Birthing Advocates: The Doulas of NYC

Written by Khatia Mikadze

New York City doulas Griselda Rodriguez (left) and Emilie Rodriguez (right). Photo by Idris Solomon

A woman gives birth in New York City every 4.4 minutes. Yet, not every one of those women receives equal access to health services or even to information about prenatal and postpartum care, which often results in a difficult — or sometimes traumatic — birthing experience. Moreover, women nationwide under-utilize postpartum visits, upping their risk for difficulties such as unintended pregnancy.

Two new mothers, Emilie Rodriguez and Griselda Rodriguez-Solomon, are trying to change that.

Emilie holds a degree in medical anthropology with a focus on reproductive health in the United States, and Griselda is a professor at the City College of New York. They’re both trained doulas. After meeting each other at the City College, Emilie and Griselda developed a close relationship, discovering that they are both passionate about birth work and shared many values with each other.

Eventually, the pair decided to combine their experiences and expertise to found Ashe Birthing Services in the Bronx in 2016. Ashe is a Yoruba word from West Africa that means “life force,” but it also implies that you have the power to make things happen. Ashe Birthing Services provides holistic prenatal, labor and postpartum doula care, with Emilie and Griselda working as partners.  This means they work together and share the responsibility for each client, making sure that each client receives a dual consultation and the opportunity to bond with both doulas. The partnership helps ensure that clients will always have a well-rested doula by their side.

“Our role during birth is to make sure that the person knows that the sensations she is experiencing, which can often be intense and sometimes frightening, are all natural parts of the process of birthing new life on Earth,” says Griselda on her blog. “Being a doula is a labor of love for us. Being present for the birth of a new human being is priceless.”

According to NYC Health, doulas can also be described as trained birth assistants, and are responsible for providing non-medical support for women and their partners throughout the childbirth experience. Before, during, and after birth, doulas help to answer questions and provide emotional and physical support to make sure their client is safe, healthy, and satisfied with her experience leading up to and after birth. Doulas can also help educate women about the variety of birthing options that are available.

“I think Griselda and I are doing things differently,” says Emilie. “We are creating a family here that approaches pregnancy, birth and postpartum holistically. We use meditation, yoga, herbs, aromatherapy and more with each of our clients.”

Having experienced pregnancy and birthing themselves, both Emilie and Griselda saw firsthand how little New York City women know and are educated about reproductive health — not to mention the disparities that exist when it comes to accessing adequate birthing information.

“We want to help women who lack information,” she says. “We are not taught about our bodies, about our choice and options.”

According to the New York State Department of Health, access to quality prenatal care can help prevent negative birth outcomes and also provide an opportunity to educate and counsel pregnant women when it comes to the adverse effects of alcohol, tobacco, or other drug use. One study found that women who receive late or no prenatal care during a pregnancy are three times more likely to give birth to a baby that’s underweight and the baby is five times more likely to die, and a New York City Department of Health and Mental Hygiene study from 2012 found that the severe maternal morbidity rates in NYC were 1.6 times higher than the national average. Mothers in low-income neighborhoods — particularly Black and Latina women — are especially vulnerable.

A 2013 report on maternal and infant health in the Bronx indicates that more than half of all live births in New York City in 2010 were to foreign-born mothers.

Though New York City offers a variety of low-cost resources and community-based organizations and Medicaid is available to pregnant women regardless of their immigration status, the challenges of pregnancy and postpartum abound — particularly for immigrant women who often lack family support, financial means, language proficiency, adequate information on their rights as mothers, and other valuable resources. A 2013 report on maternal and infant health in the Bronx indicates that more than half of all live births in New York City in 2010 were to foreign-born mothers. Yet, the report also notes that “the majority of health care received by undocumented immigrants comes through emergency departments, while most of the remaining care is obtained through public clinics and community health centers.”

This is where doulas play a vital role.

“We support women physically, emotionally, informationally, and sometimes spiritually,” says Emilie. “In a hospital setting where the woman is often removed from the birthing process in a lot of ways, we help women navigate the system so they can advocate for themselves. We tell them their rights as a patient, and their options so they can make the best decision for themselves and their family.”

Dozens of studies prove the effectiveness of doulas during prenatal and postpartum care, especially for immigrant women. Doulas fill in the gaps for language and cultural and emotional support that many immigrant women lack. Findings suggest that doulas can greatly help immigrant mothers in gaining access to effective care by acting as advocates and cultural or emotional brokers. Immigrant women often bring their traditional practices and beliefs about birthing with them, which can affect their pregnancy and birthing experience — they also have different needs when it comes to prenatal care, further complicating matters. Pakistani and Bangladeshi mothers, for example, have high rates of low-birthweight infants, increasing their need for prenatal care — but both groups lack access to prenatal clinics where they live in Brooklyn, according to 2005 research in the American Journal of Public Health.

Findings suggest that doulas can greatly help immigrant mothers in gaining access to effective care by acting as advocates and cultural or emotional brokers.

Though there is no legal certification for doulas, most — including Emilie and Griselda — are trained by accreditation programs such as DONA and Ancient Song. Both share a set of professional values such as informed choice, cultural awareness, evidence-based practice, and spiritual empowerment. Doulas are not covered under Medicaid or other private insurance carriers. Although the Affordable Care Act may cover some portions of doula services in any given situation, this may very well discontinue under the new administration.

The doula costs may range from $360 to $2000. Because of this wide cost range doula services are often stereotyped as services for wealthy white women. However, the cost depends on a doula’s experience level, certifications, and the number of births she has successfully assisted throughout her experience. Many doula services offer payment plans, bartering, and other options. There are also plenty of volunteer, free or low-cost doula services in NYC, some of which are supported and funded by the city government. The New York Department of Health lists free or low-cost doula and birthing services that low-income women are eligible for.

Many doula services say that their constituent pools lack diversity, but Emilie and Griselda have encountered women from various cultural and ethnic backgrounds — and reaching out to underserved communities is something they want to work on. They are planning intensive outreach via workshops and sisters collectives in the Bronx and other boroughs to reach underserved women of color, and immigrant and refugee women. Emilie says they never turn a woman away — even if she cannot pay.

“We are bringing a village that doesn’t yet exist in NYC,” says Griselda. “We are in a group of women fighting for birth justice. Our presence can drastically alter a person’s birthing experiences. We believe that doulas play the part of the proverbial village that many of our grandmothers speak about, or that we read about in texts pertaining to the Divine Feminine. We offer a type of feminine energy that creates a sense of peace and encouragement.”