‘I’m a Doula—Here Are 3 Green Flags To Look for in a Birthing Team’ 

Assembling a birthing team and thinking through a birth plan is an important aspect of pregnancy, especially for Black birthing people, says Racha Tahani Lawler Queen, CPM, a certified professional midwife who has been supporting homebirth families for almost 20 years.

This preparation is especially important for Black birthing people, because according to data from the Centers for Disease Control and Prevention (CDC), Black women are two to three times more likely to die from pregnancy and childbirth complications than white women, and it has only risen since 2020. Assembling a team of informed and dedicated care providers, support people, and advocates won’t fix everything—but it can make safer pregnancy and delivery possible. That said, figuring out what a birth team is and who should be on it can be a challenge.

On a recent episode of Well + Good’s Glowing Live With Latham Thomas, Thomas, a certified full-spectrum doula, spoke with Queen about the history of Black birth work and explained exactly why Black birth workers are such an important resource. Below, we laid out what a birthing team is, who joins a birth team, and what to look for in ideal candidates.

What is a birthing team

The concept of a birthing team is important, according to Queen, because a person needs safe, supportive, smart people to get them and their baby safely through pregnancy and labor. There’s no one right way to assemble a birth team, especially when families consist of so many different kinds of relationships and bonds. The most important tenants of a birth team, Queen says, include a support person, medical care provider like an OB/GYN or midwife, and a birth worker like a doula.  Teams can also include photographers, massage therapists, mental health therapists, spiritual guides, and more. The most important thing that every birthing team member must possess is the pregnant person’s best interests at heart.

A birthing team is the group of people who support you throughout your pregnancy, during the birth team, and postpartum, says Paige Green, BSN, RN, postpartum nurse, and full-spectrum doula. This team varies from pregnant person to pregnant person. Typically, Green says consists of a medically certified care professional like an OB/GYN or Midwife, a doula, a support person, and potentially a photographer or massage therapist.

Who provides the medical care on a birthing team

Your medical provider can support you throughout the process: from trying to conceive to breastfeeding consultation. You want someone experienced, respectful, communicative, collaborative, says Green. Providers for pregnancy can range from an Obstetrician/Gynecologist that specializes in pregnancy care, a midwife, or a primary care physician with the right qualifications. Depending on your health needs, you may have additional specialists on your team like cardiologists and neurologists.

What’s the difference between a midwife and a doula

There are major differences. Midwives are trained, clinically certified medical professionals that can perform medical procedures like blood work, delivery, prescribing and administering medications, and more, Lawler says. Doulas, however, serve an emotional, social, and educational role during pregnancy, according to the National Black Doulas Association. This means they act as a confidant, support system, informant, and advocate throughout the experience of pregnancy, birth, and postpartum periods. Doulas are not certified clinically and do not perform medical procedures or make medical decisions about a pregnancy.

Even though doulas aren’t medical providers, Thomas says, they are vitally beneficial because they serve as a resource and supportive leader in developing and executing your birth plan. For instance, a doula can offer answers to questions ranging from pregnancy development to your rights as a birthing person. They can structure your calendar and give you deadlines for things like nursery setup, and more. 

Additionally, a doula is someone you can trust to make your wishes clear to the medical professionals on your care team as well. This can include attending appointments with you leading up to your birth and advocating for you during labor when you might be able to think or speak clearly. Doulas offer safety and support for a birthing person in a range of ways, and in some instances, they ensure more positive birth outcomes, according to a 2013 study published in the Journal of Perinatal Education. 

What’s a support person

A support person is a counterpart for the pregnant person during their pregnancy. This person could be a spouse, but it could also be a parent, sister, friend. A support person should possess the ability to take care of themselves and advocate for the pregnant person they are assisting. “Sometimes people want to add their mothers to their birth teams, in addition, or in place of a spouse,” says Green. “As a Doula, I recommend birthing people reflect on their relationship with whomever they want to support them and consider if they have their best interest in mind,” she says. For instance, if your mother is an essential person in your life but often needs extra attention or tension easily arises — she might not be the best person to have in the room with you, Green says.  Thinking about this well before it’s time to deliver, she adds, can help you decide who you want to be in the room. 

Three green flags to look for in your birth workers

1. You share similar values and feel seen

Whether you’re choosing a midwife, OB/GYN, doula, or photographer, you want to make sure that these people align with your values and are folks you can trust. A way to determine if these people are really aligned with what you want for your pregnancy is by talking about the hard things early on. This can look like asking them about views on Black maternity rates in childbirth, their ability to respect your pronouns, adhere to your wishes, or if they’re vaccinated for COVID-19. Pay attention to their answers for these non-negotiable points of discussion, and don’t hesitate to find someone else that readily answers your questions and honors your wishes. 

For Black pregnant folks, Lawler shared that it is exceptionally important for your birth workers to understand your lived experience and the risks that you’re facing during your pregnancy. This is why Black doulas and Black midwives are so essential for the health and safety of Black mothers and pregnant folks. However, according to Lawler, the presence of Black birth workers improve the safety of their clients by understanding their lived experience and advocating for care in situations that can be life-threatening. 

2. You’re able to disagree with them

It’s crucial that you feel like you can say no to anyone on your birth team, says Green. This is because you have to trust these people, especially your medical care provider, during some of the most intense moments of your life. Suppose you don’t want an epidural, have specific wishes for how your pregnancy should go, or you have boundaries during your postpartum period. In that case, these team members should absolutely be on the same page as you. 

Practice setting boundaries with these people as soon as possible, and pay attention to your team’s ability to make you feel comfortable, seen and heard. It is always okay to find someone who better understands what you want and is ready to adhere to your wishes.

3. They’re willing to collaborate with each other

An ideal birth team should be able to collaborate, according to Green. A common red flag is if a doctor or medical provider is displeased or against the fact that you have a doula. There are a lot of care providers that support this form of birth work, and you want a team that is willing to work together.

This goes for anyone else on your team, including your support person, medical provider, doula, photographer, or massage therapist. It’s your birth: You deserve to feel safe, supported and heard. 

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