Doula Helps Pregnant Women Through Home Births Amid Pandemic

“If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right,” said Ina May Gaskin, considered the mother of modern midwifery.

Doula Melissa Mapes Miller takes those words to heart with her business, Living Wild on Long Island.

I first met Mapes Miller five years ago at Share the Harvest Farm on Long Lane in East Hampton where she grew produce for the Springs Food Pantry and other underserved members of the community. Now, she is serving women in their most precious times, teaching them to reclaim the birth process by reducing the fear instilled in our culture over generations.

The birth of her first child, Juniper, born in October 2016, was an amazing but eye-opening experience. The mother-to-be did not anticipate the intricacies attached to planning a home birth.

“I had a birth pool but the baby was breached at some point,” she told me on a recent phone call from her home in Riverhead.

Mapes Miller and her husband, Army veteran Tucker Miller, both grew up in East Hampton and bought their dream home in 2018, an 1800s house with a glass greenhouse attached to the kitchen. Even dreamier, Miller’s mother lives with the family, lending a helping hand with the children.

“Childcare is impossible,” said Mapes Miller, who gave birth to her second child, Thoreau, or Thor for short, on a strange, sunny day a year and a half ago.

“I had him in the greenhouse,” she said. “A tornado touched down in Calverton and we moved inside.”

Fitting for a child named after the God of Thunder.

As a certified doula, Mapes Miller’s job is to comfort mothers in the way of emotional and physical support, before, during and after birth. Mapes Miller must be ready to go, even at 2 in the morning.

“I could be gone 36 hours straight,” she said. “I’m not going to leave a client.”

Coffee breaks and naps may be necessary between contractions.

When women give birth at home, there is no clock running as it would be in a hospital. They are free to let their bodies do the work, without medication or intervention. Of course, if the need arises for a Cesarean, or C-section, they are taken to the hospital, as Mapes Miller was with her first-born.

“I’m so grateful we live in a time where we have accessibility to that care,” she said.

During the pandemic, more and more women are opting for home births for obvious reasons. They don’t want to risk COVID-19, and they want their families around them.

Women may choose to have a midwife help them give birth in the hospital, which is a different care model than working with an obstetrician and gynecologist, or OB/GYN.

Mapes Miller stresses that midwifery is a medical profession. A doula is hired by the family and works solely for the family. A doula does not assist the midwife and is not involved in the actual birth.

“I do not provide medical services,” she said. “A doula is basically someone who holds your hand and walks you to the gates of birth. I’m there to guide them and help them in a comforting way.”

I can hear Mapes Miller cringe, when I mention the “P” word.

“We don’t like to use the word ‘pain,’” she said. “When we hear ‘pain’ we tense up and that is more painful. Staying relaxed makes the process more manageable.”

In her book, “P” is for power. Birthing is the power of nature, just like when lightning strikes, or the ocean’s giant waves roar. In the movies, a woman giving birth lays on her back the entire time, pretty much the worst position possible. At home, she has time to allow her unborn child to prepare for a more natural entrance into the world, using gravity as a friend, not an enemy.

A doula might recommend different positions such as standing, squatting, or going down on all fours. She may offer massages, ice packs, hydration, visualizations, a nap, or a shower, in order to meet the needs of the mother and help the baby move into the right position for a smooth delivery.

Normally, the cervix is not open. Each contraction opens the cervix until it gets to be 10 centimeters or big enough for the baby’s head.

“The body is working really hard to open the cervix all the way,” she said.

Once the baby makes it through the birth canal, the mother can catch the baby by herself. A partner or even a sibling can be the first to hold the newest member of the family, not a stranger.

As we’re talking, Mapes Miller gets a text from a client whose water broke, and I panic for her, but she remains unperturbed. It’s another Hollywood myth that when a woman’s water breaks, she is immediately rushed to the hospital.

“Everyone is totally different,” she said.

In that same vein, a routine doctor’s appointment can be traumatic for some women if the doctor doesn’t ask before touching her body.

“The birth world is a very intimate area and if you’re not comfortable with what’s being done with your body, it can be traumatic, similar to sexual trauma,” said Mapes Miller who encourages her clients to talk about their fears and triggers. “We’re on the most vulnerable, intimate journey together. Someone may poop on the table. I will never judge.”

The birth experience has the potential to heal generational trauma. If a woman was born by C-section, she might feel like she is slated for the same fate as her mother. If her mother is present at her daughter’s natural home birth, she has the ability to reclaim that power instead of passing on the trauma.

“I’ve seen it a lot,” Mapes Miller said. The negative stories passed down, such as “My body wasn’t able to do it. I was not going fast enough,” can bring doubts that reach far beyond a hospital bed.

Aside from the possible mental anguish of a rushed delivery, there may be health consequences for the baby. “We don’t know,” Mapes Miller said. “I was born as a C-section, did that change my flora? Now they do seeding where they take fluid from the vaginal canal and wipe it onto the baby.”

“We know so much in the medical world yet somehow women’s reproductive health is decades behind,” she said. “How much more is there? We don’t know because we haven’t taken time to learn.”

“Our patriarchal society tries to keep women as a lesser,” she said. “In my opinion it’s because they want to control us.”

It’s a matter of deprogramming and reprogramming our minds. A woman can feel empowered by simply learning about her body and questioning the medical system instead of just saying “yes.”

A mother may opt for a delayed cord clamping, where all blood flows out of the cord into the baby. “Cutting too soon leaves the baby without as much blood,” she said. The placenta is actually an organ that mothers grow and is what gives the baby all its nutrients.

Some clients keep the placenta and bury it under a tree. Some people consume it. “There’s not much science to support any benefits, because no one is studying it, but it may help with milk production, postpartum depression and postpartum bleeding,” she said. “Most mammals in the wild, eat it raw.”

The more modern way to consume placenta is to dry it like you would an herb, encapsulate it and take it as a pill, not sitting down with a fork and knife. Mapes Miller keeps the placenta on ice and processes it for her clients.

She uses her love and knowledge of plants to enhance the experience, such as growing and utilizing stinging nettles and red raspberries for uterine health. She makes salves for stretch marks on the belly and flower baths to relieve soreness after birth.

Before birth, mothers may hold a ceremony consisting of a small intimate group of her closest friends and family. “We usually host the ceremony in the comfort of their own home,” Mapes Miller said. “It is custom to put items of the ancestors on the altar or any emotionally significant items, usually adorned with candles and flowers as well.”

Once in a while, a partner will balk at hiring a doula, but Mapes Miller is really there for both parents, especially in the case of nerves. A knowing wink to a partner when the mother announces she cannot take the intensity any more can be comforting in itself. The doula knows it’s go time.

“Bow down to your wife now,” she said. “It’s amazing what the body can do.”