Natalie Peña
Natalie Peña
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Vida Saludable

Birth doulas: Interview with Natalie Peña 

Por Elizabeth Liotta
December 2023
“Motherhood is particularly challenging for Black and Latina women in the United States, as without proper support, these women can face perfectly preventable conditions. Due to the impersonal approach of American doctors, these conditions are often not prevented thanks to systemic racism," reflected Natalie Peña, who is a bilingual Dominican maternity assistant (also known as Doula) and resident of Washington Heights, New York.
The doula is a woman who accompanies the future mother, acting as a professional assistant to alleviate typical concerns that women experience during pregnancy. As reported by Senator Samra Brouk in The New York State Senate, parents who use a doula have a 25% shorter labor, are twice as likely to experience a complication, half as likely to need a cesarean section and a Sixty percent less likely to request an epidural. 

In addition, the senator confirmed that in the New York state budget, starting next year, more than 2 million dollars have been included to cover the Doula service with Medicaid health insurance. In 2025, $8 million will also be added to cover up to eight prenatal and postpartum visits (which traditionally cost $85 each). As a result, many more people will have access to a maternity assistant during their pregnancy. 

In the following interview, Natalie tells us about the fundamental role of doulas during pregnancy, childbirth and postpartum, and also educates us about the positive experiences in the birth of babies, and the emotional, physical and spiritual support they offer. 

How long have you lived in New York and what did you study to be a birth doula?

I am a first generation Dominican in New York and I live near New York Presbyterian. My family and I have a 78-year history in that neighborhood, where we have built a beautiful community. This is a part of my story as a doula, as I just completed 9 years of service to the people of Manhattan and Harlem. I graduated from City College with a degree in International Community Health and now work in reproductive justice to help those who need me. I created my own career through CUNY Interdisciplinary Studies because I knew from the beginning that I wanted to explore diverse topics. I then continued my education in Barcelona, ​​Spain, where I earned a master's degree in clinical sociology and couples therapy. I began my career as a student by attending births in 2015. It all started with a pregnant friend who asked me for help, simply saying: 'I'm having a baby and I need you to help me.' I gladly supported her and it was then, that year, when I witnessed my first birth. I feel like my eyes were opened after that experience." 

Why did you decide to start your career as a doula?

Sexuality and reproductive justice were key issues for me, since in the United States, support programs for pregnant women are not as common or accessible as in Europe. When it comes to motherhood, the United States performs poorly when it comes to supporting Black and Latina women. Too often, we see women suffering from preventable conditions due to systemic racism, poverty, and lack of education. For this reason, I wanted to study in a more open environment regarding sexuality, understanding that this is a natural part of life, not only related to the decision to have or not have children. I wanted to free people from culturally ingrained notions, like the idea that you should get married after having sex. These deep-rooted beliefs come from machismo inherited from previous generations. Raised in the United States and the Dominican Republic, I realize that women from past generations do not often talk openly about issues of sexuality. Many migrant women married as virgins and became pregnant, which imposed a standard of purity on them. All of this is related to education and healthcare. Visits to the gynecologist often focus on fertility and pregnancy, without considering women's holistic needs, from menstruation to sexuality. This lack of detailed attention and impersonal attention from many doctors led me to create my own university degree to help close this gap. 

What are the advantages of having a maternity assistant?

The Doula is someone who will accompany you throughout the entire pregnancy process. I offer prenatal and postpartum education classes with the goal of helping pregnant women understand the changes they are experiencing, preparing them both physically and psychologically to make their birth experience as pleasant as possible. I also provide therapeutic massages, physical exercises, postpartum couples communication classes, breastfeeding counseling, and reproductive rights education. It is common for many women to think that when they arrive at the hospital they must follow all the doctor's instructions, but my task is to remind them that as patients they have rights. Many women are unaware of their rights, which sometimes leads to situations where they are pressured to perform procedures they do not want, which can result in a traumatic birth. Sometimes the type of birth can change from vaginal to cesarean section without a solid basis for doing so, often due to a lack of information or the lack of a Spanish-speaking mediator at such a critical time. Therefore, the role of doulas is crucial. Additionally, doulas can also help with basic household needs to ease the burden on the couple. When the baby is resting, it is important that the couple also rests, so we take care of tasks such as cleaning the house, cooking or completing any pending tasks. Doulas who provide this type of support are called "Full Spectrum Doulas." 

How much does it cost to hire a doula?

This depends. I work in the city, in a program called CDI that offers free doula services. We had been trying to make this happen for almost 8 years and finally this year our wish came true. I also work for an organization in Harlem where I provide my services for free to women who do not have access to health insurance or who do not speak English. However, due to my years of experience and the fact that I have assisted more than 150 births in total, when I work on my own I typically charge from three thousand to four thousand dollars, although I also usually weigh the financial stability of my clients before giving them a quote. 

Any recommendations to our mother readers?

I recommend women talk to their partners about gender roles, since I think other cultures see more gender equality in motherhood much more than in Latin families. I believe that the sexist expectation that mothers should do everything is what puts pressure on and hurts many women. While it is true that it is your responsibility to care for your baby, mothers also have the right to be cared for. I invite Latino families to abandon these patriarchal beliefs. It is also important for women to take care of their nutrition and stay away from processed and sodium-laden foods, as this can negatively affect pregnancy. Additionally, it is essential to make sure you get enough vitamin D, as in our tropical countries we get it naturally, but in the grayer skies of the United States, it is often necessary to take supplements to keep our bodies well nourished. Finally, I highly recommend having a doula during your pregnancy as this support can significantly reduce any possible risks, and you are more likely to have a natural birth as a result of more detailed, warm, and effective care.

* Translated from Spanish by Waleska Brito

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