Speaking limited English and lacking experience in prenatal or postpartum care beyond raising her own four children, Maria Ordaz, 42, wasn't sure at first that she'd make a good doula. "I felt a little out of place in the classes," she says, referring to a program she attended in Atlanta to learn how to support women during childbirth. "But now I know this is what I'm supposed to do." After attending 26 classes and observing six births, Ordaz--known in the community for her friendly, nurturing personality--was hired three years ago by a local nonprofit agency to offer support to teenagers before, during and after delivery.
Role models like Ordaz are a natural choice to assist underserved pregnant women, says Rachel Abramson, director of Chicago Health Connection (CHC), the nonprofit agency that pioneered the community-based doula program and is working to replicate it nationwide. "We look for women who are good at making relationships," Abramson adds. "Many have faced their own challenges and can relate to their clients."
Indeed, "out of place" is just how teen moms feel, according to Ordaz. "Many are all alone," she says. "They have to learn to believe in themselves, that they can take control of their birth, take care of their babies and be independent." This empowerment doesn't develop overnight, Abramson says. Ordaz visits her pregnant clients once a week, teaching breathing techniques and labor positions and often accompanying them to doctor's visits. She's by their side throughout labor, then visits twice a week for three months to assist in the really tricky part: caring for a newborn. Each doula is tasked with helping nine to 12 women at a time.
The doulas' commitment appears to be paying off: A four-year pilot program involving 250 Chicago-area moms demonstrated higher breastfeeding rates, lower Cesarean-section rates and fewer subsequent pregnancies within two years among young mothers who had doula support. They also held and spoke to their babies more than other teen moms did, says Abramson. Buoyed by this local success, CHC began offering its doula-training program to agencies nationwide in 2000. The group has helped 20 agencies in eight states recruit and train doulas and is launching two or three new sites each year. A Denver program targets women in an addiction-treatment program. For more information on the replication effort or to donate to CHC, visit chicagohealthconnection.org or call 312-243-4772.