Doulas push for increase in diversity, awareness
The demand in the Duluth area for doulas and other support systems during birth is high compared to the number of practicing doulas in the area, and there are barriers to the services offered.
DULUTH — Two Duluth doulas are leading an effort to increase the number of practicing doulas in the area, as well as striving to incorporate more diversity and anti-racism in the field of birth support workers.
Cooper Orth and Dana Morrison, who operate as Doulas of Duluth, have been working together for about two years and have been doulas for about eight years each. As doulas, they offer support through pregnancy, labor, birth and postpartum and teach a five-week Evidence Based Birth course.
Unlike an obstetrician or midwife, a doula is not medically trained. Instead, doulas provide education and emotional and physical support to people having children. This includes reviewing options for pain management and laying out all of the options and outcomes in a birth plan.
“When people know what’s happening and people feel good about their choices, they have better outcomes and feel better on the other side of it about how everything went,” Morrison said.
Because doulas spend time with their clients before and during labor, they tend to form bonds that can be comforting to people during birth. And unlike nurses who rotate shifts, a doula is present throughout the entire labor and delivery process.
For Jen and Eric Mistry, having a doula helped ease their anxiety about having their first child. The Mistrys said having someone available anytime to answer questions was reassuring, and they enjoyed having every part of their daughter Grace's birth planned in advance. Jen Mistry said when Grace was taken to the neonatal intensive care unit, they had decided ahead of time that Eric would go with the baby, while Orth stayed with Jen and held her hand.
“It was really nice to have someone who we knew was 24/7 with us, who had our best interests in mind and who knew our plan and was there to support us,” Eric Mistry said. “I’m surprised it’s even optional, to be honest. It made such a difference to have them as part of our team.”
According to Minnesota Department of Health statistics, 1.4% of people who delivered a child in 2019 had a non-medically licensed birth attendant. Orth and Morrison said they believe part of the reason so few people use doula services is because there aren't many practicing doulas, especially in the Duluth area. Women Circling Women, a Duluth yoga studio with birth resources on its website, has 10 doula services listed. Orth and Morrison said they've noticed high rates of burnout and turnover in the doula world.
They also said there is a large barrier to accessibility of doulas. The services can be expensive, and because there aren't many available in the area, it can be difficult to find an opening for services.
“I think that there are people that want doulas that can’t afford doulas, more than anything else, or people just don’t know that doulas exist, so it’s really important that we spread the word,” Orth said.
Orth and Morrison said they've noticed that most doulas in the area are white, which doesn't represent the demographics of the community. While they both are continuously educating themselves on anti-racist practices and how to create better outcomes for people in marginalized communities, they also feel that it is important to have practicing doulas who understand the experiences of everyone in the community.
In a recruitment effort, Doulas of Duluth is holding a training next spring for people interested in becoming a doula, assisting someone in birth or who want to learn more about pregnancy and birth. The training will heavily focus on the politics of birth, plus historical and current inequities and racism in birth work.
Orth and Morrison also noted barriers for becoming a doula. Attending doula trainings usually costs hundreds of dollars and requires multiple full days of time commitment. Because of this, they are offering applications for free equity seats at the training.
“It’s really important to us that this doula training is going to create a more diverse doula pool for people to choose from here," Orth said. "It’s not currently super-diverse and that’s really important for people of color and queer people to have people that understand their experiences and know where they’re coming from, know them more culturally and look like them in their birth space. That can create a big safety bubble for them.”
Celeste Ekberg, Fond du Lac Band public health nurse supervisor, said Minneapolis maternal health organization Everyday Miracles also organizes doula trainings for Black, Indigenous and people of color to become doulas, including a training planned next spring for the Duluth area.
"It's mostly for people in St. Louis County because of the high minority rate and low accessibility to doulas," Ekberg said.
Rebekah Dunlap spent more than 10 years working as a doula, with about six of those years spent working for the Fond du Lac Band of Lake Superior Chippewa's community health doula program. The program is grant-funded, and provides a doula to people carrying Native American babies at no charge to the patients.
Dunlap said she believes the doula service at the Fond du Lac Band has helped people feel more comfortable about giving birth, especially because of the historic mistrust in modern health care among Native Americans and other minorities. She also believes the service being grant-funded helps overcome some barriers in accessibility for tribal members.
“I don’t think it’s just white, middle-class people that are wanting support," Dunlap said. "The need really is for minorities and low-income people, single parents that are trying to work. So I think the need is really within the social services realm and I think a lot of people would qualify and really benefit from the support of a doula.”
Dunlap is studying for her doctorate of nursing with a specialization in midwifery. She said during her time as a doula, she noticed a lack of Native American workers in local hospitals' birthing centers, and plans to continue to work in the Northland after finishing her degree.
"When I started to serve white patients, I would see a vast difference in the treatment, and started to recognize that there was a lot of racism in the way patients were treated," Dunlap said. "So that was a big motivator for me to go on, and I always wanted to go on for more schooling.”
According to the 2019 statistics from the Minnesota Department of Health, babies born to Black, Indigenous and people of color had the highest rates of infant mortality.
“That’s really scary, and Cooper and I really want to help facilitate our community doing better," Morrison said. "We want to call out all the folks in our community that are in this work — the midwives and the OBs and the doulas and people doing postpartum and prenatal care — how can we create better outcomes for our most marginalized communities?”