This Doula Says Birth Is Especially Dangerous If You're Black, & She's Not Wrong

When you meet Regina Conceição, the doula featured in Episode 2 of Romper’s Doula Diaries, she exudes calm, and calm is clearly what she brought to the birth that the episode follows. Over lunch in Brooklyn a few weeks later, Conceição recalls that her client, Manyell, and her baby “were doing really well as far as progression” when they got to the hospital. The doctors, however, were concerned about Manyell’s low platelet count, which could affect their ability to give Manyell an epidural. Manyell didn't want one anyway, and Conceição was confident that she could make it through without it. “Every mother and baby have their own marathon. They run at their own speed,” she says. On Sunday, July 16, after almost three days of labor, two and a half of which Conceição had attended, Manyell gave birth to a healthy baby named Zhalay. “I love what I do. It doesn’t feel like a job to me,” Conceição says.

Our moms are surviving. Thus far we haven’t had a maternal death.

Conceição has been a doula for 17 years. She started out pursuing a bachelor's degree at University of Massachusetts Amherst, studying science in the hopes of attending medical school and becoming an OB/GYN, but she struggled with her science classes. She knew she wanted to help women give birth, so she ultimately decided that she was better suited for doula work. She was particularly interested in making birth safer for all parties involved. The United States has a startlingly high infant mortality rate and ranks 60th in maternal mortality globally, despite spending more than any other country on maternity care. If you’re a woman of color, the statistics are even worse. But studies suggest that the presence of a doula can reduce birth complications, and doulas have been shown to reduce maternal mortality rate as well. So she decided to become one.

“Babies are dying. Women are dying,” Conceição says. Along with working at Columbia University’s Head Start Perinatal Support Program since 2004, in 2007 she founded A Passion For New Beginnings, a private doula and birth education practice that offers doula services for women through any time in their childbearing years through postpartum. In 2013 Conceição joined a doula program for lower income families run by Healthy Start Brooklyn, a New York City-funded support program for new parents. When she started, there were four doulas. That number has risen to 12, proving the increase in interests in doula work as a profession, the desire among expecting mothers to work with doulas, and hopefully greater recognition within the United States of the benefits of doula services.

I want to see all women get doulas if they want them.

“Looking at our data and outcomes, our moms are having fewer c-sections, fewer inductions,” she says. While most inductions and c-sections turn out just fine, inductions increase the likelihood of having a c-section, and c-sections are associated with increased risk of respiratory distress for the baby, and added risk for internal organ damage and infection for mothers. If a mother knows she wants a vaginal birth and the baby is not in imminent danger, a doula can help advocate for her birth plan in the hospital while the mother focuses on the birthing process.

But more importantly, says Conceição, “Our moms are surviving. Thus far we haven’t had a maternal death." In Romper’s Doula Diaries she adds:

It is so crucial for women to be supported by other women. Women are not supposed to be by themselves when they are pregnant. They are not supposed to be by themselves when they are in labor, and they are definitely not supposed to be by themselves during the postpartum period.

Doula services can be expensive — fees can cost up to $2,000 in New York City according to The New York Times — but in most cases are more affordable. Especially with the influx of young women into the field and community doula services such as Healthy Start Brooklyn that offer low cost or even free services, doulas are now accessible to women of all socioeconomic backgrounds.

“I want to see all women get doulas if they want them,” Conceição says. She hopes that Medicaid will one day cover doula services in all 50 states (currently only Oregon and Minnesota offer Medicaid reimbursement for doula care), but thanks to her private practice and part-time work at Columbia, she is also able to work with families that don’t quality for community doula programs, which only serve clients in certain zip codes.

“When some of my clients can’t afford my fee, I barter,” she says. For example, when Manyell was six months pregnant, Jamel lost his job. “She said, ‘This is seeming like a luxury for us,’ and I’m like, ‘It’s not a luxury,’" Conceição says. "I clicked very well with them, and they clicked very well with me. I was like, ‘Alright, if you really want to work we’ll figure this out.’” Manyell is a financial advisor, so in exchange for Conceição’s doula services, she helped Conceição with some estate planning. “My philosophy as a doula is that I believe everyone should have a doula. If you want one you should have one,” Conceição says.

During her time as a doula, Conceição has witnessed countless moments of beauty, like the teen mom who articulated to hospital staff exactly what kind of birth she wanted, which for her was an unmedicated one. “I felt like a proud mom when [she] was in labor,” Conceição says. When the nurse tried to give the client an epidural, the mother-to-be responded that Conceição was her epidural. “She had ginger lotion, and was like, ‘Regina is going to massage me,’” recalls Conceição, who incorporates calming scents into her practice. In her episode of Doula Diaries, Conceição says that one of her favorite things about her job is seeing not just babies but mothers be born.

We’re not all hippies. I love essential oils, and, yes, I do own a pair of clogs. But I also wear stilettos. I go out and dance and I wear perfume

Her work also entails supporting women through darker moments, like when a mother finds out she is HIV positive, and helping them amass the information they need — such as the fact that the risk of transmitting HIV to a baby during birth is less than one percent — to chart their own course. “For me, this work is so important. Even though it’s difficult, it’s rewarding to see the accomplishments that women are able to achieve,” Conceição explains in the episode.

She works hard to match the strength she observes in her clients. An important part of helping them through birth, Conceição says, is taking care of herself, which she does in a variety of ways. “For me, it’s spa days, but it’s also dance class, acupuncture, and therapy. I went to carnival in Barbados because it keeps me grounded.”

While she’s the first to admit her love for aromatherapy (Manyell chose lavender to ease her labor), Conceição laughs that one of her clients has nicknamed her “The Doula Bae,” for her love of dancing. “There’s this stereotype of doulas being all hippies. Which is fine, but we’re not all hippies. I love essential oils, and, yes, I do own a pair of clogs. But I also wear stilettos. I go out and dance and I wear perfume,” she says. “Self-care is important. If I don’t take care of myself I’m not going to be of service to my clients.”

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