Doula Duo

by Amy Schwartz Kimlat

Rebecca Amundson’s contractions were coming in strong while she lay in her hospital bed with her husband Rich at her side. To help Rebecca manage the intensity of her first-time birth, Alyssa Kaplan massaged her back and modeled deep breaths.

Neither an obstetrician nor midwife, Alyssa was the doula Rebecca hired to help her through her very first birthing experience.

Alyssa works in partnership alongside fellow Jewish doula Heather Rich. Together, they call their practice In Joy Birth, which provides continuous physical, emotional, and evidence-based informational support to families before, during, and just after childbirth.

“I had a lot of fears about giving birth for the first time,” Rebecca recalls. “I knew having a support person there who was very knowledgeable about everything birth-related would really put my mind at ease.”

By having Alyssa present at the birth of their daughter Summer (now two years old), Rebecca and Rich were able to focus on enjoying the moments of labor and delivery as much as possible, thanks to someone on their side who could help explain things and advocate for them.

The Amundsons’ experience is not typical for most American families. While doulas may be gaining in popularity, it’s likely that fewer than one in 10 births in the United States have a doula present (the most recent study in 2012 pegs that number at six percent).

So What Is a Doula, Anyway?

“A doula is a trained professional who understands physiological birth,” Alyssa explains. “The doula is like a guardian or birth keeper. She holds the knowledge of the birthing family’s wishes. She communicates between the care provider and the birthing family. Her role is unique because she doesn’t come with an agenda other than to support the family.”

As doulas, Alyssa and Heather also visit each mother’s home prenatally to prepare the mother for the birth and learn of her birth wishes. They visit after the birth, as well, to check on the mother’s physical and emotional health.

While obstetricians and midwives are primarily focused on the medical health of the mother and the baby, the doula is there to provide comfort and support – physically and emotionally. And while a birthing mother’s partner or own mother can be an integral part of a birthing experience, the doula’s professional experience in a wide variety of birthing locations and situations allows the family to be more present and relaxed. Plus, doulas can work in all birthing settings – hospitals, birth centers,  and homes.

“It’s important to have the support of a doula because, when we are birthing, we are operating from the hindbrain,” Alyssa says. “We cannot access all of our rationale, nor can we fend for ourselves. Because we are operating from the hindbrain (the part of the brain that coordinates functions that are fundamental to survival), birthing women are very vulnerable.”

It’s the hindbrain that also controls the fight-or-flight response, which can actually stop the birthing process. This can happen if a mother is feeling uncomfortable – such as if an unwelcome visitor comes into her birthing room – or anxious if a practitioner fails to explain a procedure.

“The fight-or-flight response during childbirth dates back to when we were cavewomen,” says Alyssa. “If we were being attacked, we could stop our birthing process and fight for our lives or flee the situation. Once upon a time, this saved us.  But now, birth has been modernized, and we know that the fight-or-flight response is detrimental to our birthing process.”

Alyssa also explains that a birthing mom will not be able to receive all of the beneficial birthing hormones if she cannot turn off her neocortex (or thinking mind).

This is where the support of a doula is key – to keep the mother calm, relaxed, and informed so that she can allow her hormones to naturally move her through the birth while minimizing the unwelcome fight-or-flight response.

A Friendship Is Born

Alyssa and Heather initially joined forces to support a mother whose first birth came via a traumatic emergency cesarean section at 33 weeks caused by a drunk-driver accident. The woman initially hired Alyssa but then decided she could benefit from a second doula, bringing on Heather, as well.

The pair met to discuss the client’s history and birthing preferences over a bottle of sangria. By the time they’d polished off the bottle, they were an inseparable team.

The two doulas are available around the clock, tag-teaming as they respond to text messages and phone calls that come in from pregnant women and new mothers. They rotate weeks on call, though they often step in to assist during busy off-weeks.

“Now that Alyssa and I have merged practices, I have a better work/life balance, extending the longevity of this career for both of us,” Heather says.

Both Alyssa and Heather chose this field of work after being unsatisfied with their own first-birth experiences.

“I was in a very unsupportive relationship with few friends who had become mothers,” Alyssa says of the period surrounding her first birth. “I felt very lonely and isolated throughout the pregnancy and postpartum.”

She soon started working at a local birth center as a midwife assistant. That’s when Alyssa realized this was a systemic issue.

“After witnessing many families struggle with the same feelings I dealt with, I had a realization,” she says. “We have great midwives and great doctors, but we don’t have enough emotional and physical support around such big events. That is when I decided to switch paths. I dove deep into the world of doula work.”

Heather had a similarly dissatisfying experience.

“I became a doula after the birth of my second child,” she says. “My first birth was uneventful and almost a letdown. I was not given choices, let alone a say. With my second, I had a planned natural birth on my terms that was incredible.”

Heather’s positive second birth inspired her to pursue a path of empowering women and their families no matter the way they choose to birth.

“Autonomy and informed consent are at the core of my birth philosophies,” Heather says.

Training in Tandem

When they joined forces, Alyssa and Heather realized they had a common frustration for the standard doula training process, which they agreed  was inadequate.

Heather explains that she participated in two popular doula training programs, “and I still felt wildly unprepared to support a birthing family. A three-day weekend workshop really isn’t enough to know what you’re doing.”

Both Alyssa and Heather prioritized hands-on experience and shadowing before striking out on their own as professional doulas.

“To understand birth, you need to see birth happen in many different ways and in many different environments,” Alyssa says. “It is a skill that you learn rather than something you read about.”

After several years of professional practice, the pair kept hearing from new doulas that their experience was similar – the training was not thorough enough. So, Heather and Alyssa did something about it.

They created the In Joy Birth Collective, a program in which new doulas apprentice with Alyssa and Heather for six months. They shadow births, attend informative lectures, and assist with their own private practice.

The duo took the collective’s mission one step further – not only are they attempting to provide the community with more experienced doulas, they’re trying to make the service more accessible and affordable, as well.

Once trained by Alyssa and Heather, the collective of doulas then offer discounted doula services to the community. Doulas who are part of the In Joy Birth Collective only charge $500 for their services, which is less than half the typical doula fee.

“We want everyone who feels they could benefit from having a doula present to have the opportunity and access to a doula,” Alyssa says.

“The mentorship has been such a passion project for us,” adds Heather. “Getting to help not only build a better doula, but make doula care affordable for every family has been so rewarding to us.”

Giving Birth, Giving Back

Alyssa and Heather demonstrate their dedication to positive prenatal, birthing, and postpartum experiences in all aspects of their lives. They’re both involved with the nonprofit Central Florida Postpartum Alliance, which provides education, resources, and community outreach support for mothers experiencing postpartum mood disorders.

And both Alyssa and Heather have served as gestational surrogates, carrying babies for other families.

Heather recalls pulling aside a local rabbi at an event and asking if he thought surrogacy was kosher. His response? “The Torah says to be fruitful and multiply, so I don’t see why not!”

As for Rebecca Amundson, she’s now a repeat client of the doula duo, expecting a baby boy any day now.

“I am confident that we will be well-supported and feel safe bringing him earthside, despite the pandemic and everything going on in the world,” Rebecca says. “I am so grateful that we were introduced to Alyssa and Heather as our doula team, and I know firsthand how impactful they truly are to the entire birth community.”