ChangeWorks: Doulas catch on as birth coaches

NolaVie partners with Propeller: A Force for Social Innovation on this series of articles focusing on New Orleans entrepreneurs devoted to social innovation. Today we talk to a local doula about this ever more popular movement and how it addresses prenatal health risks.

Latona Giwa and Dana Kere, founders of Birthmark Doula Collective

A prenatal health movement that took root with the rise of feminism in America is becoming more and more popular here in New Orleans.

A lot of that has to do with Birthmark Doula Collective, a business devoted to coaching parents through pregnancy, childbirth and beyond. Founded three years ago by Dana Keren and Latona Giwa, Birthmark has 10 doulas on staff, who last year assisted at more than 300 births in New Orleans. The two founders will have a new birthing center up and running in 2015, where moms-to-be will find everything from prenatal massage and yoga to birthing tubs and spacious birthing suites.

“The concept of doulas is not new,” says Keren, who first trained as a doula while an undergrad at the University of Wisconsin. “It’s only in the past century that childbirth has become so medically oriented. Before, children were born at home.”

The word doula comes from the ancient Greek meaning “woman who serves.” The natural childbirth movement of the ‘60s and ‘70s spawned the practice of having a nonmedical attendant on hand to give physical, emotional and informational support during and after pregnancy. (According to Wikipedia, anthropologist Dana Raphael was the first to use the term doula for such a person, in a 1969 report.)

Doulas earn certification from one of several national organizations, which involves classroom hours, exams, essays, readings and a set number of observed births. They mold their services to the individual pregnancy.

“Your doula can come with you to your doctor visits, and you can ask her what’s normal and what’s not, and turn to her for advice,” Keren says. “She’s the middle-of-the-night person you call.”

Doulas are not intended to replace partners, but to work with one or both parents as a prenatal counselor and birthing coach. Birth doulas work through the birth, while post-partum doulas help new parents afterward, advising on everything from diapering to lactation consults.

Keren, who came to New Orleans to work in a community health clinic, and Giwa, a registered nurse, had both been trained as doulas when they met here through mutual friends. They started working in tandem, covering for each other when needed.

“There was no goal to grow,” Keren says. “We both had day jobs.”

But the demand for doulas outpaced the two women. “When we started, no one knew what a doula was. Now people are contacting us looking for one. The city has really been receptive to what we are doing.”

Two years ago, the two women applied to become fellows in the social venture accelerator program at Propeller. When they were accepted, Birthmark got a major push. “That really kick-started us as a business,” Keren says.

So they hired more doulas, began renting birth tubs and breast pumps, and scheduled prenatal classes. Now, Keren has quit her day job to run Birthmark, and will earn her MBA from Tulane’s Freeman School of Business in the spring.

The next step, she says, will be the birthing center, staffed by licensed professional midwives who are backed by obstetricians. The center also will have an education counselor, lactation consultant, chiropractor, and massage therapist.

“Birth centers offer a great in-between alternative to at-home or hospital birth,” Keren says. “We partner with area hospitals, and we monitor everything. At the first sign of any problem, we transfer to the hospital.”

She points out that hospitals, too, are turning to natural birthing centers and treatments like hydrotherapy to ease the pains of labor.

Doulas generally cost about $700 to $800 for the duration of a pregnancy. Some doulas work with a single mom at a time, while others handle two or three.

“We’re committed to working with every mom no matter what she wants – even if she gets a C-section or wants an epidural,” Keren says.

The two women also are focused on making their services available to the masses. They have instituted a one-to-one program, so that for every paying client they offer their services free to a mother who can’t afford a doula.

“When we started Birthmark, we understood that doula support is inaccessible to some people,” Keren says. “We’ve worked with teen moms, HIV-positive moms, we go into high schools and work with girls there. New Orleans has high infant and maternal mortality rates, as well as C-section rates. We have poor breast feeding numbers here, too.”

Keren says she never saw herself as a local entrepreneur, despite the recent upswing in local start-ups. “It must be something in the water,” she says with a laugh.

Not that she’s complaining. “It is the greatest honor to be part of new families’ lives,” she says. “Birth is such an intimate moment.”

Now, she says, she needs a doula for her growing group of doulas. “Latona and I realized early on how time-consuming being a doula is. We all get together for a monthly brunch, where we talk about births and challenges and our experiences. We really are like a family.”

ChangeWorks is a partnership between NolaVie and Propeller: A Force for Social Innovation. Send feedback to renee@nolavie.com or cgans@gopropeller.org.