Every day, Kelley Tomlin awaits her baby. Labor can start at any minute.
Tomlin’s first birth traumatized her. As a larger woman who had a 10-pound baby, she felt she was pushed into procedures she didn’t want.
Hospital staff didn’t respect her space during her five-day stay, she said. The 33-year-old was induced and couldn't leave her bed for three days. She suspected her induction was botched, and nurses told her she felt that way because she had never been pregnant before. When her daughter arrived, they took the newborn before she could hold her.
To Tomlin, everything was out of her control. And looking to her next birth, she doesn’t fret or panic. Her anxiety quells when she remembers an integral part of her support system — a doula.
“I felt like the general attitude was ‘Without us, you couldn’t have a baby. Your job is to just lay there, and we'll do all the rest,’” she said. “And the more I've learned about birth and about the experience of being a mother is that I'm the only thing necessary to have a baby.”
With quarantine and the COVID-19 pandemic, local doulas — trained professionals who offer support to expectant mothers — noticed an increased interest in their services. Other types of doulas, such as end-of-life doulas, also cared for patients confronting death.
While there isn't any accurate data related to doula services, a survey found that 6% of 2,400 expectant mothers used a doula in 2012 — a figure that doubled since a 2005 poll.
A doula provides balance, Tomlin said. They work with the medical community frequently and know how to advocate for women in labor. She found her doula, Angela Daniel, after she reached out to the Gainesville mom community.
When they first met, Daniel went to her home and took time getting to know her, her husband and her daughter. Tomlin set her goals and her birth team, the people who will watch her kids, stay at her house and accompany her to the hospital.
“When you're in labor, there's nothing you could want more than a person that knows exactly what to say and that you trust explicitly with your safety and your experience and your child,” Tomlin said.
Throughout Tomlin’s pregnancy, Daniel fulfilled her role like a wedding coordinator with effervescent grace. She checked in on her, answered her questions and reminded her about self care, such as taking naps and eating dinner.
As she plans for the arrival of her baby, she’s relieved that her relationship with Daniel won’t end, as she will use her lactation consultant expertise to breastfeed the baby. Her daughter was tongue-tied, and Tomlin’s milk didn’t come in because of the induction.
“When the baby is born, the relationship [with the doula] ends when I'm ready to take the reins and do it all by myself,” she said.
The pregnancy and birthing experiences look different for everyone, Daniel said. In her 11 years as a doula, she has worked with mothers whose opinions differed on hospital births, use of epidural and C-sections.
Daniel’s love of birth blossomed in her teen years, but she became a doula after delivering her first child in a birth riddled with hiccups. She had a doula who eventually took her on as an apprentice.
Despite increased demand, doulas couldn’t always attend births at hospitals during the pandemic, and some expectant mothers opted for at-home births. They made the most of the situation and sent clients’ partners pictures of positions and counter-pressures for labor, often also FaceTiming them.
Now allowed back inside hospitals, many doulas like Daniel wait for the 3 a.m. calls. They meet their clients there and set the ambience in the room, changing the lighting, playing music and using aromatherapy.
“We try to help them to set up their space so that they can feel their most comfortable because your body works the best when it feels safe,” she said.
To Daniel, doulas support mothers, especially those who didn’t have a peaceful birth, because of their long-term relationship. They understand the mother’s wishes and don’t change shifts as the baby arrives.
“I get to be with people when they are most vulnerable,” she said. “They're working hard. There's sometimes tears because they're sad about something going on. There's frustration. There's happiness and joy and love, and I get to be a part of helping that unfold.”
Black doulas empowering expectant mothers
During her first pregnancy, Jennifer Revell wanted more than the prenatal vitamins her obstetrician told her to take. She went to a birth center to explore all her thoughts and questions.
A woman told her to look into a career as a doula, and she started assisting in 2017 until she became one herself in 2019.
After she moved to Gainesville, she believed she was the only Black doula in the area until she noticed other community members tagging Vava Cherie in Facebook posts about doulas. She connected with Cherie, even discovering that she was Haitian, too.
Revell, who was pregnant at the time, felt relieved to have found Cherie as she sought a doula. Cherie had recently given birth and wasn’t offering doula services at the time but decided to support Revell through the process.
“I wanted to keep my birth space all Black because I wanted everyone to look like me,” she said. “I wanted to just have that environment. I wanted to keep it more culturally aware.”
Already knowledgeable about pregnancy, Revell desired more emotional and spiritual support to be at ease. And that’s what Cherie offered. She became the “grand doula.”
Revell works primarily with Black women and women of color but hopes to expand her services to teen mothers in the future.
“I want to build an intimacy amongst me and my client, like a bond of companionship, so that she is at ease in labor, especially if she doesn't have a spouse or anyone to be there with her,” she said. “When you have someone that you're connected with, it allows your labor to your contractions to be more consistent.”
Like a cheerleader, she roots for her clients as she develops their birth plans and teaches them birthing positions. She explores ways to connect moms with other moms so they don't feel alone and provides information about infant care and pediatricians.
“I typically don't let go of my clients,” she said. “We probably still talk and text every now and then with pictures of the baby or things like that. There's really no end to our relationship.”
Revell noticed some partners were very involved and coached them to advocate for their significant other throughout the process. In fact, even her husband Dominique Revell did the same. The pair were duo doulas at an at-home birth of one of Revell’s middle school friends.
Pregnancy is a challenge for fathers as well, Dominique said. They want to prioritize the mother’s health and well-being, so they often hold in their thoughts.
“You will never know a dad’s thoughts unless someone asked the right questions,” he said.
Dominique provides fathers with a space to vent and ask questions. He also takes time to explain the signs of postpartum depression; his wife had a severe case.
“The reward is just hearing a baby cry as soon as the baby comes,” he said.
Even as an emergency room nurse, Cherie finds time to serve as a doula. Her aim is to help women laboring in the home discover their strength.
“The point is to focus your intention in your mind and work with your own will and spirit to bring forth that baby,” she said.
In ninth grade biology class, Cherie watched the Miracle of Life DVD, which prompted endless questions about pregnancy. Then, in nursing school, she loved helping women in labor during her obstetrics rounds.
Cherie noticed that many people now consider using doulas and alternative medicine in general. She blends her nursing knowledge and spiritualist beliefs with prayer, meditation, yoga and saging. And she always works with intention.
“Birthing is very much a spiritual process, so that's why I feel like, in my practice, it is important for me for the mother to connect to her spirit, to be able to see this through,” she said.
Cherie begins with a consultation where she discusses the expectant mother’s medical history and diet. The pair later meets, executes a birthing plan and starts to build kinship. When the baby is on the way, Cherie rushes over equipped with a birthing ball and rice packs for pain.
“Doula work is very sacred,” she said. “It's a very beautiful thing to stand in the space of someone that is birthing a baby, bringing forth a new life.”
Some welcome new life, others say goodbye
For five years, death and grief haunted Shanti Vani’s mind. She lost seven loved ones, seemingly one after another.
Two of her great-grandchildren died from a crib death and drowning. Her sister by murder. One of her daughters from addiction and depression — a loss she balanced while caring for her ailing mother.
Vani moved into her mother’s home in 2015 to accompany her as she battled Alzheimer’s Disease. She watched her slowly slip through the dying process.
“I watched her very graciously and sweetly go through losing her memory and her abilities,” Vani said. “And so I kind of felt my way through it and did the best I could, but I wished that I could have had more guidance.”
She pondered and questioned things she felt embarrassed to ask others. Her mother may have Alzheimer’s, but how would she die as she was healthy?
After her mother died in 2018, Vani continued to reflect on her experiences. She signed up for an International End of Life Doula Association training, where she learned how to support family members and advocate for the patient throughout the dying process.
“Grief, death and loss is a little bit like sex,” she said. “A lot of us, we’re just not comfortable talking about it.”
In 11 years as a hospital employee, Vani noticed people don't prepare for death. They procrastinate and don’t get the information they need ahead of time. Instead, they’re focused on doing dishes and laundry with their loved one in mind without considering self care and their own mental health.
That’s where end-of-life doulas come in.
They help explain death and prepare advanced directives, written statements regarding medical treatments. Patients often question if they know what they want as the end of their life nears.
Vani spent time with a woman in 2020, and she shared all her post-death hopes. She finally felt like she knew what she wanted: what songs would play at her funeral and who would be there.
On a visit to Prairie Creek Conservation Cemetery, she gleamed at the thought of being buried there. She told Vani that after her burial, she would join her loved ones to celebrate her life at home.
“Just in her excitement sharing about it, she saw herself in the circle and actually being present there,” Vani said.
When someone is vibrant and healthy, death brings shock, disbelief and numbness.
“You might have known in your intellect that they were gonna die, but you didn't get it in your heart and in your gut,” she said. “They're actually gone, and they're not coming back in this body.”
To Vani, society needs to normalize and accept death. Denial builds walls around mourners out of fear of the inevitable. But acceptance and understanding allows people to live an aware and full life.
A doula and photographer
After listening to a birthing podcast, Stephanie Romelus opted for a natural, unmedicated birth. The 29-year-old’s sister-in-law worked with Daniel and recommended her services.
Romelus gave birth to her first child in April. She chose to have a doula with a patient, kind voice there to support her with knowledge of medical terms. Her midwife even lit up when she found out Daniel was Romelus’ doula.
“We wanted to be owners of our decisions, but we wanted somebody who could kind of help navigate and be an advocate for us during that process,” she said.
Throughout her pregnancy, Romelus relayed all her questions to Daniel. She even learned the Rebozo technique, which she used to reposition her baby who was posterior. Daniel always reminded her to eat, take strolls and enjoy time in the sun.
When Daniel arrived at the hospital, she set up the room with twinkling lights and LED candles like a fairy godmother. Romelus and her husband compared her to an epidural as she massaged pressure points to support her through the labor process.
“My husband is a huge proponent of doulas,” she said. “I feel like it’s kind of rare because it's usually the women, but my husband and her totally hit it off. He was able to trust her and kind of be free and relax and help and do his thing as a papa.”
Romelus knew she made the right choice. Daniel was in the room to support her, taking notes and photographs. Now, she’ll be at Tomlin’s side, ready to support her through birth and capture those moments, too.