How doulas provide support and comfort in their communities

Coralee Oates first heard the term “doula” three years ago when her daughter was pregnant. Her daughter wanted a doula — a professional who aids clients during pregnancy — for giving birth but could not afford one, and Oates found herself wishing there was something she could do to help.

Soon after, Oates learned more about doulas when she read a program highlighting a man who became a doula to support his sister.

“I was so inspired by that,” she said. “I'm like, ‘Oh, I'm doing that. I'm definitely doing that.’”

In 2022, Oates completed eight weekends of doula training through UNC School of Medicine's Lived Experience Accessible Doula program, which included reading educational books, writing a paper and supporting three births, before receiving her birthing doula certification in 2023. Now, Oates works part time as a birthing doula serving Wake, Durham, Johnston and Orange counties.

According to UNC Health, doulas provide physical, emotional and informational support to people who give birth. Being a doula is not just about keeping the pregnant person and their baby healthy, Venus Standard, LEADoula co-founder and certified nurse-midwife, said. It's also about making sure the pregnant person feels supported, valued and listened to.

While some private insurance companies in the state cover doula costs, N.C. Medicaid does not. According to a study by MACPAC, an advisory group reporting to Congress and states about Medicaid, pregnant people with Medicaid coverage are more likely to have preterm births and babies with low birthweight compared to individuals with private insurance. N.C. Women’s Hospital provides patients with free volunteer doula services, but Standard said doulas should not have to volunteer.

“People that need it the most — the people that are being damaged the most to make those disparity ratios so high — are the ones that can't afford to pay for a doula out of pocket,” Standard said.

Oates said she has tried to work with clients regarding the cost of services because affordability is an obstacle for many pregnant people who want a doula, as she saw with her own daughter. Oates said serving others is what her family does — she has even encouraged her sisters and nieces to consider becoming doulas. 

Oates said she loves being there for her clients because, though there may be family and friends in the delivery room, these people are often more spectator than support. She said she would be a doula even if she wasn't paid because she enjoys it so much. 

Michelle McKelvey, Oates’ coworker and friend, said Oates has strong motherly instincts and brings calmness to chaotic situations.

“She cares about what you think [and] how you're feeling, and she always tries to bring good energy,” McKelvey said.

According to a study by the Centers for Disease Control and Prevention, the maternal mortality rate for Black women was reported to be 2.6 times higher than the rate for white women in 2021. Standard said gaps like these can cause people of color to distrust medical establishments.

“Women of color go into the hospital not knowing if they’re going to come out,” she said.

Doulas of color can build trusting relationships with clients of color because the clients can have assurance in their doula’s lived experience, Standard said.

Oates said she does not tell her clients what to do but instead tries to guide them in making informed decisions for themselves. She prepares her clients before labor and helps them process new information during labor so they are not making decisions out of fear, stress or exhaustion.

“It’s helpful to have doulas there as another sounding board,” Oates said.

Looking forward, Oates said she wants to dedicate more of her time to being a doula when she eventually retires from her full-time job. She is currently working on earning her certificate to be a postpartum doula.

“Doulas are a bridge,” Standard said. “They’re a bridge between the medical establishment and the client.”

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