Imagine being admitted to a hospital in a foreign country.
You're alone as doctors explain your condition in another language. On top of that, in just a matter of hours, you'll be completely responsible for a new life.
In one of Vancouver's most multicultural communities, this is exactly what Jalana Grant sees on a regular basis. New parents who are also new to Canada are virtually alone. Some have fled violence while others look to begin a new life. Either way, bringing a baby into that transition is terrifying.
That's where Grant puts her doula skills to work.
Doulas have been gaining popularity but are still a relatively uncommon. The word comes from ancient Greek, meaning "woman servant." But, in fact, they are much more.
Doulas are women who provide emotional, physical and informational support before, during and just after childbirth. Unlike midwives, they don't assist in delivery. They do help with pain management and act as a coach. They are also a comforter and an advocate in the delivery room.
"Doulas mother the mother and include the partner to make sure everyone is working together," explains Grant, a doula of 26 years. "When labour gets started, the doula comes to the couple's house. As things start to get more interesting, she makes sure they don't end up at the hospital too soon. They are a constant presence so no one has an urgent feeling."
That urgent feeling is hard at the best of times. But, for the women Grant works with as the doula coordinator for the South Community Birth Program, those fears are compounded with other pressing issues.
"We have had women who are HIV-positive, in abusive situations, homeless, single women giving a baby for adoption, concealed pregnancies, teens," says Grant. "Birth is a huge transition and our doulas really make a difference in helping women through this transition, in particular those who are marginalized by class and ethnicity."
As of 2006, about one in five Canadian residents were born outside the country. While a doula's role is usually filled by grandparents, aunts or friends, these people are inaccessible to new immigrants. So is service in a native language.
That's where Grant's team comes in.
The goal is to ensure everyone has a positive birth experience, no matter their circumstance. One client from El Salvador had come to Canada at 14. She lived in foster care and in her twenties became pregnant by a man who was forced to leave the country.
The woman had no family support. But, through her doula, she received care in Spanish. The doula became her mother-figure, alleviating the woman's fears and offering encouragement. Afterward she kept the baby, finished her degree at the University of British Columbia and still regularly contacts her doula.
Grant says she often sees women in similar situations and works to pair them with a doula. That means she's always looking to expand her multicultural team.
Recognizing Vancouver's obstetricians couldn't reflect the city's diversity, Grant seeks women with varied language skills who often don't call themselves doulas but help with pregnancies in their communities.
They are offered official training through DONA International, a doula association providing certification based on international standards, and learn massage techniques and how to determine when to go to the hospital. The volunteers attend a few deliveries as observers. Soon, they begin seeing clients.
Since 2003, they've assisted with over 600 births.
"We speak 17 languages right now as well as English," she says. "But, just when you think you have lots, you have some woman speaking a language you've never heard of."
This makes Grant's search for new doulas ongoing search. As long as there are new moms, she'll need new doulas.
Knowing the answers is easy. Delivering them is the challenge.