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!