TRANSCRIPT EPISODE 9 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #9: 
all about doulas with keisha graham

Transcript

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00:01                                Today on the podcast we have an expert interview with Doula, Keisha Graham

00:12                                Welcome to the All About Pregnancy and Birth podcast. I'm Doctor Nicole Calloway Rankins, a board certified Ob Gyn physician and certified integrative health coach. Every week I break down topics, share birth stories or interview experts to help you have your very best pregnancy birth. Quick note, the information is for educational purposes only and is not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:41                                Nicole: Well hello there. Welcome to another episode of the All About Pregnancy and Birth podcast. I hope you are having an absolutely, positively fabulous day. I am over here feeling it pretty fabulous because you all keep leaving me these absolutely lovely reviews. Let me give a quick listener shout out and I'm just going to spell it out. K. A. T. H. R. A. R. K. She left me a review in iTunes and it says even though this podcast is just starting out, the sound and presentation is excellent, great information, reliable sources and real. And that real is in all caps. I was so happy to find this podcast. Well thank you so much for those kind words. I am happy that you found the podcast too and I'm so excited about continuing to deliver excellent reliable information for you. Now. I would love to leave you a shout out on the podcast, so drop me a review in iTunes and I will leave you a shout out on a future show.

01:46                                Nicole: All right, so today we have a great expert interview with Keisha Graham. Keisha is a birth Doula, a childbirth educator and an Octavia Butler fan. Keisha has been supporting birthing people for over eight years and she's also passionate about raising awareness of the black maternal health crisis in this country. Keisha's also the community manager for the private Facebook group for members of my online childbirth education class, The Birth Preparation Course, and she's a community moderator for the podcast community Facebook group. I hope you're in the podcast community Facebook group. It's called All About Pregnancy and Birth podcast community and it's a great place to connect to share tips and swap insights. So definitely join the group if you haven't already done so. I will link to the group in the show notes. Now today Keisha is going to tell us all about doulas. I'm a huge supporter of Doulas, so I'm really excited to bring this information to you and Keisha is going to talk about what a Doula does, how to choose a Doula, how a Doula works with your partner, and so much more. So without further, let's get to my interview with Doula Keisha Graham.

03:04                                Nicole: Hey there. Keisha thank you so much for coming onto the All About Pregnancy and Birth podcast. I am so glad to have you here today to help women learn more about doulas.

03:15                                Keisha: Yay.

03:17                                Nicole: Awesome. Awesome. So I thought we would start off by having you tell us a little bit about you and your work and maybe even your family if you want to.

03:27                                Keisha: Awesome. So I am a birth Doula in Richmond, Virginia. I also am a wife. I'm a mother of two little queens in training is what I call them.

03:27                                Nicole: Oh I like that!

03:27                                Keisha: Like not quite princesses, right? But queens in training. So McKayla's 10 and Carter is four. So, in addition to running around with them, I'm also a part time cashier. I teach childbirth education in a classroom setting at one of the local hospitals. And I'm also the Facebook community manager for The Birth Preparation Course.

04:14                                Nicole: I feel so fortunate to have Keisha as part of The Birth Preparation Course. She is such an outstanding resource and help to women in the course community. So thank you for being a part of that.

04:24                                Keisha: Thank you for having me.

04:25                                Nicole: Absolutely. Okay. But we're not here to talk about the course. We're here to talk about doulas. How about you tell us what exactly is a Doula?

04:34                                Keisha: So a Doula is like basically a support person or a labor coach. So a Doula is a professional that will be with a person and a family throughout their pregnancy, labor and delivery, and in the immediate postpartum period. We provide physical, emotional, and most importantly educational support throughout those phases and a woman or family's life. And then there's birth doulas and postpartum doulas. A postpartum Doula kind of picks up where the birth Doula ends, in that fourth trimester period and they help the family kind of transition with that newborn in the home. Doing light housekeeping, groceries, and I think one of the most awesome things that postpartum doulas do, most of them do is overnight visits. So families can get that rest without worrying about taking care of that newborn.

05:37                                Nicole: Okay. So is it common that usually be just a birth doula or, and just a postpartum doula or does it go across or does it vary?

05:46                                Keisha: Uh, it varies. Some people are just birth doulas, some people do postpartums and some do both. It really, it depends.

05:52                                Nicole: Okay. Okay. Okay. So what kind of training does someone have to go through to become a doula?

05:59                                Keisha: So two of the most common ways to train to be a doula or traditional classroom settings are workshops where you go to a location and it's like a three day immersive training or there are online courses that you can take too.

06:17                                Nicole: Okay. Now do you have to have training in order to be a doula or can you just kind of say that you're a doula?

06:26                                Keisha: You can, you can kinda just say your doula. Because basically it really is just a person that's going to support you. It is nice to have a doula that has some type of training and or certification just so that you know that the are very well versed in that support that they're giving you.

06:43                                Nicole: Okay, got it. Now if it does the training involve like a requirement for any hands on type of work.

06:52                                Keisha: So if you want to specialize in like acupressure or spin babies, that's a little bit more hands on and you'll need extra additional training beyond your doula training. But other than that, it doesn't, we do go over like in the classroom settings, labor positions and some of the main points to help with like counter pressure and things of that sort.

07:17                                Nicole: Okay. Okay. Okay. So why should a woman have a doula? I definitely have thoughts about this already. I'm definitely very supportive of doulas. But let's hear your take on why a woman should have a doula.

07:31                                Keisha: Everyone deserves to be supported in, throughout this journey that they're going on. And sometimes even if you have like a midwife and a very supportive like nursing staff or Ob, there are times where they're not in the room and they're not available to give you, the immediate questions that you have. So it's great to have someone that's going to be there with you that's not employed by the hospital, that's not pushing their own agenda, supporting you throughout your labor and delivery.

08:00                                Nicole: Support is crucial. And actually I will add that research studies have shown that having the type of support that a doula provides can increase your chances for a vaginal delivery. It can decrease your need for pain medicine, decrease your use of an epidural if that's something you're interested in. So there is research behind having a support person, like a doula in your labor for sure. Yeah. So now I've decided, okay, I think I want to have a doula. Well, not me personally. I ain't having no more kids but I'm a two and through kind of girl. But where can women go if they have decided that they want a doula, where can they go to look for a doula?

08:47                                Keisha: The like most universal place to find a doula, no matter where you are in the world is www.doulamatch.net.

08:54                                Nicole: So that's a website, correct?

08:56                                Keisha: Yeah, it's a website, and you can put in your zip code and your due date and it should automatically populate tons of doulas that are available for your time, that you plan on going into labor. If you don't have www.doulamatch.net or internet or whatever, then you can always ask your providers. They should have lists of doulas or a midwife. Just ask around. We're around.

09:23                                Nicole: Yeah, I've looked on www.doulamatch.net before and it's a pretty straight forward website and I'll link to that in the show notes for anybody who was interested in that resource, you may get like plus or minus about some providers, whether or not they do or don't know doulas, but you can ask the hospital, for sure. Now, once you've found some options, you've found a few people that you want to interview. What are three questions? At least three questions and you can say more if you want to, but what are at least three questions a woman should ask before she hires a doula?

09:56                                Keisha: I believe the most important question is asking the doula about their birth philosophy. You basically want a doula that kind of aligns with the birth that you are planning and envisioning in your head. So that's really important. You would also want to ask the doula what their backup schedule looks like. Especially during this time of year, it's kind of cold and flu season and you don't want your doula showing up to your birth with sniffles.

10:21                                Keisha: So you want to make sure that they have a solid backup and then lastly, I would think, think of something like really personal. And again, your doula is going to be somebody who is going to be there with you for a long period of time. So you want to have that connection. Even if it's like, what's your favorite TV show? Or like what's your favorite color? Something really personal. So that way you know that you have that connection with your doula.

10:51                                Nicole: So just an idea just to kind of feel like you know this person and you can feel comfortable with this person during a really important time?

10:59                                Keisha: Definitely.

10:59                                Nicole: Yeah, that makes perfect sense. Now once you have decided on a doula, like what can a woman expect in terms of the services?

11:08                                Keisha: It kind of varies, but mostly you want to use your doula as a sounding board in your pregnancy. I say the earlier you hire a doula the better. So that way after every appointment you're able to chat with her about things that you didn't quite understand in your appointment or that you want to elaborate a little bit more on.

11:27                                Nicole: Oh, I haven't thought about that. So you can like any point in time during your pregnancy. I mean, is there a too early time or is there...

11:34                                Keisha: Oh no.

11:35                                Nicole: I've always thought about it like right before, you know, closer to delivery kind of thing. This is good information. Yeah.

11:42                                Keisha: The earlier the better. You definitely want someone who is going to be there throughout the whole journey with you and knows all of the concerns that you had even in the beginning because some of those things might up later on in your pregnancy. So I've been hired like with women who just found out they were pregnant and then I've also been hired with women who have been walking through the door like, yeah. Like, in labor.

12:12                                Keisha: Women who are like on the fence and then they are like, okay, I need to hire a doula. I'm in labor right now. Wow. It varies, but the earlier the better. So that way you have someone and you're building that rapport throughout your entire pregnancy.

12:30                                Nicole: Yeah. I was here to say, I guess that that helps to kind of build the connection.

12:34                                Keisha: Oh yeah.

12:35                                Nicole: Do you ever worry though about getting, like, are, I don't want to put you in a bad spot, but are people like texting you all the time or constantly or do you just put limits on that?

12:44                                Keisha: Yeah. So, what I do personally, I tell all of my families that my witching hour is like at night after I put my kids to bed. So like early pregnancy I will address nonemergency related things like in the middle of the night and for the next day. But I take phone calls whenever and then, at 38 weeks, my phone, goes on and then it's always on. So 24 hours a day, whatever you need, just let me know. Okay.

13:14                                Nicole: Okay. Okay. Okay. So do you just have like a separate phone kind of thing? I would imagine

13:20                                Keisha: Just my regular phone.

13:23                                Nicole: Okay, okay. When you said I turned my phone on, I've envisioned in my head, like the secret phone.

13:32                                Keisha: No.

13:34                                Nicole: Now how much can women roughly expect to spend on a doula?

13:41                                Keisha: It depends on like where you are and the cost of living for where you are in the world. It can range anywhere from $500 to like 1200, $1,500. It really depends on where you live and experience level.

13:55                                Nicole: Yeah. Okay. Okay. Okay. All right. So that's a good range. Now, one of the things that women may be concerned about is they're going to have their partner with them during labor. And want support from their partner. So how does the doula work with the woman's partner during Labor?

14:13                                Keisha: I feel like doulas are the best for partners in that way. We take all of the pressure off of them. They don't have to remember anything because we're there telling them, say this to her, rub her back this way, you know? So the woman doesn't see us in the background telling her partner to do all these things. What she sees is her partner there because that's really all that you're worried about. You know, just the two of you and those connections that you have. So we're great for giving out suggestions, giving out tips and if they need a break and it's been a really long birth and you just need a break to have a sandwich or take a drink or take a phone call, you don't have to worry about someone not being there to support the birthing person. The doula's there and you can take that break.

14:55                                Nicole: That makes a lot of sense. For sure. Cause some labors can be long, for sure. They can be. So, do you ever, have you ever heard of stories where doulas kind of don't work with the partner so well or interfere with the partner or anything like that?

15:12                                Keisha: Yeah, you hear stories like that, but that's not the way that it should be. The doula should be the duola for the whole family, not just the laboring person.

15:19                                Nicole: Got it. That makes perfect sense. Love that. Love that. Okay. So what is the biggest misconception that you see women have about doulas? I know a common misconception I see is that sometimes women think doulas have medical training.

15:34                                Keisha: Yeah. We don't give out any medical advice or anything like that. But for me, I guess the biggest misconception is that you don't need a doula. And I think I feel very strongly in that everyone deserves a doula and everyone needs one. That continuous support is very important during labor and delivery. And I really strongly believe that everyone deserves a doula.

15:58                                Nicole: Yeah, I can, I can see that for sure. Like I said, even just from the, I mean I have a background in research so I'm always into research, but just from the way that, obstetrics is practiced and I don't want to say I'm part of the problem because I'm not the problem, but I'm a hospitalist so I walk into a woman's room and I've never met her before.

16:21                                Keisha: Right.

16:21                                Nicole: So I am able to quickly establish that rapport, but there is something to be said for having someone there who you know and who's with you the whole time because the Dr. may change and maybe the doctor who's on call. The nurse may change with a different shift, but your doula will be there. I've seen it. They are there the entire time of your labor and that makes a difference.

16:47                                Keisha: Yeah. We have like, we don't get tired.

16:54                                Nicole: All right. Now you have been a doula for eight going on nine years now. Is that right?

16:59                                Keisha: Yeah. Yeah.

17:00                                Nicole: Okay. What's your favorite part about your work?

17:03                                Keisha: I just love being there to support families and not have to take the baby home. So I get like all of it. I'm able to give you all of the information. I'm able to help you formulate questions to ask. I'm there when everything may not go according to plan. But that satisfaction that you have after your birth because you were so informed with all of your options and choices, and just seeing that and seeing families and then leaving like, hey that's your baby, I can't do all this for you. It's not mine.

17:39                                Nicole: That is funny. I kind of have the same sort of thing where I feel like I get to be a part of this special moment and every now and again I get a bit of a like, Ooh, maybe I want to have another baby. But no, it ain't happening now. How many births do you attend roughly like in a month?

18:00                                Keisha: So I do like two to four. Some people do more. Some people do less and it really depends on, I guess your doula's backup and what they're comfortable with. I feel for me, two to four is something that I'm really comfortable with that I know that I can be there to attend all of my births.

18:16                                Nicole: Okay. Okay. All right. Now, one thing, this next question I like and I feel like I'm about to get some like juicy intel or something, but you have this unique vantage point where you get to see lots of different doctors and lots of different hospitals. Like I don't know how my colleagues deliver babies. Like I'm not in the room when other doctors deliver and I don't go to other hospitals and you know, unless I'm working there. So what are some of the things that you've noticed that are different? And be honest. You know, the differences, that women might want to look out for between doctors and hospitals.

18:54                                Keisha: I used to think that all doctors are the same, that all hospitals are the same.

18:59                                Nicole: That ain't the truth.

19:02                                Keisha: And I think that's one of the things that I've learned is how to navigate those settings, those hospitals settings, doctors and how they practice. So I'm able to give the families a little bit more insight on the things that I've seen their providers do or at the hospital or just resources that those places have. And if they're telling me that they want, let's say for example a low intervention birth and with the birth tub and they're at a place or they're with a provider that doesn't already offer those things, I can say, okay, you might want to look at these other places or these other providers. And I can say that with confidence.

19:43                                Nicole: And that's a good thing. Going back to like getting a doula early in your pregnancy is that, and the question you asked about the birth philosophy, you can actually help women kind of see like, oh, you might want to stay away from this doctor or no, this doctor is really, really great. So women have an opportunity to find someone who really works for them in their pregnancy.

20:07                                Keisha: Definitely. I always tell families that I work with that they have a choice and you can always change your mind later or earlier or anywhere in the middle.

20:19                                Nicole: Yes, absolutely. Absolutely. The thing, I will say that it's easier to change in the beginning.

20:27                                Keisha: Yeah.

20:29                                Nicole: All right. Now the final question I have related to doulas before I ask a couple of like personal questions is you talked about the cost of having a doula and unfortunately it's not, I mean the reality is not all women can afford a doula. So what if a woman can't afford a doula. What are some options that she may have to do her best to get that support?

20:53                                Keisha: You can put it on your registry or write it on, I guess your baby shower invitation. Let your family and friends know that this is something that you really want and hopefully they can donate towards the costs towards a doula. You know, crowd funding sites like go fund me are really good about getting funds for doulas. And like I said, the price range, it really varies. So you'll find doulas that are lower cost or they'll take lower cost births or they'll do free births. So it really is all over the place. Just reach out and anyone that you reach out to should be able to give you information for a doula in the price range that you're looking for.

21:35                                Nicole: So I think that's a great point aboutnputting it on your shower registry because like you get, and don't get me wrong, clothes and whatnot are fun, but you end up with like 45 onesies. This stuff that is really useful, paying for a doula would be useful either during pregnancy and postpartum ideally. You know, food, come in to clean up. Those are the things that we need to start focusing on. I'm on a tangent now, to actually help women. Especially for your first baby, you do get like, I don't want to say caught up, but of course you're like excited about the clothes, you know make sure you have the diaper bag and all that kind of stuff. But let me tell you, it is the doula, the key things, some support is what will really matter. So definitely think about putting it on your registry to get some help paying for a doula. What are your thoughts on having a student doula at your birth?

22:40                                Keisha: I think that's great because we all have to learn somewhere. I think that, it's a really good opportunity for doulas to learn more and for families to help other doulas out cause it's a community effort.

22:54                                Nicole: Okay. Awesome. Awesome. Well thank you so much. That was really great information and I know that the listeners will find it very helpful.

23:02                                Keisha: Awesome.

23:03                                Nicole: Yeah. Now what I want to do is finish by asking just a couple of more kind of personal questions. I like the listeners to learn a little more about the actual person that they are hearing from. So, let's start with, I know you have a particular interest in raising awareness about the issues black women face during pregnancy and childbirth. What would you like to share about that and your work surrounding that issue?

23:30                                Keisha: I think what a lot of people don't know is that people of color are at a higher risk for maternal mortality and morbidity, especially black women. I think the number stands as of right now, that black women are still three to four more times likely to die in childbirth than our white counterparts. And a lot of that is due to racism in our medical system and not listening to black women and black families. So, it's really important for us to have someone there to advocate our wishes for us and give us our options in our choices and amplify our voices so that we can be heard.

24:09                                Nicole: Yeah, absolutely. And before people start like, you know, plucking their teeth that the word racism clarify that it's kind of different. We're not talking about like, and this is an issue that I'm passionate about as well. We're not talking about like KKK who would wear and kind of thing. A lot of it is just what's called implicit bias, where people don't even realize that they're treating someone differently based on race. And maybe other factors. There's socioeconomic status. So this is a real issue and a real concern. It's a podcast for a whole other episode. But yes, it's, there are some issues that we have to deal with in our system and, and black women, like I as the college educated black woman have risks that are higher than a woman who, a white woman who hasn't completed high school just by virtue of being black. And there's something wrong with that.

25:07                                Keisha: Yes. Yeah. Yeah.

25:09                                Nicole: So, okay. Now, next thing. I'm curious, is there anything from your own personal experience with pregnancy and birth that influences your current work? Like for me, I'm definitely influenced by the fact that I had a preemie baby, a Nicu baby. Is there anything from your own personal experience that influences your work?

25:30                                Keisha: I think everything from my personal experience. Like, my whole life story, my life story surrounding pregnancy and birth is the reason why I do this work. I was young when I had my oldest daughter, and I wasn't married and I didn't realize that those things were a factor until after I gave birth. So, I just wasn't receiving the type of care that I thought I deserved at the time. I wasn't given my options, I wasn't given my choices. And then at one point, I remember my Ob coming in and telling me that we have to have this baby by noon because I'm going on vacation. And I was like, um, I dunno how to do that.

26:17                                Nicole: Oh my gosh, that's awful.

26:20                                Keisha: Yeah. And then I started going to births after that with my family and my friends and seeing that they were receiving the same type of treatment and realizing that this is not the way that birth is supposed to happen. This is not how, you know, birthing people aren't sick.

26:39                                Nicole: Right, right, right, right. Oh my goodness. That's awful that someone would tell you that you have to have your baby by noon. Okay. Now last question I'll ask is, what is one piece of advice, like the most important piece of advice that you feel like you would give to expectant moms?

26:58                                Keisha: Um, like I said, you're not sick and you can do this. Birth is hard work, but with the right support, you can get it done no matter which way your birth decides to unfold.

27:11                                Nicole: That's a very good point. I love the you are not sick, like birth is pregnancy is not a disease. It's a normal and natural thing that happens. Yes. Sometimes things don't go exactly as you anticipate, but for the most part, women are gonna have a normal, happy, happy, healthy pregnancy. And that's how it should be approached. And to your second point that you can do it, man, women are strong. Let me tell you, we, Kesha and I get to see women are strong and you find strength from places that you didn't even know you had during birth. So yeah, I love that. Love that. Love that. All right, well thank you again for being here. I really appreciate you taking the time to talk to me.

27:57                                Keisha: Thanks so much for having me.

27:58                                Nicole: Yeah. Where can people find you if they're interested in your services as a doula? I know you're only in the Richmond, Virginia area, so my apologies to everyone who outside of the area, but for those who are listening in Richmond, where can people find you?

28:14                                Keisha: So we can also do like, phone doula support. So that's doula support over the phone.

28:22                                Nicole: Well look at that, I didn't know that! So people call up Keisha if you need some help!

28:26                                Keisha: Yeah, if you're in the hospital setting and you just have questions and stuff so I can do that. But you can find me at www.doulamatch.net, my name is Keisha Graham on there or I work at a doula collective in the Richmond area called My Birth. And their website is www.mybirthrva.com.

28:48                                Nicole: All right. And I will link to all that information in the show notes. So if you're interested in that, you can just find the links in the show notes where you can reach out to Keisha okay. So that is it. Thank you again Keisha. I really appreciate it.

29:02                                Keisha: Yay. Thanks for having me.

29:03                                Nicole: Okay. All right, I'll talk to you later. All right, so wasn't that an awesome interview? I learned a ton that I didn't know it. I know that you did too. Now after each time that I have a guest on the podcast, whether it's a birth story or an expert interview, I give something called Nicole's notes. And that's just my top three or four takeaways from the interview. So here we go.

29:26                                Nicole: First thing I took away is that everyone deserves support during labor. Amen. Amen. And Amen. Every woman should have support during labor. Now I know that financially you may not be able to afford a doula. That's just the reality of things. So maybe you have your partner there, maybe you have a trusted friend there, but every woman deserves support during labor, so get that support for yourself during labor.

29:55                                Nicole: Number two, you can get a doula at anytime during pregnancy. I was kind of surprised to hear this one, for some reason I had in my mind that you didn't link up with the doula until the end of pregnancy, but no, you can find a doula early and kind of build that relationship during your pregnancy and have her there as a resource for you.

30:12                                Nicole: Number three, and this is also a good one, expand what you ask for on your baby registry. Yes, of course, you know you're going to ask for clothes and wipes and that kind of thing, but you tend to get tons of that stuff and it's not useful anymore after about three months or so. So for sure. Consider asking for support for a birth doula or a postpartum doula. I promise you, you will not regret that decision.

30:40                                Nicole: And then the last thing, do not be afraid to change providers. As Keisha said, you have choices. Do not be afraid to exercise those choices at any point during your pregnancy. I talked about this more in episode three of the podcast on how to choose the right Ob doctor. So definitely go back and listen to that episode if you want to know that information.

31:05                                Nicole: All right, so what about you? What were your big takeaways from this interview today? I'd love to hear your thoughts in the podcast community Facebook group. That's the All About Pregnancy and Birth podcast community on Facebook. I'll link that up in the show notes. And be sure to subscribe to the podcast in iTunes or wherever you listen to podcasts. And if you feel so inclined, I'd really appreciate a review. It helps other women find the show and I can give you a shout out on a future episode.

31:32                                Nicole: Next week on the podcast, I'm talking about a very serious topic and that is maternal mortality. I'm going to cover information that you need to know to help you stay safe and alive during your pregnancy and the postpartum period. This is an episode that you will not want to miss. Until then, I wish you a healthy and happy pregnancy and birth.

31:59                                Today's episode is brought to you by Women's Wellness Coaching by Doctor Nicole Calloway Rankins. Head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan as well as my comprehensive online childbirth education class, The Birth Preparation Course with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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