SR: From the UCLA Labor Center and KPFK, you’re listening to Re:Work.
[“Sweet Baby of Mine” – Ruth Brown]
SR: I’m Stefanie Ritoper
SW: And I’m Saba Waheed.
SR: So here’s a question – do you know what it was like to give birth to you?
So all of us are on this planet because we were born. Still, giving birth is so mysterious to most of us. I know I haven’t ever been to a birth. And I mean, what do you imagine when you think of one? A room full of doctors and nurses? Or a woman in pain, just cursing at her partner?
SW: And that’s the thing, you don’t really learn about what it’s like to have a baby unless you’re about to have one. Yet the process of giving birth is complicated. A person has to make huge decisions before and during the birthing process. Should I give birth at home or in the hospital? Should I get a C-section? Should I get an epidural?
SR: And so, in comes a doula, whose job is to act as a guide, to provide support, give information, and in some cases, even act as a bodyguard. In this week’s episode of Re:Work, we follow one doula, Pati, to understand more about the journey of giving birth.
SW: On the day of a birth, the pregnant woman is under extreme pressure and needs to make quick decisions. Pati is a doula, and she is there to help manage the pain and help them understand the choices. She tells us about a woman whose pregnancy she assisted. They were in the hospital and the woman was in extreme pain, struggling through growing contractions.
P: You know, we did different positions, she didn’t like many of them. And then I just looked at her and then I said, ‘Do you dance? Do you like to dance?’ And she said, ‘Yeah im belly dancer’ and I said, ‘Oh, is that right? Can you show me how you belly dance?’ So then she spent the next hour and half belly dancing, like a big belly ready to give birth, and she really knew how to move, right?
[“Ya Rayah” – Rachid Taha]
So it was real fun to watch and then she was laboring. So I just handed her water in between contractions and I was like you look great. And then at the end it got really intense and it was towards the end and she was like I’m done and I wanna get an epidural.
And, I mean she was like 9 centimeters and I was like, ‘Cool, what is it about the pain that its unbearable?’ and she was like I’m just tired, I don’t want it. And so, luckily the nurses were also really supportive of natural birth and long story short. We were able to distract her from the pain long enough for her to give birth naturally.
SR: So Pati has been working as a doula for eight years and has witnessed a total of 70 births. Her role begins months before the birth even happens.She meets with the family and talks them through the entire process of what could happen during the birth. She shares different options from the least to the most invasive procedures and the pros and cons of each. From there they create a birthing plan that fits them.
P: I’ve recently been attracting a lot of families who don’t want to gender their baby, before its born and I had a family that made it, put it in their birth plan, that they didn’t want anyone to speak. Specifically they didn’t want an announcement of the gender.
So when the baby came out it was silent. And it was mom and dad talking to the baby like, ‘Welcome and you’re finally here, we love you so much’ They looked and they saw what the baby had, but they really just enveloped the baby with a lot of love and welcoming and energy without saying it’s a boy or girl or anything like that. That was a very special moment.
SW: Leading up to the birth, Pati provides support. She checks in after doctor’s visits and answers questions, since sometimes the doctors will only visit with the family for 10 minutes at a time. And perhaps, most importantly, she provides the reassurance and support to get them through having the baby. Giving birth is an incredible process and sometimes parents don’t fully understand all that their bodies can do.
P: There was definitely a lot of conversation of like, ‘I can’t do this, I can’t do this.’ A lot of people end up saying that over and over again because they never done it before and it’s incredible what their body is doing so they are in disbelief.
So a lot of the time, my response is, ‘You’re doing it, you’re doing it, you’re doing it great.’ You know just cheerleaders. Like I remember the husband and I were just cheerleaders. ‘You’re doing wonderful, I know its intense’ and just validating everything they are feeling and at the same time reflecting that it’s almost over.
SR: For Pati, being a doula wasn’t her first choice, or even her second. Like many of us, she hadn’t even heard what a doula is.
Instead, she was a self-proclaimed feminist, and she started working at Planned Parenthood. She thought this would be a way for her to be on the frontlines of defending the rights of women, and standing up for what she believed.
But soon she began to find herself ill at ease with they way the clinicians treated patients. One incident was the final straw.
P: The door was open to clinic room where the patient had just been seen and the practitioner came out, got the birth control or whatever to bring back to the client, and she yelled, ‘I am going to throw an extra emergency contraceptive pill in here for the next time you screw up’
And that floored me and I immediately said, ‘Excuse me but I think you need to go in there and apologize because that is inappropriate, it is not okay for you to talk to her like that from over here. If you want to tell her that go in there. But then again you shouldn’t be telling her that either.’
I got fired because of that. There were other reason like, I think I was just angry because I thought that we would be respectful of all the people that came in for any kind of services and there was a lot of judgmental comments made about people coming in for their third, fourth, fifth, sixth abortion. The clinicians and staff people would like go to a little corner and talk smack about people. It was so disheartening.
It was very much like if it was a Latina or someone undocumented or a dark skinned person it was very much hatred and anger towards them but if we would had a 17 year old honor student that was white that was coming in for their abortion it was like no one mentioned anything. There was no facial expression, nothing about it and it was just normal.
[“Simmerdown – Dexter Remix” – Nostalgia 77]
SW: A realization hit her. So often we hold the right to choose as one of the central pillars of feminism. It represents the ultimate woman’s right to her own body. It’s the last frontier of defiance against a society that typically decides so much about what women can do and cannot do. Yet so often this was a defensive battle. And women who are not white, middle class are often left on the sidelines.
And that’s when Pati started to look more think more about the field of birth.
P: Here is the thing, we don’t really get taught about our really bodies really at all. And so then I think we get taught about our periods, a little bit about how ovulation works, when we learn about sex we learn not to get pregnant and how to avoid disease.
Here you are totally feminist, totally liberated, educated, and you’re pregnant and the, you are just expected to breathe and trust the doctor and everything is going to open up and you are just going to give birth.
What people don’t realize is that if you are not aware of what your body has the potential to do, the doctors and nurses will tell you what your body is going to do. And its going to be based on what they feel comfortable with. And I’m being nice by saying what feels comfortable to them but I’m also talking about what’s convenient for them. And so that’s the major problem that we have this blind trust in doctors that they are going to do what is in our best interest and its not necessarily that way all the time.
There is a lot of other factors that affect them like vacation times or holidays. Like I have experienced where people are due around the holidays and so doctors are trying to get the clients induced before the holiday so that they don’t have to be on call. You know things like that. So I don’t know that families are alert or aware of those things. They are counting on that most people don’t understand their bodies.
[“A Walk” – Tycho]
SW: For Pati, whether it was the right to choose to have an abortion, or the right to be informed and make choices during a pregnancy, at the core of her belief is having agency over your body.
She felt a particular responsibility to work in the field of birth as a woman of color. The majority of people giving birth are people of color. And yet, if you’re black, you are 4x more likely to die or have your baby die at birth or within the first year. If you’re Latino, you are 3x more likely.
Another one of the first births Pati helped with was pretty unusual. She was in a couple’s house with two midwives, a breathing coach, and a student midwife. They had pushed aside the breakfast nook in the kitchen put a small inflatable kiddie pool in its place, where the mother was sitting, wrestling with her contractions. There were five people in the house to support her because she was about to go through a breech birth.
SR: Usually babies come out head first. Breech births are when the baby doesn’t flip over, and comes out instead with its butt or feet first. These births are notoriously difficult and many doctors insist on c-sections in place of natural births. However, Pati was in the presence of expert midwives who preserve this lost art.
P: Basically it really felt like we were doing something really old, really ancient, we all kept the faith that this could totally happen, no problem. You know they kept checking the heart rate of the baby and everything was fine throughout the whole process. The whole concept is to be hands off with the baby and kind of let the baby figure its way out and the baby came out right butt cheek first and then the right leg came out and then kind of the left butt cheek came out and then you could just see the low back of the baby riggle on out and then you could see the spine come out and then the shoulder blades were wiggling and then her arms came and then at the very end her head came out so he totally came in backward.
[“Cirrus” – Bonobo]
SR: Watching this, Pati felt she was witnessing something ancient. It was inspiring and beautiful. At this point she was working as a caseworker for a non-profit organization and had essentially taken a sick day to go and support her first birth.
P: I thought wow this is a really trippy message I am getting right now because I am in a home breech birth just hanging out doing what seems like nothing but trusting that öh this can happen, you know its 2008 and we are doing a home birth and it’s normal and it’s okay I trust the midwife, the mom, the baby knows what they are doing and that was what I was doing for work and I thought man maybe i actually belong in these spaces and not in actual cubicle because I had never had anything deep inside me affirm that that’s where I need to be. Like I never felt that way when I was in my cubicle. You know, but at this specific birth it was a specific message that I didn’t belong anywhere else.
SR: Pati was finished working two jobs. Her calling was certain and she decided to double down and focus on just being a doula.
SW: At one birth, Pati helped a mother who was an athlete.
P: She would rock back and forth on hands and knees for a like a contraction or three and then she would sit up on the toilet right after that and she would have two or three contractions there. She did this for I swear it must been like 4-6 hours, and no one could believe that she was so far ahead in her labor. Because usually first time mom will take 12 hours or more and she had only been there for 4 to 6 hours and she said, ‘I think the baby is coming out’ and the nurses were saying, ‘No, no, no you can’t give birth yet the doctor is not here.’ And she said, ‘No, I think the baby is coming out and so she got up on the bed on hands and knees and she was rocking back and forth.
And she said, ‘Oh! I think the head came out’ and no one was near her, it was just hilarious because she didn’t want to be touched she was an athlete so she was really working the labor like she was on some marathon and when the head came out that was the only moment where the nurses knew she was serious, like that aware of where she was in her labor that she could say the baby’s head is coming out and it did.
And there were no doctors or nurses by so when they saw the head her butt was facing the door and her hands were like at the edge of the bed where her butt usually would be. And so they were like, ‘Oh, no no no you cannot give birth in that position she was like I am not moving you guys have to figure this out.’
So eventually the doctors were able to convince her to get on her side and lay on the table and the doctor came and they really encourage you to hold it in for the doctor to catch it and that has a lot to do with who is going to get paid. And so its really trippy on how the birth gets placed in the hospital setting it really has little to do with the sacred moment of a human coming onto the planet. So much more to do with everything else that is so not important.
[“A Walk” – Tycho]
SR: And that’s the thing that interesting about being a doula – you get full access into the medical system and the business of birth. Many hospitals prohibit midwives from being present during while the parent is having the baby, but doulas are allowed in, right alongside family and medical staff.
With each birth that she attended, Pati found that often times the woman giving birth and the people taking care of her at the hospital aren’t quite in sync. Doctors seem so official sometimes and we want to trust them, but they are mere humans too, who make mistakes. And there’s a lot of politics that shape the work that they do.
SW: In fact, the practice of giving birth in a hospital is a recent phenomenon. In 1900, 95 percent of births in the United States took place at home. Through a purposeful and calculated campaign on behalf of the medical establishment, doctors were able to convince women that the hospital was the best place to give birth. Thirty years later, the number of home births had shrunk in half.
Today the number is less than 1 percent.
SR: So what happens when birth becomes an industry? When medical professionals have more say in what happens in the process than the people giving birth themselves?
Today, one in every three births occur surgically via C- section. Most women are lying in bed during their labor, without food or water, restricted by monitors strapped around their belly that measure fetal heart rates. The majority of women opt for an epidural, the spinal medication that numbs the body from the waist down. Inductions that accelerate labor are also common practice.
SW: And the system discourages any deviation from these practices. Sometimes this can even lead medical professionals to treat pregnant people violently and disregard their requests. This happens even more frequently when patients are not educated and don’t speak English. In one case, Pati was helping a young, mixed race, single mom who had done most of the laboring at home and then entered the hospital in the last stages before having the baby.
P: The moment she walked in, ‘Why didn’t you come in earlier, you were suppose to come in when blah blah blah.’ So being yelled out for coming whenever she did come in. So she has to ignore that and stay focused on the labor and try to push the baby out.
So this particular person experienced, wanted everything to be natural. So many times after giving birth they tear and then a doctor will suture the tear. And so this particular doctor decided that he was going to suture without putting local anesthesia. And she started saying, ‘Ouch, that hurts!’ And we are talking about a needle with a thread innervaginally to the labia. Most doctors will put Lidacaine in that area and numb that area.
This particular doctor was sewing or suturing saying, ‘This is what you get when you don’t get an epidural, when you don’t come early enough to get an epidural,’ and she is writhing in pain. At the point I didn’t know to tell this fool to put Lidacaine on her and just call it a day. Like why are you torturing her right? And so he said, ‘Oh but you didn’t want an epidural so let me give you this.’
So he puts a narcotic into her I.V. and she had specifically did not want any kind of drugs so that makes her so drugged up that she can’t hold her baby, but now she is numb enough to finish the suturing without pain right. These are the ways that I think is birth rape because he’s giving her pain that she doesn’t need to feel. And its because he is upset because she didn’t come early enough to get an epidural. Basically she probably didn’t come early enough for them to bill for a lot of other things.
[“Transits” – Bonobo and Szjerdene]
SW: In hindsight, Pati came to realize that there were a number of signposts throughout her whole life that lead her to become a doula.
P: My sister, her whole life has been interested in babies and she had always baby dolls and she pretend to breast feed. And loves babies and trips out watching pregnant woman and will point point out a pregnant belly and so sometimes I wonder if there is a huge energy of my sister coming threw me to feel this work.I show her the pictures of my babies I helped out. She just smiles and she definitely appreciates it.
SR: When Pati was younger, she and her sister were in a car accident that changed the course of their lives completely. A family member was driving them home, on the freeway, when all of a sudden her sister got sick.
P: And my family member pulled over in what he thought was an emergency lane, which was actually the fast lane, the carpool lane, and so I took off my seatbelt I went to take a nap kind of and I leaned my head over, while he got into the back and changed her. And I, was looking at the rear view mirror and I saw these lights coming at us and I was like, ‘Damn that car is coming really fast.’ And so I kind of braced myself and then hit us.
I popped on over to the front almost. Since my family member was in front of my sister in the back seat their heads collided. And she was like 22 -23 months old. And they both passed out and I didn’t at all, I looked over and everything’s shattered and messed up and I was waking up my cousin and was like, ‘Hello we just got in an accident, you need to wake up.’ And he finally came to and was like, ‘Oh man, what’s happened?’
Eventually we got out, but my sister was kind of stuck with the seatbelt because she had her seatbelt on. Eventually we get her out and we lay her out and she was having convulsions. I remember, basically it was a drunk driver came out of his big truck and he was stumbling all over was like, ‘Oh no,’ all messed up I remember yelling out, ‘You’re so stupid, you’re so stupid’ I mean I was just a kid.
SW: Luckily, everyone survived the crash. But Pati’s sister experienced traumatic brain injuries that took a toll on her small body. That day began a never ending cycle of going in and out hospitals for her family.
P: My mom had tried to address this many times in the doctor’s office that my sister cried a lot and always touched her head. My mom was like, ‘I think she might have hydrocephalus or something is wrong with her. Please evaluate her.’ Obviously she not speaking english, so no one really cared. So they would just tell my mom, ‘Oh she’s just a cry baby. She’s just a cry baby.’ But what happened is with the car accident and the the Cranial fracture It made everything worse. Water pressure made more of the brain damage.
Here is the thing my mom is newly an immigrant, she is undocumented basically. She can’t advocate for better care. They do mind you all surgeries done in County USC Hospital. Students. So my sister comes out of one surgery and she comes out and her right side is paralyzed and she goes into another surgery and the left side stops working and her right side starts working. There was so many mistakes and things that happened with my sister. They kept telling my mom to leave her alone like don’t stimulate her. Leave her there, she’s a vegetable. You’re going to just have to put her in a home.
My mom was like no, she needs to stimulated and liveneded and held. They always wanted my mom out of the hospital room. My mom was like no im going to stay here and so. I just remember witnessing a lot of that fighting, of like my mom claiming her daughter. I mean, my sister, she is pretty good for what she went through. She is verbal, she can talk. She’s really funny. She is witty. She has extremely good hearing kinda like dog hearing, from far away. she is hilarious.
That accident was very much a big influence in my life, it pretty much dictates a lot of what I do or what’s important to me.
SR: Pati’s strength to lead families through the process of birth comes from many of these experiences. She learned how to stay calm in chaotic situations. She learned how to navigate a complicated medical system, and then translate it, for a family that might not understand English. She learned when she should and when she shouldn’t just take doctor’s words at face value. And, she learned, through her own process of healing, how to help in others heal too.
SW: And it helps to remember that the process of coming into the world is one that is so unique and special. Pati recalls a c-section birth.
P: I don’t know came over this family but they decided they were going to sing.
[“Sabemos Parir” – Rosa Zaragoza]
P: And as the baby is being lifted out, the mom and dad are singing. I don’t know what song it was, but they sang it through the surgery and when the baby was coming out and until the baby was handed to them. And they kept singing and the baby was put in the incubator and they kept singing that song and they sang that song until they were done working with mom and that was amazing ‘cause it may have cured the trauma of being born that way.
Yeah, I think its helpful to remind the world that nurses and doctors that this is actually ceremony. Its actually real special moment beyond all the technical stuff and so I’ve been fortunate to work with really interesting people that will do things like that.
SR: Today, Pati is an advocate and she sees the power of doulas to transform births.
P: What people need to know about doulas is that we need more doulas. Ideally, I wouldn’t have this job. Like there is no reason why I should have to be in a hospital to basically protect and be the bodyguard of a pregnant person. No, that shouldn’t exist but it does. Okay but what do we do? It’s hard work but it’s so necessary. We need more dulas of color, we need more conscious, politicized doulas. There is a lot of power power in being a doula. I think if we can use that power differently, or not even differently but like combine our power like connect other doulas to each other, we can make a big difference.
SR: Pati is currently pursuing training to become a midwife. She recently moved to El Paso Texas to attend Maternidad La Luz, a birth center that provides a unique and holistic learning experience for aspiring midwives.
[“To Zion” – Lauryn Hill and Carlos Santana]
SW: Thank you Pati for sharing your story. You can learn more about Pati at her website – chula doula.com. To learn more about doulas particularly with a race, class and queer and trans lens, visit radicaldoula.com. There you can purchase the Radical Doula Guide, a political handbook on how to support people during pregnancy and childbirth. You can also visit the Community Birth Center to learn about midwives and doulas at LA-community-birth.com.
SR: You’re listening to ReWork a program of the UCLA Labor Center and KPFK. This week’s show was produced by Tyler Milles, Stefanie Ritoper, Saba Waheed, Gardenia Moreno and Crystal Zamora. Music support by Francisco Garcia Nava. Special thanks to Henry Walton.
For more information about ReWork, visit our website at reworkradio.org. There you can listen to previous shows and subscribe to our podcast. You can also tweet your reactions to this show to @rework_radio.
SW: Until next time re-think, re-work!