Doulas as Essential Medical Care

Jane Fonda

Georgia's 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.

Editor’s Note: This post was updated at 1:06 pm on July 1, 2009 to correct a minor error in the earlier text.

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.

Georgia has the 10th highest teen birth rate in the US and the second highest repeat birth rate among teen mothers. To combat the problem the Georgia Campaign for Adolescent Teen Pregnancy Prevention launched a community-based doula program.

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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.

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