Saturday, February 14, 2009

What does a public health doula do?

One of the recent comments on my blog noted the idea of a "public health doula", and in the course of writing my reply I thought I'd talk a little bit about my training as a doula and why I chose that title for my blog.

I self-designed a major in public health, medical anthropology, and languages (mostly Spanish) as an undergraduate. I was interested in public health because of all the issues it pulls in - medical, cultural, political, environmental, and more. I wrote my senior thesis on breastfeeding, looking at it from a public health perspective and critical medical anthropology perspective, as well as doing original research. The reading and researching I did for that formed the basis for a lot of my thinking about birth, breastfeeding, and issues of motherhood, encouraging me to look at these topics from multiple perspectives. For example, what does an intervention do if we implement it on a broad scale? What does it mean to individuals medically? How does it seem to them culturally? What is the history behind it?

When I graduated from college I worked for an AmeriCorps program as a maternal/child health educator and doula. Everyone says "I didn't know AmeriCorps had doulas!" I feel so lucky to have stumbled across, and been accepted to, one of the few AmeriCorps programs that trains and provides doulas to low-income communities. It was the best job I've ever had, hands down. However, it was very different from private doula work! Every AmeriCorps doula program functions differently, but ours was an on-call service. We very occasionally met prenatally with clients who called us in advance, but more often one of the hospitals our community health center served would page us cold. Only twice in the whole year did I work with someone I'd met prenatally.

There were drawbacks to this model, but as a way to get a huge range of experience as a doula it was unmatched! I would say the majority of women who hire doulas are looking for a particular kind of childbirth experience, usually unmedicated and with as few interventions as possible. There is this idea that a doula is just there for someone with one particular need (extra support for unmedicated birth). The nurses at the hospitals we worked at understood that continuous labor support is beneficial for many more reasons. They paged us in for women who had a wide range of needs. Some examples of women I worked with: teen moms, women who had come to the hospital alone, moms whose first language wasn't English, families who just needed extra attention and support. I loved it! To me, there's no greater privilege than to be there for a woman when she is giving birth.

I know both I and the other doulas sometimes experienced gratitude out of proportion to what we "did" - sometimes we just sat there! But that's all we needed to do in some cases. To me, being a public health doula means being committed to the idea that every woman deserves caring continuous support during birth. I have done some private doula work and am excited about doing more, but there's still a very special place in my heart for being a public health doula.

Now that I'm pursuing a master's in public health, I'm also thinking about "big picture" issues and complicated questions, and learning much more about maternal and child health. When I chose the title for this blog (and I thought of a bunch) I wanted to pick something that would give me a space both for doula thoughts, for public health thoughts, and the merging of the two. I hope I'm doing OK at that!

15 comments:

cbarcelos said...

Yes, right on. I am doctoral student in public health and a doula (though its been quite some time since I've been to a birth) and I intend to do my dissertation on public health models of doula care. I'm surprised to learn that Americorps has doulas. Can you reply or post with some more info on the program?

publichealthdoula said...

Awesome! I DEFINITELY want to read that dissertation! Looking at your journal I see you've been to the repro rights conference at Hampshire so you've probably met Christy Hall/heard about the prison doula program? I will definitely post more on the AmeriCorps program since there's interest! I wish more people knew about it. I was shocked the year after I did it that they had trouble hiring enough people to fill the spots; given the number of young women I know who are passionate about birth issues and working in underserved communities, it was puzzling to me that more people didn't apply.

cbarcelos said...

Yes, I've met Christy...she's actually not with the Birth Attendants anymore which sucks because she's fantastic. I'm actually part of a similar doulas in jail project which has been taking off at a new womens facility where I live- we will be presenting at CLPP this spring. Does Americacorps having anything about the doula program online? I can't seem to find anything. I'm wondering about how the program is set up, how are doulas trained, who trains them, where is the based (ie, a community health center). Sorry lot's of questions...maybe email me sometime?

ps. my blog is oooooold

publichealthdoula said...

That's awesome you're doing prison doula work! It was one of my goals at one point to start a community doula project. Maybe in the future. Christy is great.

I'll e-mail you and/or post here with AmeriCorps doula info.

Anonymous said...

Public Health Doula. I love that. I am an RN who was a doula first and then went back to school for the RN license. I have worked primarily in public health as an RN and am thrilled to see that there are more of us out there than I ever imagined.

Eiko said...

Public Health Doula - I love it! I too have an MPH, am a doula, am an
IBCLC, and currently in a Master's Entry Program for Nursing. Hawaii had a couple of small community health Doula projects but we would love to see something bigger that could touch way more moms. Would love to hear more about what you're doing and also find out more about the Americorps program. Keep up the great work.

Rebecca said...

@Anonymous: There really are! Often hiding in unexpected places, too.

@Elko: You sound like my twin - I am considering a master's entry program right now. I wish I were doing more actively right now with community doula work but most of my current ideas are just little seedlings right now...

Katie the Baby Lady said...

Can you share with me what you did for your undergrad? My school has a "Health promotion" degree, but really it looks like all you be able to do with it post graduation is work in a gym. I have been a childbirth educator and doula now for six years and a recent (hopefully) clc, and thought I wanted to be a midwife (doesn't everybody?) and then well, I decided on public health, and I'm having a hard time finding something to fit what I want to do.

Rebecca said...

Hi Katie,
I did a self-designed major! Good for those of us who like to mix things up. Depending on what you want to do in public health a lot of different majors could be a good match. Sometimes I think a Spanish major would be the most useful!

ArmyCoilz said...

This is awesome! I would love to link up with more doulas on similar paths! I am currently working on a women's center with a community doula program that offers support to pregnant women in prison. I am in SC...so I have def hit some speed bumps! Please if you have any advice, support, conversation, or suggestions...please touch basis with me! I would love to hear from you ladies!

Rebecca said...

Hi Amy, I suggest joining the forums of the Full Spectrum Doula Network - lots of people there for you to connect with! http://www.fullspectrumdoulanetwork.org/

Christy said...

Thanks so much for this blog! I randomly followed a link on fb to a different article and ended up spending a lot of time reading various posts... and then I saw my name in the comments. How fun! I can't figure out from your bio how I know you, but i'm really glad to reconnect with you through reading this blog. I've been contemplating starting my own blog and so i've been exploring how those in my field use the tool and you use it well. You've set the bar very high. See you out there on the internet!
Warmly,
Christy

Bethany Hutchens said...

Cbarcelos, I am a master's student who is trying to set up a prison doula program at female institutions in Atlanta. I would love to have some tips and insight onto how to do that.

ediazordaz said...

LOVE YOUR BLOG. I am currently a HealthCorp member doing the doula/maternal and child health job in Denver. Love it! I have also been considering going back to school for my MPH. I have a BS in Latin American studies and a certificate in Global Health. What kind of jobs are you interested in pursuing once you complete your masters? My concern is that employers would prefer an MD or RN or any other medical professional who has their MPH as well over us with no medical degree. What has been your experience with this?

Anonymous said...

ediazordaz,
I coordinate a bilingual doula program for a Denver hospital. Would love to talk to you about your doula work. I am attempting to find out more about doula resources through Community Health Corps.If you are willing, I will give you my contact info.
Keep up the great work!