Commentary Maternity and Birthing

By Comparing Doulas to Amazon Prime, the New York Times Seriously Minimizes Our Impact

Miriam Pérez

The doula community may be growing, but it is still struggling with mainstream understanding and acceptance.

The doula community may be growing, but it is still struggling with mainstream understanding and acceptance. That means representations of us that miss the mark—like the one published in the New York Times last week—have the potential to devastatingly minimize the impact doulas can have, particularly on the birth experiences of people who need support the most.

As I read the series of responses to the Times piece from across the doula community, I felt a strong sense of déjà vu. It only took a quick Google search to remember that the paper got it wrong about doulas only a few years ago. In a 2008 story about a woman who didn’t like her doula, a Times writer characterized the doula as combative; the anecdote ended with the doula leaving the birth altogether, supposedly because an epidural was employed, without getting the chance to tell her side of the story.

This time around, reporter Anemona Hartocollis portrays the doula in her piece as a helpful, comforting presence to the mother. However, she also depicts doula services as the newest luxury for the very wealthy: “a manifestation of the growing demand for personal service (the doorman, the yoga teacher, Amazon Prime).”

As Hartocollis recounts the story of one client’s experience giving birth with a doula present, she continues to include telling details about the client’s personal life, such as her lower Manhattan loft apartment, her partner’s post-delivery sushi order, and repeated references to private car services. She includes this gem, from the client’s music-producer husband: “I’m ready! … Would you like the finest that Uber has to offer, babe? V.I.P. S.U.V.? What’s the name of this hospital?’”

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By portraying doula services as an extravagance, Hartocollis dismisses both doulas’ availability and potential significance. Doula care is not always expensive. There are many organizations in New York and elsewhere that provide accessible options, such as Ancient Song Doula Services (ASDS), a Brooklyn-based group that centers the experiences of women of color. They provide doula training and services at low to no cost. If I were writing that Times article, I would have followed ASDS Founder and Executive Director Chanel L. Porchia-Albert to one of her births, and seen the ways her support changes the experience of the women she’s working with—very few of whom live in lofts in the Financial District.

A doula’s effect is shaped by the people she supports. If a doula works with a relatively privileged woman, like the one depicted in Hartocollis’ article, that woman will see the emotional benefits of the tailored attention; for that client, it can be an indulgence. But doula care is not going to have the same effect on her as it will on someone who is already facing a challenging and potentially negative experience.

The chances of facing such troubles can be high, especially for women of color. What the Times article fails to discuss is that the United States has really bad birth outcomes: We rank below dozens of other countries when it comes to maternal mortality, infant mortality, and premature birth. Experiences of labor in U.S. hospitals aren’t just “lonely,” as one obstetrician quoted in the article calls them—they can be downright dangerous. This is particularly true for Black women, who face much higher rates of all of the above problems compared to white women. Race is a major determinant of whether you’ll have a healthy pregnancy and healthy baby in this country. In New York City alone, according to ASDS, Black women are nearly eight times more likely to die during childbirth than white women. These disparities exist throughout the country (although at varying levels based on geography), and for Native and Latina women too. For example, nationally, Native American and Latina women have higher risks of premature birth than white women, but still lower than the rates for Black women.

So doulas serving women of color can make a difference that is far more lasting than, as that same obstetrician put it, someone equivalent to a personal trainer. We’re talking about the difference between premature birth and getting to full term, the difference between a cesarean section (major abdominal surgery with serious risks) and a vaginal birth. We’re talking about the difference between life and death. Ninety percent of the women ASDS provides doula support to are Black; among the 200 women for whom they cared between 2010 and 2012, they saw significant beneficial outcomes as compared to city averages. The c-section rate among this group was only 12 percent, compared to more than 32 percent citywide. Only 2 percent had preterm births (compared to 9.3 percent citywide), and only 3.25 percent had low-birth weight babies (compared to 8.6 percent citywide).

ASDS isn’t the only group reporting improved outcomes with doula care. A University of Minnesota study looking at 1,000 doula-supported births also showed significantly lower c-section rates than the national average. The study looked at Medicaid-funded births, meaning the sample was predominantly low-income women.

All that said, there is one thing the Times article may have gotten right: The future of the doula movement will likely be determined by money. I wrote about this for Rewire in 2013, and the questions I raised then—about what it will take to bring doula support to everyone who needs it—endure.

ASDS, for its part, survives off modest grant funding (they received their largest grant ever at the end of last year from Every Mother Counts, a foundation founded by former supermodel Christy Turlington Burns); women who can afford to pay the full fee for their births; and the fees from the doula trainings and workshops they offer. But volunteers drive a lot of their programs, which Porchia-Albert acknowledges isn’t sustainable. In December, Porchia-Albert told me that her vision for the doula movement would be “to educate and create jobs for the doulas and the moms who come through the door [of ASDS]. Money shouldn’t limit us to anything we want to do. We can’t have access to things if we can’t pay for it. That shouldn’t stop you from getting the care that you need.”

In order for doulas to have the greatest impact possible, we must ensure doula care doesn’t turn into exactly what the Times suggests: a frill only the wealthiest can afford. There are many out there working to ensure this, in addition to Porchia-Albert and ASDS. There are doulas who offer sliding scale or barter services for low-income clients, doulas who start organizations that apply for grant funding to serve low-income people, and, as briefly mentioned in Hartocollis’ article, doulas who are advocating for Medicaid and insurance reimbursements. The doula movement I’m a part of is not about creating a new luxury service for the wealthy; it’s about making sure those who need it the most have support.

Roundups Sexual Health

This Week in Sex: New York City Doesn’t Really Have a Masturbation Booth

Martha Kempner

This Week In Sex: Sex education gets controversial in Omaha, senior men need a refresher course on HIV risk, a new sex toy helps strengthen pelvic floor muscles, and NYC's masturbation booth is just a marketing gimmick.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

School Board Meetings Get Heated as Omaha Updates Sex Ed for First time in 30 Years

For the first time in about three decades, the school district in Omaha, Nebraska, is updating its sexuality education program. In addition to including new scientific research on growth, development, and medications, the proposed curriculum includes discussions of gender identity and gender roles starting in sixth grade, a lesson on sexual orientation beginning in seventh grade, and information about abortion and emergency contraception in the tenth grade lessons on birth control. All of these topics had been previously excluded from the program.

Most members of the community seem to be on board with the possible changes. In fact, of the nearly 4,000 community members who reached out to the school district via phone or email, reported local television station WOWT, 93 percent supported the overall shift. But at recent school board meetings, the small minority who disapproved were very vocal, to say the least.

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Kathryn Russell, a former employee of the Omaha school district, argued that the change “rapes children of their innocence.” Another speaker bemoaned, “Marriages never make it into the picture of sex education in the schools.”

Still, school administrators argued that many of those opposing the changes were not actually members of the community.

School member Marque Snow told WOWT in December, “So that is the thing with controversial topics like this, is when you do open that up to the public, you get people who aren’t from the district or aren’t from the community commenting … and it kinda skews that view a little bit.”

Despite the controversy, at a meeting this week, the board voted unanimously to approve the changes to the fourth-grade, fifth-grade, and middle school curricula. The changes to the tenth-grade program were also approved with a vote of 8 to 1. Though the board had considered removing information on abortion and emergency contraception from the lesson plans, the package voted on this week still included these topics.

Of course, not everyone is pleased with the board’s decision. Gwen Easton, a mother in the district, told WOWT, “I don’t think they spoke for 52,000 kids or their parents. I don’t. I think that they had their minds made up all along to what they were going to decide to do and it doesn’t matter whether parents like it or not because that is what they are telling parents: It doesn’t matter what they think.”

Older Men Who Pay for Sex Need Some Safer Sex Reminders

A survey of men who have paid for sex found that the older they were, the less likely they were to use condoms in those interactions.

Researchers from the University of Portland identified 208 men between the ages of 60 and 84 who had paid for sex and asked them about their sexual behavior, condom habits, and perceived risk of disease.

More than half of the men surveyed said they did not always use condoms with sex workers. Forgoing protection was most common when men were receiving manual masturbation or oral sex.

Many of the men did not perceive themselves to be at risk for sexually transmitted infections—three-quarters reported that they perceived their likelihood of becoming infected with HIV as “low” and only about 60 percent reported having been tested for HIV. However, the men who reported more unprotected sex acts did perceive their HIV risk to be higher.

In addition, 29 percent of the men reported having an “all-time favorite” sex worker with whom they had sex repeatedly. The researchers found that in these cases, men were more likely to engage in unprotected sexual intercourse. The lead study author noted in a statement, “There is a nearly universal perception that older men do not pay for, or even engage sexually with regular frequency. This view may contribute to a false sense of security for both clients and sex workers during their encounters, and may lead to less protective strategies than with younger purchasers of sex.”

Perhaps it’s time for a safer sex refresher course for, and about, seniors.

New Sex Toy Measures Pelvic Floor Strength

OhMiBod, a maker of high-end sex toys, recently released the Lovelife Krush exerciser designed to help women strengthen their pelvic floors. Suki Dunhan, the company’s founder, explained in a statement that most women lose strength in these muscles due to childbirth or just age. She added: “Our Lovelife Krush measures the pressure, control, endurance, and grip of [pubococcygeus muscles] and helps women strengthen them through training challenges.” This, she said, “can lead to stronger, more intense orgasms.”

The device, a small bulb inserted into the vagina, is Bluetooth-enabled and comes with access to an app that sets goals and guides users through a pelvic floor workout, during which they squeeze and release muscles.

Strong pelvic floor muscles not only aid in orgasm; they can also help women overcome issues such as vulvodynia and incontinence.

New York City’s New “Masturbation Booth” Is Nothing More Than a Marketing Gimmick

There have been a number of stories this week about a new “masturbation booth” being installed in New York City. The “GuyFi” booth was originally announced in a press release by the sex toy company Hot Octopuss. Adam Lewis, the company’s co-founder, said in the release, “At Hot Octopuss we are all about looking for new solutions to improve everyday life and we feel we’ve done just that with the new GuyFi booth. We hope the city’s men enjoy using the space we’ve created in whatever way they want.”

The structure consists of a phone booth modified with a wireless connection, black curtain, chair, laptop, and a Hot Octopuss ad.

Of course, public masturbation is illegal in New York City. As questions mounted about how real this was, the company backpedaled a bit. A spokesperson told Mashable: “We may be insinuating that these booths could be used in whichever way anyone would like to ‘self soothe,’ but the brand is not actively encouraging people to masturbate in public as that is an illegal offense.”

If the goal was publicity, this campaign was a success. If the goal was to create a good place for men to masturbate during the workday, well, they’re just going to have to keep looking.

Analysis Politics

Major Anti-Choice Donors Among Biggest Presidential Campaign Contributors Identified by New York Times

Sharona Coutts

Just 158 families have provided nearly half of all the money donated to White House contenders so far. But the two families that have contributed the most to presidential campaigns also give prolifically to anti-choice groups and candidates.

Over the weekend, the New York Times published another piece in its series on who is financing the campaigns of this crop of presidential candidates.

The piece presented eye-popping new information: Just 158 families have provided nearly half of all the money donated to White House contenders so far.

But what the report didn’t mention was that the two families that have contributed the most to presidential campaigns also give prolifically to anti-choice groups and candidates. This is consistent with a little-noticed trend on which Rewire has been reporting for a while: the merging of political mega-donors with anti-choice activism. This fact is worth bearing in mind when listening to the anti-choice rhetoric being spouted by Republican presidential contenders.

At the top of the New York Times list is the Wilks family, the fracking barons who are cementing their place as arch-conservative mega-donors. According to the Times analysis, brothers Farris and Dan, and their spouses Jo Ann and Staci, have contributed a combined $15 million during this campaign so far in support of Ted Cruz’s campaign.

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Their choice of candidate should come as little surprise, given Cruz’s longtime alliances with the fundamentalist Christian right. For example, Cruz is a regular attendee of the Values Voters Summit, an annual gala held in D.C. by the Family Research Council, an organization that the Southern Poverty Law Center considers a hate group for its virulent homophobia, among other things.

As Rewire has previously reported, the Wilkses are significant anti-choice donors, and have also plowed millions into a program that seeks to indoctrinate school children and university students with their right-wing views.

While the Times did mention the Wilkses’ anti-choice stance in a list of donors that accompanied the main piece, it’s worth noting the extent of those activities.

The Wilks family uses at least two foundations—the Thirteen Foundation and the Heavenly Father’s Foundation—to funnel donations to dozens of right-wing organizations, including crisis pregnancy centers, anti-choice advocacy groups, and religious organizations that oppose the right to choose whether to carry a pregnancy to term.

Records for those foundations show that the Wilkses have pumped at least $33 million into right-wing causes since 2010. Some of that largesse has gone to causes and candidates that support fracking. Despite the conservative rallying cries of local control and states’ rights, the Wilkses have been major backers of laws that prohibit local communities from attempting to ban fracking.

Second on the Times list are Robert Mercer, a Wall Street hedge fund manager, and his daughter, Rebekah Mercer. Also Cruz fans, the Mercers are reported to have given $11.3 million in campaign contributions so far.

Mercer is emerging as a conservative presence within the more traditionally liberal enclaves of New York City. Between 2005 and 2013, his foundation, the Mercer Family Foundation, contributed nearly $40.1 million to mostly conservative causes, including some prominent anti-choice groups, federal tax records show. Some of his giving has gone to neutral groups or causes, such as the Mayo Clinic or supporting ovarian cancer research. However, he gave $10.5 million to the anti-choice, right-wing Media Research Center between 2008 and 2013, as well as a quarter of a million dollars to the Becket Fund for Religious Liberty, a legal group that takes on high-profile conservative cases.

What’s particularly interesting about the New York Times list is what it suggests about how the deluge of campaign cash is affecting the Republican Party in the wake of Citizens United.

The 2012 contest saw an unprecedented amount of money flow to presidential candidates, mostly conservatives. But instead of allowing the monied interests to shore up the election for Republicans by outspending Democrats, what resulted was a prolonged period of public infighting and mutual denigration that left the Republican candidates diminished in the public’s eye.

As Ken Vogel has pointed out in his reporting for Politico, as well as in his book Big Money, the new ability for billionaires to pick pet candidates and keep their campaigns afloat, despite poor public support, has had the ironic effect of damaging the Republican Party’s ability to put forth a candidate who can win the general election.

The rise of anti-choice donors to the top of the donors list indicates that this trend could increase in 2016—precisely what Republican Party officials and former kingmakers had hoped to avoid in the aftermath of 2012. In the wake of Mitt Romney’s defeat, Karl Rove called for a mechanism for the party to weed out weak candidates earlier in the process; the GOP establishment, in its “autopsy report” on the election, substantially agreed.  

Another reason to believe the problem has been exacerbated for Republicans this time around is the absence of certain family names from the list of 158 top donors, suggesting that some of the heaviest hitters may be waiting to see which candidates to back. (For instance, Paul E. Singer, Sheldon Adelson and Foster Friess are missing—they were some of the most significant political donors to competing Republican candidates in 2012.)

Most notably, the Kochs are missing from the list. Their name has become synonymous with the post-Citizens United era of dizzying sprays of money spurting in the direction of multiple candidates at once. Of course, this could be due to the byzantine methods they employ to channel contributions through multiple foundations and other nonprofits, often making it difficult or impossible for the public to learn who has backed which particular candidate or cause. In the last cycle, Koch-related money flowed to a nonprofit called the Center to Protect Patient Rights, which acted as a pass-through entity for millions of dollars in funding to many of the nation’s foremost anti-choice organizations.

With the manufactured controversy over Planned Parenthood having dominated politics over the summer, there is good reason to believe that the confluence of campaign cash and anti-choice donors could continue to propel Republican candidates to take positions on many issues—especially reproductive rights—that are at odds with the majority of American voters.

Brie Shea contributed research to this report.

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