Numerous studies highlight the significance of having a doula through pregnancy, childbirth, and the postpartum period for healthy maternal and infant health outcomes. Trained to provide continuous and comprehensive physical, emotional, and informational support, doulas, in many cases, reduce the need for medical interventions by lowering the risk of complications. 

Despite growing knowledge of the value of our vibrant workforce of birth workers, there exist few intentional efforts to buttress their work in the United States. What’s worse, the issue of birth worker burnout threatens to drive doulas away from the workforce altogether. On Saturday, May 20th, 2023 at Mama Glow’s third Doula Expo, Mama Glow Doula Yasmine Fequiere, Mama Glow Foundation Research and Partnerships Lead Salma Mohamed, and New York Coalition for Doula Access (NYCDA) co-lead Jennifer Gonzales spoke with Carol’s Daughter Founder Lisa Price about the necessity of cultivating a culture of care as we work to heighten the accessibility of doulas, in a panel presented by Carol’s Daughter. 

The dialogue occurring at the first and only festival for birth workers is an extension of the culture-shifting conversations occurring at the Mama Glow Foundation. At the start of this year, the foundation worked to explore the conditions contributing to burnout in birthwork. This culminated in the Birth Worker Burnout Report, which explores integrative solutions for nurturing a healthy doula workforce. One major finding in the foundation’s research was the contribution of questioned autonomy, authority, and qualifications to the dissatisfaction of doulas. When coupled with compensation that does not account for the demands of the job or the cost of living, these factors wear birth workers down as they attempt to pour their effort and care into a population of great need. 

The work at NYCDA is about subverting the above findings. The organization is working on establishing a more equitable reimbursement structure for doulas in New York City, and it is their hope that this will be a baseline for doulas in the United States in general. “In New York City, we want to be the stepping stone. We want our rate to be the highest for the nation,” said Jennifer Gonzales. Thanks to the tireless efforts of the NYCDA, the One-House budget the Senate voted on in March included Medicaid Reimbursement for doula services at a rate of $1,930 and $10 million in budget appropriations. The NYCDA’s other major focus of this year is developing a plan for establishing a doula-friendly designation for hospitals in New York City, which would tackle the issue of unforeseen instances of disrespect. 

Gonzales urges the United States to continue to invest in its birthworkers. “Who is the doula to the doula?” she asked. “This workforce is everything. It is an emotional thing. To be a doula is to do it from the fibers of your hair, to the fibers of your toes. We have to take care of them so that we can continue to do this work and invest in the future. It is a community thing.”

Implementing integrative approaches is about promoting change in more spheres than one. Yasmine Fequiere spoke to the line of distinction between work as a private doula for clients, and work within the medical sphere alone. “As a hospital staff member, there is a shift model of care. Whoever is in labor and delivery at the time is who I am going to support while I am working there.” This is antithetical to the continuous, intensive nature of birth work. “I meet people for the first time at various stages of their labor. They could be coming in for an induction, or 10 centimeters dilated.” Despite the chaotic nature of the hospital setting, Fequiere’s experiences are a testament to the necessity of doula support—at any and all stages. “Things that you learn at prenatal visits, you’re learning in the moment, in between contractions. But I’ve been staying grounded, and developing fast, strong relationships.”

Furthermore, an integrative approach is one that creates conditions for doulas to reach all birthing people—especially those who would most benefit from services. Fequiere serves many clients through Carol’s Daughter’s Love Delivered Initiative, where she provides pro bono doula services to birthing people in New York City. Love Delivered was launched in April 2021 by Carol’s Daughter and its founder, Lisa Price, and the Mama Glow Foundation and its founder, Latham Thomas, with a focus on raising awareness of the Black Maternal Health Crisis in the United States, and the importance of doulas and advocates when Black birthing people and babies are most vulnerable. In the United States, Black birthing people are disproportionately impacted by maternal mortality and poor birth outcomes. Carol’s Daughter has committed $225,000 over 3 years to positively impact birth outcomes for Black families in need by funding doula services. Black mothers and birthing people can apply for a grant through the Mama Glow Foundation and be matched with a Mama Glow Doula.

 This kind of work is of utmost importance to panelist Salma Mohamed. “It is especially critical that we rally behind our community-based doulas because they are in the spaces that are facing the greatest need around the maternal health crisis. It is doubly necessary that we show up and require necessary stakeholders to engage in this conversation about reimbursement.”

The panel ended on a simple, yet powerful note that speaks to the mission of the Doula Expo and the Mama Glow Foundation. “We need the community behind us,” said Gonzales. “Keep pushing for what we know doulas deserve.”

Learn more about the Love Delivered Initiative

Learn more about the Doula Expo