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A story of how a doula helped a mom find her voice and build positive relationships with her health care team.
Mom Regina and Doula Kianna hold 11-month-old Destiny.
Regina was 38 years old, happy to be pregnant but also a bit scared, having experienced a miscarriage the prior year. She signed up for doula services offered through Maternity Care Coalition (MCC). Kianna, MCC Healthy Start program manager, became Regina’s doula. This would be Regina’s first time using doula services. Regina explained, “I never knew about this service before but had always wanted something like this.”
While Regina was pregnant, Kianna learned about Regina and her life. She found out that Regina had two children, 18-year-old Devon and 2-year-old Divine. Regina loves her pet fish and dog and loves gospel music. Alvin, Regina’s husband, is a truck driver who is home on weekends.
Kianna described Regina as “tiny and fiery. She’s strong.” Regina laughed and responded, “Yes, I’m fiery. I’m 5’2”, but I tell people I’m 5’4”. I tell people that I’m a lion, and I’m going to protect my cubs.”
As part of the doula support, Kianna made sure to include Alvin in her outreach education. “I can’t tell you how much we both appreciated Kianna taking my husband into account. He was able to text her and say things like, ‘I’m concerned because this or that is happening to Regina, and this didn’t happen in the other pregnancies. Is this normal?’ He built a relationship with her, and that helped us,” Regina explains.
During Regina’s pregnancy, Kianna delivered education on different topics such as preparing for birth, developing a birth plan, coparenting, and self-care for mom. Regina expressed that she wanted her doctor to listen to her, and that she wanted, “more control in the delivery room this time.” She said, “last time I felt like the doctors and nurses were delivering my baby rather than me delivering my own baby.” Regina was also concerned about being induced.
Regina believed the discussions and information that Kianna provided—and specifically the written birth plan—were the key to her own empowerment and what led her to build a better relationship with her doctor. “When I went to see my doctor and he saw my birth plan and how prepared I was, he applauded me for it and asked me where I got it. He even wanted to share it with other moms. Before, I didn’t feel I had a voice with my doctor, but now I did.” Kianna agrees, “She asked the right questions and shared the right information. They listened to her closely.” Regina described that her health care team at Einstein hospital in Philadelphia, “did a wonderful job. They monitored me a lot. They would call and check up on me. They clearly cared about me.” She developed a relationship of trust and respect with them. Ultimately, she went into natural labor at 40 weeks.
Kianna met Regina and Alvin in the delivery room. They put into place the things that Regina wanted during labor: gospel music playing; husband holding her hands and walking with her; Kianna helping her to change positions to ease the pain. Labor progressed with the limited interventions Regina hoped for. She only had some oxygen at the end of the labor.
After laboring overnight and with just three pushes, Regina delivered her daughter, a much wished-for and healthy little girl. “I named her Destiny because I felt like it was my destiny to have a little girl. I call her Madam President because I want her to hear and know that she can be anything she wants to be.”
“I cannot say enough good things about Kianna and just having a doula. Having someone who is Black and from my community made me feel more comfortable and understood. It made a huge difference having her as part of my health care team,” stated Regina.
Kianna looks forward to continuing this work, saying, “We are essential, and we play a major role in this space, just like doctors and nurses. We have different skills but we’re all on the same team and share the goal of healthy moms and healthy babies. Things don’t always go exactly according to the birth plan, but still the delivery should be based in joy and love, and I try to bring that into the space. This work helps moms have a seat at their own table in the delivery room.”
MCC reports that for the 174 people participating in their Healthy Start-supported Community Doula program in 2022:
32% had an epidural (compared to 78% of US birthing people)1.
24% had a c-section (compared to 31% of Pennsylvania and 32% of US birthing people)1.
What the moms said about their experience:
90% stated that the relationship with their doula helped them feel prepared for birth.
95% felt involved in their decision-making during birth.
85% felt safe with their doula (compared to 56% that felt safe with their health care provider).
83% felt supported by their doula (compared to 47% that felt supported by their health care provider).
81% reported a positive birth experience.
Since 1980, Maternity Care Coalition (MCC) has served nearly 150,000 families impacted by racial and social inequities in Southeastern Pennsylvania. In the last decade MCC has trained over 240 community doulas and peer lactation counselors.
HRSA Maternal and Child Health Bureau’s Healthy Start program funds Maternity Care Coalition. Visit the Healthy Start webpage to learn more about this investment to improve health outcomes before, during, and after pregnancy. The Healthy Start program invests in doulas as part of its overall effort to ensure babies are born healthy and specifically through a 2022 funding opportunity: Healthy Start Supplement: Community Based Doulas.
Join HRSA’s mission to improve the health and well-being of America’s mothers, children, and families. Apply to our open funding opportunities to improve maternal health outcomes.
Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2021. National Vital Statistics Reports; vol 72, no 1. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi. org/10.15620/cdc:122047.
