Community-Based Doulas: A Good Investment in the Future

The bond between a parent and child is the primary bond, the foundation for the rest of the child's life. The presence or absence of this bond determines much about the child's resiliency and what kind of adult they will grow up to be. For some, being a parent who enables bonding is a natural gift, often learned from one's own parents. For others it is a real challenge. If our mother was unable to bond with us due, for example, to depression, addiction, narcissism, extreme stress or immaturity, it will be extremely difficult for a bond to develop.

The Doula Story from Stuart Productions on Vimeo.

While not impossible, it is especially challenging for teenage parents to develop bonds with their children. A high percent of them were themselves children of teenage parents and have never experienced appropriate parenting. Eighty percent of teen mothers were already living with the stultifying stresses of poverty long before they became pregnant. Without early and on-going interventions, their early parenthood virtually guarantees that they and their children will remain vulnerable and mired in poverty. Children born to teens have less supportive and stimulating environments, poorer health, lower cognitive development, and worse educational outcomes.

If we as a nation are to break the cycle of poverty, crime and the growing underclass of young people ill equipped to be productive citizens, we need to not only implement effective programs to prevent teen pregnancy, but we must also help those who have already given birth so that they become effective, nurturing, bonding parents.

This is why, a number of years ago, I brought the "Community-Based Doula Program" to Georgia where it has been under the wing of the Georgia Campaign for Adolescent Pregnancy Prevention (G-CAPP).

A doula is a birth assistant who provides emotional and physical support to the mother and her family during labor and delivery. Our doulas, however, go beyond the call of the traditional doula. Many times they take on the role of mother, big sister, friend, counselor, social worker, advocate, life coach and more. The doulas make weekly home visits to pregnant teens and their families starting in the third trimester and up to one year after the birth of their baby. They help young mothers (and often times fathers) understand the birth process, and support them during labor and delivery. So many of these young parents don't know what a real relationship feels like, but through their example, the Doulas model for the mothers and fathers how to be in relationship, how to bond. This is what transforms the young parents forever and gives their babies a better chance in life.

The Community-Base Doula Program has produced some amazing results including c-section rates nearly half the national rate and breastfeeding initiation rates 25% greater than the national average. It's harder to quantify parental bonding, but we listen to what the young mothers in the program have to say. "I don't really have a support system anymore," says one girl, "but I can always call my doula because she still comes around and helps me when I need her."

Another young mother says, "I had a lot of situations when I just wanted to give up. I wanted to give up on school and I wanted to give up on finding the baby's daddy. My doula told me to stick in there. You going to get it. Don't just let it go."

"Don't just let it go." Profound words from a young woman who, under different circumstances, might have given up. When I see the results of our Community-Based Doula Program I know that if a Doula was a medicine, it would be unethical not to provide it. My great hope is that one day every Women, Infants and Children (WIC) program in the country will include a Doula Program. Funded through the Department of Agriculture, WIC serves the population of poor, often teen mothers but as currently implemented, WIC only address the nutritional needs of disenfranchised parents. The addition of a Doula component isn't rocket science and it would create jobs for an army of community women who are chronically underemployed, thereby changing their lives along with the lives of the young parents and their children. A Win/Win/Win as I see it. President Obama take heed!

By the way, this isn't some "charity work" we're doing for others. This has a direct effect on every one of us whatever our socio-economic status. Think about it: Reducing crime and poverty and ensuring that we have an educated, stable work force has a direct effect on you and me and the future of our country. And we cannot do any of it without reducing teen pregnancy and the dysfunctional parenting that so often accompanies it.

Follow Jane Fonda on Twitter: www.twitter.com/janefonda

Comments

[prgrsvmama26]

I have worked as a doula for 8 years. All mothers can benefit from a support person after birth. Unlike our European allies who have socialized medicine, we do NOTHING to take care of mothers after birth other than tell them as six weeks post partum their husband can have at them again and what birth control would they like. Its truly pathetic. I stay in touch with my mamas for several months after birth to offer any support I can. So many people have splintered or distant families and mothers are truly isolated during their maternity leave (if they can even cobble together any leave). The reasons for our high rates of post partum depression and low rates on ongoing breastfeeding are easily explainable!

[jackq]

Thanks Jane !

[AntiClast]

My daughter had an unexpected Caesarean to deliver her first child. Twelve hours after the baby was born, he was transferred to the neonatal unit without explanation. (Healthy 9 pound baby). We found out later these are risks for postpartum depression.
My daughter obstetricians had a large joint practice so any one of 10 doctors saw her on a visit. They did not check for postpartum depression or notice it as it grew. It was pathetic to see her. She could hardly tend her much-wanted baby, cried, and couldn't eat. She improved fast when she was on medicine and got more sleep.
She had doulas at night after her second delivery so she could sleep. She also realized that the anti-pain medicine the hospital gave her caused fear and paranoia.
Natural birth involves the release of chemicals when the baby pushes against the cervix. These chemicals promote the mother-child bonding. My daughter's caesareans were necessary but many aren't.
Compared to other mammals, we are born underdeveloped. A lot of skill has to be learned to take care of a newborn. It's not instinctive. New mothers used to be helped in tribal societies by experienced mothers. Now we are mostly isolated from other people rearing infants and often our mothers are far away.
France had a government program to help new mothers in the early 1960s. Vermont added a program a few years ago, already some of the social statistics are better.
Good work, Jane!

[webweaver]

What an interesting string of comments.

Thanks Jane, for introducing a new word to the vocabulary of the HuffPost readership. And for your work.

I am writing a book about my birthing experiences, and I read these articles and discussion threads with interest to see what people know, think and believe about birthing. This thread it illuminating.

[autumnimprov]

Good column & good work, Jane. I had my first child in a hospital & I had my second at home with a midwife present & with the consent, review & support of a physician. Childbirth is profound & it is experienced that way. Doulas are focused on helping women implement what women naturally are capable of: being healthy, birthing (with or w/o medical intervention; the last thing we should be doing is criticizing birthing mothers), nursing & nurturing infants & creating & maintaining healthy spaces around & with the entire family - fathers, siblings & other relatives included.

Thank you for your work.

[Rational-1]

Let's invest more in preventing teen preganancies first... eliminating the need for more tax-payer funded doulas. More personal responsibility, less welfare.

[Bearangaria]

Why not invest in both? Support personal responsibility and qualified caring doulas.

[Rational-1]

I agree. Some of these teen parents who did not have loving mothers or fathers or good role models, do need our help and love. However, those receiving a doula's help should be required to contribute to the program... by answering the phone, stocking office supplies, etc. They should be required to give back by paying it forward.

[Kari Henley - Huffpost Blogger]

Thank you for initiating such an important program. As a mother of 4, I had a chance to experience the process of pregnancy and birth from many different angles. I do believe doulas offer a type of "human value" that is difficult to measure - yet the stats you have put forward are so compelling, I hope the WIC program sits up and gives it a listen!

Even those in the middle class often do not have adequate understanding of what is to come in birth and prenatal care, and benefit from having a wise and caring mentor to help them though.
Thank you for continuing to take a stand for causes you believe in!

[mwinik]

i almost didn't read this post because i was so sick of hearing about doulas from self-righteous, home-birth crazies when i was pregnant. these women--most of whom are married to rich men, don't work, and sit on boards, etc.--acted like i should be reported to child protective services because i was going to have my baby in a hospital. (how could i be so selfish as to want to give birth in a place where there are doctors, nurses, and medical equipment?) and i was given the dirtiest of looks when i said i didn't know what a doula was and didn't plan on having one. so, i wrote off doulas as some sort of new-age wannabe-hippie crutch used by wealthy desperate housewives-type mothers who have nothing else to do but watch ricki lake's movie over and over. then, my friend decided to hire a doula because her husband was traveling out of town so much for work that there was a chance he wouldn't be there for the birth. the doula ended up being her coach and really helping her through it and she is forever grateful. so, i see how beneficial doulas can be--especially for someone who might otherwise be along for the birthing process. great idea, jane!

[Eggsackley]

I almost didn't read this myself, not because I was sick of hearing about doulas, but because I had never heard of them. I'm glad I read it. I have spent too much time working in the child abuse/neglect system and seen too many children suffering terribly from failures of bonding. Bonding is the first key to good parenting. As a society we do a terrible job of teaching young people to be parents, and we are paying for it in rising crime rates and welfare costs.
The doula program appears to be a very good remedy, but we need to educate everybody about parenting before they are mature enough to be parents. It's probably the most basic "social study", and we don't teach it in our schools. We require people to take parenting classes only after they have done too much damage.
I learned almost everything I know about parenting from my parents, not all of it was good, but I had good parents. There are too many children out there who don't, they need to be taught basic concepts like bonding before they are mature enough to have children.

[clevelandchick]

I almost didn't read through your whole comment because, Jane's post was clearly not about a Doula program for well-to-do mothers but about helping lower income and teen mothers manage motherhood and poverty. If a Doula can help a soccer mom...imagine what she could do for a single mother or family in dire financial stress.

Teenagers are genetically in a self-focused, selfish phase of their lives. When they are confronted with motherhood, as somebody who has not at all become an adult themselves, a Doula would be a godsend to both mother and child. A teenager needs guidance to understand her role, she may not have a mother as a role model or her mother may work two jobs to keep them in a house and not have time or the patience needed to help her daughter and her grandchildren.

This is a program I would love to see as being supported by both sides of the aisle...especially those who profess to be Pro-Life whose focus is soley on forcing birth but not helping with the aftermath.

Imagine doulas available for every working or teenage mother. Imagine children, regardless of socioeconomic status, growing up feeling loved, safe, and well cared for because their mothers had help and an advocate. I think it would mean a sea change in our society.

[WilliamL]

Due to Vietnam and living on bases and Fonda's activities, I heard a lot of hate for Jane but can not help my self from liking her.

[juliaizen]

Want to know why people HATED Jane? (who none of us knows) Because she has this unfortunate (at least in the U.S.) liability, called a brain!

[Mishima1]

William, I understand how you feel. I am no longer in the military, but I still work on a military base. Any soldier who remembers Fonda feels the same. She was the cause of much suffering of veterans who were imprisoned in her "agrarian reformers' prisons." We do not forget.

[juliaizen]

I am a Viet Nam Era veteran who, partly because of my opposition to the war (I knew several other recruiters who were), was relieved of my position, demoted, and sent to a very unattractive assignment. Jane Fonda is an easy scapegoat for "the suffering of veterans who were imprisoned in her (?) "agrarian reformers' prisons." Being the young, passionate humanitarian that she is, she may have made some missteps, but when are you going to get over yourself, and put the blame for the suffering of our soldiers where it belongs - on the U.S. government?

[clevelandchick]

Well, you need to expand your knowledge base my friend.

Her activities in those days were by a younger woman only seeking to end a bad war. Jane Fonda is an amazing woman and she's added so much more to her life's resume than the unfair bashing she received by conservatives who wanted to continue the Vietnam war.

She did apologize for some of her actions back then by the way. America is supposed to love redemption. Jane has more than redeemed herself since then. I have an awesome admiration for Ms. Fonda's grace and solid committment to social justice even in the face of her detractors.

I am glad you've opened your eyes and I hope you support her call for the Doula program.

[Anandas]

Doulas are a very very familiar word and concept among holistic /alternative healing circles-
there are many dozens of excellent training programs around the country, and have been for
at least the past 20 years. In fact I would be so bold to say that it is the alternative community
who have put "doula" and "Doula care" on the map, through their hard work, training programs,
and the reputative work of individual doulas.

They are trained to assist during pregnancy, during labor, and of course, after the birth, for a year
or longer. They are trained in pregnancy massage, informal counseling skills, herbal therapeutics, natural therapeutics, first aid, and home health. Naturopathy schools, Child Birth Education centers,
and massage schools are the places to look to seek doulas and doula training. Google "doula
training " in your area if you are interested- you are sure to come up with great information.

The entire concept brings back the respect and honor that should have never vanished
from the sacred process of bringing a child into the world

Furthermore, although doula care is useful for vulnerable social groups, doulas and doula employment cuts across all classes.

[juliaizen]

When I was 19, I married another child, and gave birth to a beautiful daughter I was completely unprepared­/unqualifi­ed to raise. Fortunately for her, my family intervened, and she has become a magnificent person. I also had an opportunity to do some work on myself. The fact is; I am not mother material. I love children, but I'm a much better caretaker of animals. I once felt ashamed/inadequate because of this, but now accept that it's simply how I am, and it's fine. I am sure that I am not the only woman to realize this. I observe all around me, unconscious, indiscriminate breeding; which I view as a form of consumerism, addiction and greed. Deficient human beings, having babies; in the hope of having a family (a mini-laboratory for mental illness), hoping to find out who they are, to win approval from their peers, to solve romantic problems, etc. Not a day passes that I don't read about babies in dumpsters, in toilets, burned, buried, missing. It has to stop, or, like Pacman, we are going to simply gobble everything up, until there's nothing left. And who knows? maybe this is what's supposed to happen! I love the justice, the generosity and the compassion in providing mothers with doulas, but I also love the idea of supporting women fulfilling themselves in other, maybe more appropriate ways.

[Tulka2]

If this administration could actually learn lessons about how F.D.R. pulled us out of the Depression of the 1930s.....? Community action programs like this are great ways for older, successful, but out of work women, to use their life experience.

[loonwalk]

Forgive my ignorance, but the title of this great educational piece prevented me from viewing it earlier. Only my curiosity and respect for the author won over that unfamiliar word... eventually.

[Amy Windmill]

What a wonderful issue to take up! Thank you, Ms. Fonda!

[JSaeger]

Any plans Ms. Fonda for bringing on a government-based doula program for world economic theorists, bankers and political decision makers who had better be in the midst of their own rebirthing process? Thank you for your brilliant work, on and off the stage!

[Midnightrain]

Great comment and questions!!