|'Mothering the Mother' During Childbirth, and After
September 25, 2005 By JODI WILGOREN
THE NEW YORK TIMES
CHICAGO, Sept. 23 - Loretha Weisinger tickled the tummy of 1-month-old Kejuan Kelly, then twirled his tiny blue bootie on her finger. She cooed and cradled him, all the while softly lobbing questions at his young mother.
How many bottles does he drink in a day? (A lot.) How many diapers? (About five.) Does he have a bowel movement every day? (Yes.) Are you reading him bedtime stories? (Yes, that book you gave me.) Do you turn out the light when you put him down? (Yes, so he knows the difference between day and night.)
"Tell me something amazing about him," Ms. Weisinger prodded, "something amazing that you're discovering about him."
"He likes to look at a lot of things," ventured Kejuan's mother, Lakenya Cannon, 19. "I didn't think babies would be that nosey. If he sees my eyes wide open, he'll open his eyes wide."
Ms. Weisinger is neither family member nor social worker. She is not Ms. Cannon's doctor, but her doula.
Part mentor, part coach, all-around hand-holder and advocate, doulas are an increasingly popular childbirth accessory, with the leading organization counting 5,000 registered professionals in 2004, up from 750 a decade before.
But while doulas, who often charge $1,000 per birth, are typically an indulgence of upper-middle-class mothers-to-be, Ms. Weisinger is leading a newer trend of providing such services to low-income teenagers who usually face labor with far less support and knowledge about the process.
Once a teenage mother herself - she had her first baby at 16 - Ms. Weisinger, now 49, is the star of a new documentary being screened here on Monday evening, as doula devotees try to replicate her work on the West Side of Chicago in cities around the country. Already, there are similar programs in Phoenix, Indianapolis, Denver, Atlanta and Albuquerque, with nascent plans to start up in San Francisco, Seattle, New York, Cleveland, Milwaukee, Washington and even a small town in Alaska.
"Every woman needs that kind of support around birth," said Rachel Abramson, director of Chicago Health Connection, the organization leading the replication effort. "But in terms of resources and need, it's particularly critical for women who are underserved, who face a lot of challenges in their lives."
Doulas date to ancient Greece; the word means "woman servant" in Greek, though Ann Grauer, president of DONA International, the membership group formerly known as Doulas of North America, translates it as "wise woman of birth."
"The concept of the doula has been around as long as there's been people," Ms. Grauer said. "If you look at any birth art, going back 2,000 or 3,000 years, there's always an extra woman who's in the picture or in the sculpture supporting that mother. We just didn't have a name for it."
Unlike midwives, doulas do not deliver a baby, but typically support the mother throughout the process.
In the late 1980's and early 1990's, researchers found that women who used doulas had shorter labors and fewer Caesarean sections. For low-income teenagers like Ms. Weisinger's clients, having a doula provide prenatal classes and postpartum counseling led to increased rates of breast-feeding - 50 percent with doulas compared with 30 percent without in a new University of Chicago study - as well as less tangible benefits.
"The mothers who had the doulas talk more to their babies, smile more - they're just displaying a lot more positive affect and engagement," said Sydney Hans, the University of Chicago psychologist who ran the study, made up of 248 mothers ages 14 to 21. "When they talk about childbirth they tend to use more first-person words, like 'I did this' or 'I did that,' as opposed to 'the doctor did this.' There's a sense of ownership about their childbirth experience."
Ms. Weisinger's work is part of a broader teenage parenting program at Marrillac House, a stalwart community center in the largely poor and overwhelmingly African-American neighborhood of East Garfield Park, one of three doula experiments started in this city by the Irving Harris Foundation in 1996. Now there are six such operations in Chicago and 18 in Illinois, serving 750 mothers a year at a cost of about $2 million, most from the state Departments of Human Services and Education.
Marrillac usually handles 28 births a year; Ms. Weisinger has been through 10 since summer started, with Ms. Cannon's 29-hour ordeal one of two she witnessed on Aug. 22 alone. "I try not to remember those numbers because it makes me tired," Ms. Weisinger said when asked how many deliveries she had attended in her career.
A mother of 4 and grandmother of 13 who had previous jobs as a bus attendant and at a box factory, Ms. Weisinger was about to start work as a cook in a downtown restaurant in 1996 when Marrillac, where she had long volunteered, invited her to train as a doula. She almost quit after the first birth, an extreme episiotomy, but soon saw it as a calling.
"The main thing that I think I'm doing is giving them their voice," said Ms. Weisinger, who earns about $20,000 a year. "It's a way of helping them to help their children. My thing is, if you don't speak up for yourself, it's hard for you to teach your children to speak up."
So Ms. Weisinger makes the young women write down three questions to bring to each prenatal doctor's appointment, which she often attends with them. She takes donated children's books, toys, pregnancy magazines and parenting videos to twice-monthly home visits.
She tells the women she is available "25/8" because when she used to say "24/7," some would still not call past midnight or on holidays. Once the babies are born, she has the mothers map out six-month goals.
In the hourlong documentary, which is scheduled to be broadcast on PBS stations starting next month, Ms. Weisinger lays hands on women's stomachs to feel kicks, holds their shoulders as they breathe through contractions, dances in a prolonged hug with one in the delivery room.
"Mothering the mother" is how doulas explain the essence of their work; Ms. Weisinger says she is often the first nurturing presence in troubled lives.
Je'Taun Ball, one of the mothers featured in the film, said that during her delivery, her own mother was busy crying and the baby's father stayed in a corner, scared, "but Loretha was telling me techniques to keep the baby safe."
"She was telling me to breathe to slow the baby's heart rate, was telling me to stop pushing so she wouldn't strangle," Ms. Ball, 22, recalled of her labor three years ago. "She got me to stop panicking and breathe the normal way."
And when an exhausted Ms. Ball waved off the nurse trying to hand over her newborn daughter, Ms. Weisinger made her take the baby in her arms.
"That was the first moments of my baby's life, and I would have missed out, I would have regretted that," said Ms. Ball, who is now working in a nursing home and attending night classes to become a nurse.
"I was a teenager, you know, scared, shy - I didn't really know a lot about the world," she added. "I thought it was the end of my life when I had that child. The only encouragement I had was Loretha, who told me I could move on."