The Unlikely Story of a Researcher-Gone-Doula: Darlin’ Baby Co. at Shanti Uganda

 

My trip to Uganda for DONA International’s 7-day doula training is one of several steps towards my goal of supporting women in childbirth. I boarded a plane in Washington D.C., traveled 20 hours to Entebbe, the capital city of Uganda, then rode in a vintage VW bus for three hours to the town of Kasana, Luweero, to train alongside 15 other students at Shanti Uganda Birth House.

 

But, why? At least five people asked me, and those just the day I called to let loved ones know I was traversing international waters to participate in a training that was also on offer about 20 minutes from my apartment. All I could say was that I wanted to learn about childbirth and I wanted to feel close to my sense of mission. Other ideas felt too clunky to articulate. Like how I suspected the journey would trump the instant gratification, how much I needed those long dusty travel hours to exhale and think.

 

The fact was that I had never envisioned myself giving birth. Never imagined what my birth plan would look like. Never flipped through pregnancy books, and certainly didn’t start the hope chest so many women begin when they imagine a child gracing their life. Instead, my work squarely focused on the postpartum period and very squarely focused on supporting the women and infants I have the honor of caring for in their first tender months at home.

 

The idea that I was unsure how to voice to my questioning friends was that I couldn’t manifest a vision of brown women birthing in complete safety, power, and autonomy. So I needed to travel to another continent and borrow someone else’s vision for a while.

 

Shanti Uganda showed me what childbirth could look like

 

Shanti Uganda is a non-profit organization with a vision: “a world where all women have access to a midwife and are respected, empowered and able to thrive throughout the birth process.” The organization provides Ugandan families with child and maternal health services from conception to the infant’s 1-year immunizations, all for the grand total of $2.65 USD. The menu of care includes:

 

• Midwife supported birth services and postpartum care
• Optional doula care during births
• Access to emergency transport for referrals
• Postpartum home visits from a Village Health Worker
• Breastfeeding support and education
• Well-baby checkups and infant immunizations up to 1 year
• Family planning education, counseling, and delivery
• Nutritional and gardening workshops
• Weekly prenatal yoga classes
• Acupuncture
  

 

Every time one of the staff mentioned Shanti’s hallmark statistic, I almost couldn’t comprehend what I was hearing: Shanti has never lost a mom in childbirth. None. Zero. My mind boggles at the idea.

 

The former research associate in me knows that outcomes like those at Shanti are inspiring in a time when researchers are grappling to explain why women of color are exponentially more likely to die while giving birth. Except, not at Shanti.

 

But how? It all comes down to the individuals who work under their shared vision.

 

 

I met Kato, a groundskeeper, with a passion for maternal nutrition, neighbors, and children, as well as brickmakers who carried water, built the birth center’s walls, and welcomed us along the road when we walked to class every day.

 

One of our lessons was with Flora, a doula who also provides prenatal yoga classes and acupuncture for Shanti mothers. She welcomed us into her home where she spent three hours teaching on the importance of skilled doulas who have undergone approved training and certification. More than that, though, she fed us, introduced us to her family, and told the story of how entrepreneurship gave her a sense of purpose in her community. She knows well that her work saves lives, but her purpose has been elevated beyond just making sure childbirth is safe: at Shanti, birthing women are thriving.

 

One thing she said that I loved was that having families pay for their services gives them the power to hold their providers accountable. I enjoyed hearing about the commitment that Shanti staff make to their integrity as professionals and their relationship with the community.

 

It can be tempting to want to see ourselves as benefactors or heroes. My week with Shanti was a good reminder of how important it is to be egoless in order to truly connect in a way that prioritizes relationships. When we let our own need for validation fall away then we can truly deliver the highest standard of evidence-based care.

 

I found a vision of myself:

 

Our teacher for the week was Emily Shier, a DONA International Doula Trainer. She was supported by Sarah Longacre, founder of Blooma prenatal yoga studio, mama, doula, yoga teacher, and lover of all things birth! Emily and Sarah were like doula spirit guides- they were so inspiring to study with. I know that many of us walked away transformed by these incredible women who exude the ethos of a doula, or highest female servant.

 

One exercise we worked on was to describe birth using our right brains. I found myself drawing a large net from the fable, Indra’s Net. In the fable the deity Indra hangs a net which is infinite and stretches in every direction. At every node hangs a single glittering jewel and, since the net is infinite, the jewels go on forever. If we select one jewel to look at, we discover in its surface all the other jewels are reflected. Not only that, but every jewel reflected in this one is also reflecting in all the other jewels. So the process of reflection goes on infinitely.

 

I imagined all the individuals participating in Shanti’s vision at any moment, and that was how, finally, I found a vision of myself that is hardly apparent here in the United States. It was a vision of holistic, skilled, evidence-based maternal and child healthcare. It was a vision of women leaders and entrepreneurs galvanizing the birth community to ensure every woman has access to a safe, empowered childbirth, with women who look like me sitting at the center of it. I found myself reflected in Shanti’s mission.

 

The struggle I have now:

 

My thoughts about my time in Uganda have come slowly. I have worried over my sentences and images, praying that I put it all down correctly while honoring my experience there. In fact, I have been so anxious about how to articulate my journey that I’ve even struggled to feel entitled to my own story. I’ve worried myself sleepless.

 

One of the reasons I have struggled to talk about my time in Uganda after returning home is the perception so many people have of suffering, poverty, and voluntourism in continental Africa. For a long time, we were fed images of broken people being empowered by Western, white missionaries. However, I can honestly say I did not witness any suffering, and I was inspired to learn of Shanti’s commitment to never exploit children and families in order to gain attention. We talked a lot about consent. An important marker of an ethical doula is to step aside and allow mothers to control their own narrative, a commitment that doesn’t end when we go out into the world. Even something as simple as asking permission to take a child’s photo puts the parent in a position of telling her own story- or not.

 

I want people to read how humbled and benefited I was by my time with an amazing group of women leaders and entrepreneurs. I want the enduring message to be the absolute graciousness I was given to step into a place where my worldview is not effective. Basically, my whole paradigm was illuminated.

 

So here is what I can tell you without a doubt:

 

As I flew 20 hours across the Atlantic, I struggled with my own imagination. After all, brown women are dying in childbirth at an alarming rate in every corner of the world, including in the resource-rich United States. Every night of the trip I lay in bed and began piecing together a new vision that I could have a safe, respectful childbirth, if that was what I wanted, and I would not be alone.

 

By the time I boarded my flight home, my mind was filled with the faces of midwives and doulas; boda drivers and cooks; brickmakers and board members; children and groundskeepers; nightguards and lab techs; all reflecting a shared mission and amplifying the vision of women thriving in childbirth.