Did you have a doula when you had your son?

I had an assistant for my midwife. I didn’t have a doula who was there for me, so I really felt a big void there, and a big lack of support. I felt that the medical piece was taken care of, but emotionally I was floundering. I had my baby at home, but it was a long labor, a very very big baby, and a lot of emergent intervention. However you want to birth your baby…I really feel like I experienced every color of that rainbow. That’s the thing I feel like I bring as a doula – there are doulas who had their babies at home and experienced it one way, and I had to transfer to the hospital and have a lot of intervention, so I now can stand and respect the need for medical intervention. So I hope I bring that nonjudgmental support to a mom, whether she’s having a scheduled C-section or birthing in her living room.

What is the difference between a doula and a midwife?

A doula is emotional, physical, spiritual, informational support, and a midwife is essentially about the birth of the baby and postpartum. I feel like the role of the doula is to help a woman stay present and feel safe, just by being there, holding space for her and being a familiar face during an experience that can be so shapeshifting. To be a constant and a calming presence; that one person who’s like an emotional touchstone.

What’s the process for hiring a doula?

We meet with moms before, at least three times; we get to know their history – emotional, family, everything we can possibly dig up – and then we’re there postpartum at least once to help them transition into being home. We have postpartum support at Carriage House Birth so we keep the family under our umbrella for a least a year. We don’t ever say, “Ok! You had your baby, good luck!” That’s why I wanted to create the space, so people can come physically to our place and just be in the presence of someone they trust, that they had an experience with – a life changing experience.

What kind of training is required?

There’s a foundation training and the work is actually attending births. They want you to attend three births before you finish all your paperwork if you’re verifying with the foundation, but some people do the training and then just kind of jump in. So technically they’re trained doulas but they’re not certified. I’ve attended over 150 births and I didn’t feel like I was ready to do this work until I’d attended my tenth. The training is really just giving you some basic tools and ideas, but getting out there, being on call, getting called at 3:00 a.m. and dropping everything, not sleeping for four days…you can’t really get that in a training.

Having had a baby myself, and having had a really crazy long labor and such a need for support, when women come to us, like “I want to be a doula,” and they say they did the training, I’m like “yeah, but is it in your gut? Is it in every fiber of your being to want to support women through this process?” There’s a big burnout rate. We’re not midwives. We’re not catching babies and we’re not getting paid midwife rates. Sometimes we’re up three or four days, you know? But the training really comes from going out into the field, throwing yourself into it and seeing if you can hang.

What qualities make a good doula?

A good listener; and you have to have a good support system if you have children. You have to be able to drop anything at any given moment to go to a birth. And presence – calm. If you’ve gone through the labor process, of course that helps, but every woman goes through it so differently. You have to know how to take yourself out of the game as a doula. Not make it personal, not get angry at that doctor that didn’t listen, keep the focus on her and that’s it. Sometimes you’ll meet a woman who wants to have a doula and she’s so sure of why, and then the OB will come in and tell her that she needs to do this other thing and she will completely ignore you if you’re not medical, no matter how much you’ve planned.

What’s the biggest misconception about doulas?

The biggest misconception is that doulas are for people having their babies naturally. We attend C-sections, inductions. It’s advocacy, it’s holding space. If the family wants to have their baby naturally, we’ll probably be utilized more because we are trained to support labor, so there’s going to be a lot more labor and more need for support. But if you’re having a medicalized birth, you’re still going to need us to massage you and give you information and help guide you, even though you might not be as involved. We’re still holding space for you and trying to adhere to your birth preferences.

So if someone wants an epidural, you won’t try to talk her out of it?

No way. If it’s a family that knows they want that relief, then I’m like, that’s great, let’s get that epidural but maybe let’s get it once you’ve hit this point. Sometimes doulas just help manage and produce and time manage. I don’t ask “if,” I ask “when” if the family knows they want it. If she’s like, “Forget this, I don’t want to do this anymore!” it’s like, fine, let’s get an epidural. I’m not there to shame a mother. I have no judgement. I don’t believe in circumcision and I don’t love epidurals. At all. But I hold my tongue almost weekly about both of those topics.

How do most women react to you?

You’d be surprised. Some people hire doulas because they heard they should have one. You never know how you’re going to labor and we get first time moms more than any moms. You don’t know how the family is going to respond to you and sometimes a family doesn’t know what to do with you. They suddenly realize they just want the drugs. And that’s great! But then let us give you a massage or tell you what’s coming next or help you get even more comfortable. Often people are very surprised by their experiences with a doula. I get a lot of, “you should charge more for this,” or “I don’t know how I could have done it without you!” When we get cards sent to Carriage House Birth, often the first line is, “Couldn’t have done it without you.” And it’s not just a funny or sweet thing they say. I think they really believe that it would have been so much more challenging if they hadn’t had someone there who knew the lay of the land.

9. What if you can’t afford a doula?

Our mantra is that anyone should be able to walk into our facility and breastfeed and cry and not be asked a million questions, and anyone should be able to have a doula at their birth. We have doulas from every tier in terms of price point, so we have literally a doula for everyone who wants one. We have women being like, “I have no money, I’m a single parent and I just want someone to be in the room with me,” and then we have the family that’s planning their birth the way they’re planning their wedding. That’s the way this collective is set up and most collectives in the U.S., as far as I know, are set up in a tier system.

Birth is such an intimate experience – what does that feel like from your end?

I still cry every time a baby is born. It’s new, every time. If you’re not moved by childbirth every time one of your clients delivers, if you’re just, like, great, thank god that’s over, then you might need a break, because you’ve seen too many and you’re exhausted and it’s just a job. I think the beauty of being a doula is it’s work that I get to do. It’s a job that’s a real privilege so it doesn’t ever get old. And the relationships come and go, sure; the woman delivers and you never hear from her again, but you went through that with her. I’ve got people that I see in Williamsburg who had their babies with me, and I don’t see them all the time but when I do see them it’s so beautiful.

What’s the general reaction from a mother’s partner?

Partners don’t really ever know what’s going on. (Laughs.) They understand that they’ve never seen their partner uncomfortable like that or in pain, out of her body like that. When I explain to them that I’m not there instead of them, I’m there to facilitate closeness and support for both of them, often they’re like, oh, ok, that makes sense. Because they still want to be the one to give her massages or soothe her and calm her down. That’s another misconception – that doulas take over from the partner, and it couldn’t be more opposite. We calm partners down to the point that they’re able to reconnect to their breath and who they are and what their relationship is and be there more for her, because they know what’s going on and can reconnect to her without being nervous or fearful.

What about a woman’s postpartum experience?

Having the mom have a self-care routine in postpartum…she just succumbs to her child, she’s not sleeping and barely eating and barely remembering to do anything…she’s going to crash, you know? There are people talking about depression. So many women don’t know they have it. And it goes misdiagnosed. And it can be really terrifying. That’s why I opened Carriage House Birth, because too many women were home crying because breastfeeding was so challenging, and they had no idea, you know? We opened our doors because we just want people to show up and meet other moms and be like, “Oh my gosh, you too?” It’s not just doulas and lactation consultants supporting these moms, it’s other families there, too, having the same issues. You get to meet these women just because you showed up that day.

Does meditation ever factor into the birthing experience?

I’ve had a meditation practice for over two years, and it’s really enhanced my doula practice because I walk into a situation that could be loaded like a little landmine, and I am able to hold my ground and invite that woman to come be in that space with me. Just by showing up and feeling that I took care of myself before I got there if I can. If it’s a long labor, I’m able to excuse myself if everything is going well, to check in with myself so I can better tend to her. Because if you have a high strung doula and you’re trying to do something like give birth, it doesn’t really work very well. Women in labor are so heightened intuitively, and they really do feel…bullshit. It’s like, you get called into work and you just had an argument, you don’t have a way of emptying out and resetting before you walk into someone’s birth space, then you’re going to bring that into her experience. Some people have things they do before they go to work and that’s great, but you need to do those things every day because you never know when you’re going to go to work.

I’m always asking families to have some kind of app or stream in their phones or partner’s phones and bring some cushy headphones and be ready to pull out that tool, something to ground, whether it’s mantras or chants or an actual guided meditation. It’s a huge tool for us.

What’s next for Carriage House Birth?

The next level of Carriage House Birth is to build curriculums where we’re training doulas in areas where there are none, and also webcams, where we’re streaming the class. We’ve been asked to come to Los Angeles to teach and maybe manage some doulas there. We’ve got the whole doula mentor management thing down to a T now.

Image Credit: Pamela Hanson

Brooklyn-based Domino Kirke is a mother, musician, doula and co-founder of Carriage House Birth in Williamsburg.