Giving birth is, in so many ways, an act of faith. It involves a kind of radical trust in our bodies that I equate with tawakkul, trust in Allah, the One who made our bodies. For me, being a doula is also an act of faith. A doula is someone who supports and comforts a mother in childbirth, building a relationship with her over the weeks leading up to the delivery and sometimes continuing to support a new mother in the weeks that follow.
It’s a contemporary word for a role that, prior to modern obstetrics, most women found in friends, neighbors, or family members.
I attend births in hospitals, birth centers and homes, and many of them are with Muslim families. I choose to do this because I am awed by birth, because I witness the positive effects of my support, and because I see the ways in which my work can mitigate the harm done by health care professionals who are sometimes uncompassionate, hurried and even poorly trained. There are growing numbers of Muslim doulas out there, but we need more.
Why more doulas? A comprehensive review by the respected Cochrane Collaboration, a nonprofit that independently reviews medical research, showed that doula care—including the information and emotional support we provide, the pain relief measures we use and the advocacy we perform on behalf of women and their partners—has undeniably positive benefits not only on women’s experiences of their labors, but also on labor outcomes themselves.
Studies show that today’s medical model of childbirth involves practices that can impede the normal process of labor, one result of which is our shocking cesarean rate. Today, one in three babies in the United States is born via surgery, which can have both short and long term negative impacts on mother and baby, some of which we are just beginning to understand; mothers have trouble breastfeeding and experience a painful recovery in the early postpartum stage, while babies have a higher prevalence of allergies and autoimmune diseases. Meanwhile, women supported by a doula are more likely to give birth vaginally, without the use of forceps or a vacuum. They are less likely to request pain medication and, on average, have shorter labors. Aisha al-Hajjar, a doula in Saudi Arabia and founder of a Muslim birth doula training program called AMANI, also reminds us that “birth has a profound, lifelong effect on women, that can either be empowering or traumatic.” Having a doula increases the probability that a woman will remember her child’s birth as a positive experience.
I’d like to see these benefits expanded within the Muslim community, starting with African American Muslims. African American babies (regardless of socioeconomic background) are over twice as likely to die in infancy and see the highest rates of preterm births and low birth weights. While researchers posit many theories as to why this is the case, the most convincing one looks at the physiological impact of racism itself, finding that the long-term physiological effects of racism-related stress and underlying health disparities can trigger preterm labor. Because over half of native-born American Muslims are African-American, it is critical that we use doulas to curb these alarming statistics. If this weren’t reason enough, as Islam becomes increasingly racialized in the U.S., the stress associated with acute racism is impacting Muslims more broadly than before. A 2006 study found that in the months after 9/11, women with Arabic names in California experienced the same kinds of negative birth outcomes associated with racial discrimination against African American women.
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The immigrant community constitutes another segment of Muslim Americans who are in need of doulas. Some of the women I work with, hindered by language or cultural barriers, have a hard time navigating our medical system. They find themselves confused and overwhelmed by the amount of information doctors and hospital staff throw at them, and to add to the problem, some are refugees carrying memories of traumatic and violent experiences, which leave them even more psychologically vulnerable during birth. It is an immense blessing to support these women, ensuring their comfort and increasing their awareness and understanding of the choices they can make. We need more doulas to guarantee that these Muslim women’s voices are heard.
Regardless of which slice of the Muslim American population Muslim doulas work with, they bring cultural literacy that the modern-day health care system simply cannot offer. The religious and cultural traditions that shape our pregnancies, births, and postpartum periods, are usually unfamiliar to our care providers. Muslim understandings of modesty, hygiene, gender relations, privacy and dietary requirements are relevant to women’s feelings of comfort, yet care providers rarely receive training to help them understand or anticipate these differences.
There is tremendous spiritual reward in supporting a woman through birth. I am a first-hand witness to the vulnerability, curiosity, discomfort, laughter, frustration, sadness, and incredible delight of childbirth. I am there when a woman is amazed by the power of her own body. I am there when mothers and their partners see their babies for the first time and their hearts break open with joy. I am there when births don’t go the way mothers imagined, and I am there when a mother undergoes surgery and recovery. Muslim doulas serve God by serving women and their families. As Aisha al-Hajjar puts it, “One can’t help but keep strong bonds with Allah when witnessing the miracles of pregnancy and birth over and over again.”
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This work is important because it involves women supporting women, women nurturing women, and women empowering women. As Muslims, those are gifts that we’re called to bring to all of our sisters. I invite Muslim women to step up, maybe step outside of their comfort zones, and bring their energy and compassion to a place where it will not only change the families they work with, but it will change themselves.
· AMANI Community Center: http://www.amanibirth.com/p/teacherdoula-training.html
· The International Center for Traditional Childbearing Doula Training: http://ictcmidwives.org/
· Doulas of North America (DONA): http://www.dona.org/http://www.tolabor.com/
Krystina Friedlander is a childbirth doula, midwifery student, and childbirth educator in Boston, Massachusetts. Her website is www.barakabirth.com.
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