautiful. That’s beautiful, that’s the thing that I think sometimes it's easy to forget, or forget for a while at least. That, you know, our parents have birth stories and our aunts and uncles have birth stories, and our just about everyone has a birth story, or a story that is about a transition like that, you know? One where an addition or a loss was experienced. And those things are ceremonies and there's always going to be somebody who is a space holder for that experience and Part of the retelling of those stories is like you said you know a way to to release the pressure of holding all of that but I think that there’s also something really amazing about the fact that although we are the guests stars to our client’s leading role, we are also having our own experience. Because birth is one of those things that is so charged, you know? Ceremony is one of those things that is so charged that all of your stuff gets activated as well. And I think part of the skill of a birth worker is to be able to, you know, recognize when that is happening to put it aside to deal with later and then to continue showing up at this experience present and grounded and clear enough to hold space for the person who's having, you know, the main experience in the moment.
And then I think that the telling of the story to each other and to others and especially the practice of telling the story from my own experience as opposed to trying to interpret what my client was feeling or thinking or what, you know, trying to figure out or guess at what their motivation was for whatever they're doing is futile and frankly disrespectful. Because there's no way that I can know what my client was thinking of, what was coming up for them, and it's not really my place to try and tell their story. But I can tell my story. And I think that when, you know, when birthworkers get together and tell each other the story of this birth and what I did and, you know, how I was and what I felt and what came up for me, there is so much richness to be delved into and to just really share, so much to learn from each other. Not just about how to better support folks in birth but honestly how to live better, you know? How to just be more here now. And it is always such a gift to be the person that another birthworker calls to debrief about a birth. And I think amongst my birthworker friends we're always like, “What happened! Tell me what happened at that birth! Did you hear?” Yeah, and I think you do get really skilled at being able to describe an experience from your own perspective that still protects the anonymity of your client as it should, right? And it's a beautiful thing. So that's something that we're definitely conscious of. I think that there may be some hesitation potentially for people who are listening to this, like, are we going to be putting other people's business out in the streets? And the answer is no.
Keelia: Right. We’re going to be taking lots of precautions to make sure that the parents who we’re talking about are kept completely anonymous if they want to. So actually on that note: some logistics about how this podcast is going to work. Obviously this episode we just wanted to let you know who we are and why we're doing this but from here on out, every episode we're going to be hearing a birth story from a doula’s perspective and either that will be shared by the doula as a guest, and if that's the case then the story is being shared with the full, informed consent of the birthing person. Or we’ll be sharing a story from the doula’s perspective and to preserve the anonymity of the birthing person then the doula is also going to be anonymous and in that case it'll be me sharing their story for them. And at the end we’ll close with any words of wisdom and resources the doula wants to offer us.
So tips and thoughts will be shared along the way, and there’s one more note that I wanted to make which is: as you probably already know, there is a huge range of doulas out there and how they practice. So every doula’s style and beliefs are little bit different so don't be surprised if you hear a few different takes on an issue amidst these stories. We think each story is unique and important to hear so that's what we're here for. You'll probably get a sense very quickly for Ajira’s and my styles which are very similar, but you'll probably hear differences of opinion, which we think is really important.
Ajira: Absolutely. I think that's something else, that there are as many different kinds of doulas as there are people, and that that is important because you may not be a person who wants somebody who's going to, you know, hold your hand and sing Kumbaya. You may want somebody who is matter of fact and focused on the logistics and the mechanics and you should have a person who can support you in the way that you want and the way that you need. And so there's, you know, there are doulas out there who are wearing silk blouses and pearls and kitten meals, and there are doulas out there who are, you know, rocking cowrie shell earrings and a head wrap and bringing a lot of crystals, and the full spectrum between those two things. And I don't know why I put those two things as opposites but you get what I mean. The point is that there is a birthworker for every birthing person that there is, and it's important to really I always encourage folks were looking for a birthworker to trust their gut to keep talking to people until they find someone that they connect with and feel safe with because if you don't feel safe with the doula that you choose then they’re not going to be able to support you in the way that you need.
Keelia: Absolutely. So we’re here to support and celebrate each other, to lift up each other’s work, to share the inherited guidance and wisdom from our guests and those who came before us, all while listening to some damn good stories. So with all of that said, it is so great to have you here. We look forward to sharing doula stories with you soon! We’ll see you next time.
Ajira: If anything from today’s episode resonated with you, leave us a review on iTunes or your favorite podcast listening app, and follow us on Facebook or Instagram @doulastories. If you’re a doula and you have a story to share, email us at firstname.lastname@example.org.
Keelia: This episode was produced by me, Keelia Alder, and our music is by Rick Bassett. Special thanks and love to Tali Perelman, Alyssa Codamon, Chris Alder, and Cameron Sharp, and of course to my fabulous beyond words, goddess to the skies, most beautiful, marvelous, incredible, brilliant, sexyaf co-host, Ajira Darch.