In honor of International Day of the Midwife, supermodel, activist, podcast host, and dear Mama Glow friend Ashley Graham used her platform to amplify the voices of doulas and midwives, educating her followers on the importance of birth work with a day of Instagram Live-programmed Q&As for Pretty Big Deal Live, bringing the real-talk vibe from her podcast to her audience who is at home during quarantine. Observing this year’s International Day of the Midwife days before Graham celebrates her first Mother’s Day holds extra significance for the new mama, since she gave birth to her son Isaac at home with midwife and doula support in January.

Considering the day as an opportunity to “celebrate not just midwives and home births, but everybody in the process,” Graham invited her doula, Mama Glow founder Latham Thomas, to join her in an Instagram live conversation. Introducing Thomas, Graham explained to her audience that “whether you’re thinking about being a doula or you’re looking for a doula, your doula should be your 100% advocate and not sway you, but just give you information.”

Here’s what Ashley Graham and Latham Thomas had to say about Graham’s birth experience, the importance of doulas and how they’re complementary to (but different than!) midwives, and how we can be better advocates and supporters for pregnant women, birth workers, and ourselves:

ASHLEY GRAHAM: Can you tell us a little bit about how you became a doula?

LATHAM THOMAS: My journey to become a doula really started after the birth of my son, who’s now 16. Back then, it was so different. People now have the access to the internet, you have all kinds blogs you can go to, information is really out there. And if you can think about the internet 16 years ago, it was inflexible, it was hard to navigate, and so I just had to go to phone books – which are relics now – for information. I had to go through friends and get recommendations. But it was really after the birth of my son. He was born in a birth center on 14th street called Elizabeth Seaton Childbearing Center. It doesn’t exist anymore, but it was a freestanding birth center in New York City run by midwives. And so I could go there and have this incredible birth experience with my son and be honored through the process, be supported. And that kind of sparked in me after his birth, which was a beautiful vaginal delivery – I went in at like 1:09, he was born at 6pm, and I walked home with this baby and I was like “Where are the grownups?” But right after that process, I said “You know what? I have to protect this experience because no one told me it could be this way.” Nobody told me it could be so beautiful, so empowering, so transformational, and I was like I have to protect this for women. We need to know that there’s another way, and that whatever that way looks like, we should come out on the other side feeling supported. So that was really a part of my journey.

And like you said, it’s not really about what my intentions are for your outcome. It’s about me helping you carry your vision into fruition and me supporting you along the way. So that means providing emotional support, physical support, psychological support, educational support, advocacy tools, and really partner support. You guys probably saw “Pretty Big Deal” when Ashley talked about Isaac’s birth. Justin was a huge part of the process and a huge advocate, and he got really educated as well. So, to me, it’s like the best of both worlds when we can have both parents, if it’s possible, be as educated as possible.

ASHLEY: Really, midwives and doulas go hand in hand, but can you explain what the differences between a midwife and a doula are?

LATHAM: A midwife actually provides all the clinical support for the birthing person. So what that looks like is doing all of your appointments that you would do at your doctor’s office with your OB/GYN, you would do that with your midwife. A lot of midwives do home births or birth center births so sometimes you see them at their facility, other times you see them at home. In the delivery process, they don’t just come with towels, they bring tools with them and they’re able to support you through the process of the delivery if it’s a low risk birth at home. So for the experience that we went through, it was great because Ashley was able to have a tub, she was able to have access to a lot of things that would not have been possible in the hospital, and she was also allowed to move freely and eat and whatever she wanted to do, which can only happen in the comfort of your home or in a birth center.

And so, I think that’s really critical in terms of the difference between the midwives and the hospital space, but for doulas, we provide non-clinical support. So that means everything else, it’s kind of like having a producer for your birth or like having a best friend or a therapist – somebody who can be a nonjudgmental presence of support for you, but also who’s thinking about all the things you need to anticipate your needs in the birth process. So my job was really to think about what you would want to eat afterward, what you would want at your most challenging point in that process, how to navigate the pain, being there to provide counter pressure and making sure you got through those moments. It’s a team effort, but it’s really all hands on deck when you get in the process – as you know.

ASHLEY: It really is all hands on deck. And I’m so thankful that I had you there because even if I wouldn’t have chosen a home birth, I still would have had you in the hospital with me. I think that any pregnant woman who’s about to go through her first birth should really think about having a doula because the amount of education I got before I walked into the home birth – which is a whole other plethora of information that I would have never had – but walking up to that point, there was information that I never would have even thought of. Like you just said, for example, “What am I going to eat afterwards? Am I going to be hungry?” I never even thought of that. So right now, and maybe because I’m in this space and maybe because you’re in this space, I feel like doulas are kind of trending. Is there a reason why they’re trending? What’s behind all this “trending doula-ness?”

LATHAM: Well, I think right now with everything that’s happening with COVID-19 and folks really trying to figure out how they can navigate this process, I think there’s a lot of fear – number 1 – a lot of anxiety, and also a sense of people don’t think that they know enough. And so, if you’re in this process and you thought you were going to have access to a doula or you thought you were going to have access to your partner in the delivery room and you’re being told that maybe you’re not going to now, you’re feeling isolated, you’re feeling underreported, and you’re also feeling like “How do I navigate this system?” Whether you’re having a hospital delivery whereby you really do need the tools, you do need to have advocacy tools, you need to understand what the patient advocacy net looks like for you in that setting, especially in a global pandemic. That’s why I think doulas are trending – people are now trying to figure out “How do I get virtual support if I can’t have somebody in the room?” And everyone should know that it is possible to have virtual support. A lot of hospitals are allowing you to bring your device that you’re on right now or an iPad in the delivery room and have your doula present, or another partner or whoever it is that you want to talk to or have present to support you as you navigate the process.

A lot of people are accommodating in that way, but like Ashley said, it doesn’t just start at this point of birth, it starts ahead. So we need to be thinking about, before we get into that position where I’m gonna deliver the baby, how do I prepare myself for this moment? How do I make sure I’m educated? How do I make sure I know how to advocate for myself? That takes time, so we don’t just wanna do it at the last minute. What we’re finding is, in a pandemic when everything is so up in the air and rules are changing and policies are shifting constantly, people feel like they’re grasping for that handholding and that continuity that a doula can provide, so I think that’s a big piece of it too.

ASHLEY: I just saw a question in the comments and it was “Why would you need a doula if, in the end of it all, you have to go in for an emergency c-section?”

LATHAM: So I think what’s interesting about that question is people tend to think that a c-section somehow is like less work just because it takes a shorter period of time. It’s like a 20 minute surgery to get the baby, and then maybe 45 minutes to sew back up – it does not mean that the work ends there. I mean, the postpartum period and recovery period after a c-section is really lengthy. It could be at least 6 weeks but it could take up to a year to heal. So you need someone there to help you recover, you need someone there to make sure you’re eating, that you have stuff to help heal your body, that you have anti-inflammatory foods, that you have support because your mobility is affected after a c-section, to help you with breastfeeding support because breastfeeding doesn’t come as easily after a c-section. You need so much more support, and so the idea also that it’s like you “failed” or something is not how we think about this. We think about a c-section as another pathway to a baby being born and it is a necessary pathway in some instances, and because of that we want to make sure that we do have somebody there who is a nonclinical who can support you, cheerlead for you, make sure that you have the way to adapt on the other side of that.

The other piece, too, is that if you planned for a vaginal delivery and you have this entire experience in your head and you’ve been dreaming about it, we need to help you process the sort of failure of that dream being fulfilled. It’s not a failure of you, but it’s like this idea that you mourn the process of something that you wanted to have happen. We have to have the time to mourn what has occurred. That is important as well, because if we don’t process the healing on the other side of that experience, no matter what it was, I think that that sticks with us and it affects us. I’ve talked to people who, 16 years later, are still in mourning around things that they didn’t get to process. And so a doula can help you process that experience.

ASHLEY: This is kind of like a birth trauma conversation I was having earlier. It’s the regret also, and I think that brings up a really great point. And I have to say, my aftercare, you were there once a week, called almost every day just to check in – it wasn’t annoying at all. You brought over elixirs, you brought over all these power balls that I still make to this day, by the way – they’re so good because in the middle of the night when you’re breastfeeding and you’re starving, those balls came in handy. So your company is actually called Mama Glow, and you are training women how to be doulas, correct? So walk us through that process and how people can sign up. 

LATHAM: You know, COVID-19 forced us to go online with our trainings – we were doing in-person trainings and now they’re online. So you can go to mamaglow.com/gatherings, we have May training, which is basically full, and we have a June training that is once a week and goes through July. And it really walks you through how to prepare yourself to support people through the pregnancy and early postpartum period. It’s a really incredible training, it really helps us to meet people where they are and meet their needs. I’m just thankful to be able to be a part of it, obviously we have other teachers who come and support. It’s a global training, we have people from all over the US, 6 continents represented in our trainings, and it’s a global community of birth workers who are really helping to change birth outcomes in this country but also globally. What we know, and I’m sure you’ve talked about this, is the US is really failing women when it comes to birth. We have the highest maternal mortality rates, and then black maternal health and Native American women are really suffering in terms of maternal health outcomes in this country. So we’re working to eradicate that through the doula training program in making doula access more affordable, more accessible, but also to make more of them so that they can do this work in their community where there’s less access. We’re so honored to be able to work with midwives, to celebrate midwives, and to celebrate someone who had an incredible birth with midwives – you, Ashley!

And I’m so grateful that you would have this conversation because people do need to know that, while we want to celebrate midwives, you should know that our country has sort of built against midwives so they’re not everywhere, they’re not as accessible as they should be. So please, in any way that you can, find organizations – you can research a bunch of them today to see who is supporting midwifery education. Maybe you want to help someone to get educated, maybe you wanna donate to mothers to be able to support them to have births with midwives or get doula access for their births. Because this is really important that we all support each other as a community.

ASHLEY: And you bring up a great point about midwives, because it’s not just about having a home birth and having a midwife or a doula. You can also be in a hospital with a midwife or a doula. So, when we talk about birth and we talk about midwives and doulas, remember everybody at home – it’s not just about home birth. It’s about every kind of birth. What is your advice right now, especially being a doula, being an advocate for mothers – what’s your best advice for them during this time of COVID-19?

LATHAM: I have a few pieces of advice. Number 1, we’re also in the midst of maternal mental health week and we know this is a really challenging time for so many moms and so many moms-to-be mentally and emotionally, so I would say have access to a licensed mental health provider. Right now it’s really easy because everyone’s doing telemedicine, so you can find a provider and, just like we are right now, you can be with a provider virtually… Also, know how to advocate for yourself whether you have a doula present or not. It is important to know what your rights are. It’s important to understand, when you enter a space, how to be in that space and have your own personal sense of authority and autonomy over your body. It is your body, so being able to speak up for yourself and your needs is super important. And it’s really hard in spaces where we’re intimidated and we’re taught to kind of speak down. So, be in that position with yourself through relationships with people like doulas where you can get educated, you can do virtual classes with people to get yourself up to speed, there are tons of videos you can watch. But I would just say education is so important because you’ll feel more confident as you enter into this process. You don’t wanna just show up and let things unfold, you really want to prepare, especially in a time like this.

And then also, check your hospital’s policies. See what the policies are on visitors, on partners, what is the discharge policy, what’s it gonna look like when you check in – get an understanding of what your entire experience could look like so that you’re clear on what it is that you’re walking into. A lot of people, and Ashley can speak to this, have started on the path of going into a hospital and then deciding “You know what? I think I want to do a different route.” That is your right to change your mind. You have the right to change your mind. So if right now you’re not 100% settled, please look at all your options. You’re always going to feel better if you explore all options.

ASHLEY: Which I’m so glad I did, because I was gonna be in a hospital and then I thought “Oh, is this really the right choice for me and for Justin and my baby?” And then I went with you and we looked at a bunch of birthing centers, which really there’s only one actual birthing center in New York. And it was beautiful and lovely and all the people there working were so nice, but it was the end decision to do it at home and I’m so glad I made that decision. And again, I felt empowered through you to make that decision, and I just thank you so much.

LATHAM: I’m so proud of you because, you guys, Ashley the entire pregnancy was sharing, just educating people. And now, she’s on the other side of this as a huge advocate which means that, through this process, you get to see her journey but you also get to be inspired and learn more about how you can navigate your own. So I just thank you for that, because so many people are going to get to learn by watching. That’s how we learn.

ASHLEY: The biggest thing I’ve learned, and I’ve always known this about myself and my business, was that I’m an advocate for myself. But then walking into something that I knew nothing about, education is key, advocacy is key, and standing firm in your beliefs.