Jennifer Washington was working at Gregory’s Coffee on 40th Street and Madison Avenue in Manhattan when one of her regular customers visited the shop and ordered his usual coffee; an El Salvador blend, made on an aeropress.
At the time, Ms. Washington, 28, was about six months pregnant with her first child. She and the customer had built enough of a rapport for him to ask about her pregnancy.
Ms. Washington, the store manager at the time, was worried about how she was going to take care of her child and stay at her job. She also knew that she wanted a peaceful, healthy birth and did not want to have a caesarean. The man, Roy Rodriguez, then told Ms. Washington about his wife, Emilie Rodriguez, a doula at Ashe Birthing Services.
“I didn’t really know what a doula was,” said Ms. Washington. “He just gave me her number and I called her.”
Mrs. Rodriguez and Ms. Washington met for the first time at Bryant Park in Manhattan.
“I was a little nervous because I didn’t know exactly what to say, what a doula was,” Ms. Washington said. “But she was very comforting and told me exactly what a doula was.”
A doula advises the mother on hospital standards and the medicine they might use, and teaches exercises and movements that can ease labor. Doulas are also present before and during labor, and make sure the mother is relaxed and prepared for when the baby arrives.
“I just felt her passion and her caring,” Ms. Washington said. “She just made me feel like she was an angel. I felt really, really comfortable.”
Studies by the Centers for Disease Control and Prevention showed significant racial disparities in pregnancy-related deaths, particularly among black women in the U.S. During 2011-2013, the ratio of pregnancy related deaths were 12.7 deaths per 100,000 live births for white women and 43.5 deaths per 100,000 live births for black women.
New York City’s maternal mortality rate is above average, according to a ProPublica study. Between 2006 and 2010, black women in the city were 12 times more likely than white women to die of pregnancy-related diseases.
Partly in response, New York is expanding the use of doulas to try to prevent problems during pregnancy and birth.
On April 22, Gov. Andrew M. Cuomo announced a pilot program that would expand Medicaid coverage for doulas in New York. The program is expected to begin in early June; the Department of Health plans to meet with women health providers, midwives, doulas and others to explain the program.
Doulas have been around for decades, and Nyota Nayo, a doula and prenatal yoga teacher at Harlem Yoga Studio, grew up seeing many women working as them.
In black culture, she said, “A doula was a mom, an aunty. That’s what it was. Volunteering services just for help.”
Ms. Nayo traced it back to when African women were brought in as slaves to the United States.
“We came out of slave culture,” she said. “Women came from Africa and had traditions from Africa,” Ms. Nayo said. “Birth was no big thing; it was just baby out and that’s it.”
She also said that as society changed and more births began shifting from the homes to hospitals, fewer of these “granny midwives” were used.
“Traditions got lost. I think that’s what happened,” Ms. Nayo said. “It happened with black culture and other cultures, trying to get Americanized and all that. You break that tradition and you just do whatever the doctor says.”
Not all black women have the benefit of having a doula throughout their pregnancy. Some women are not aware of doulas while others simply cannot afford one: A doula can cost up $1,500.
Ms. Washington said the doula was a great help in communicating her desire to the doctors. “I think that without her, it would’ve been easier for them to do whatever they needed to,” she said.
From covering the clock and dimming the lights in the hospital room, to visiting the mother and newborn at home after birth, doulas can create a safer and more comfortable experience for the mother, just as Mrs. Rodriguez did for Ms. Washington.
It was a Monday around noon in August 2016 when Ms. Washington began feeling contractions. As they increased, so did the pain.
“That day I was walking on the pier with my boyfriend and by the time we got home my contractions were a little heavier but not unbearable,” Ms. Washington said.
The contractions kept going until 4 a.m.
“I was eating a bowl of cereal when I was whining my way out, I put my cereal down, I couldn’t go to sleep,” she said. At around 8 a.m., Mrs. Rodriguez arrived to the house.
“She was with us driving to the hospital, she comforted me, she wiped my throw up,” she said laughing. “It was like a movie and Emilie was there for everything.”
After birth, Mrs. Rodriguez kept in touch with Ms. Washington and her daughter, Amara, who will turn 2 this August. Mrs. Rodriguez visited, she called often, she brought them food, held the baby and even went with Ms. Washington to the hospital again when Amara was sick.
“Emilie is such a beautiful person,” said Ms. Washington. Because Mrs. Rodriguez understood the financial situation Ms. Washington was in, she volunteered her services. They remain in touch. “I was so grateful,” Ms. Washington said. “That’s how you know that she really loves what she does.”