Special Delivery for New Parents Seeking an Old World Touch

What’s an expectant mother to do when it feels as if there’s no one to turn to? Mother is off in Palm Desert recuperating from a face lift, Grandma’s on a cruise with her third husband, HMOs limit the time doctors spend talking with patients and the literature of childbirth is rife with propaganda? There should be someone a woman can hire, a wise, nurturing mother surrogate experienced in guiding a typically terrified woman through pregnancy and delivery.

There is. She’s called a doulah, a Greek word describing the traditional woman’s servant. As traditional in many cultures as midwives, doulahs, in their current Southern Californian incarnation, do not deliver babies. They provide physical and emotional support for pregnant women, especially during labor, and in some cases give postpartum care to mother and infant. They’re part of a burgeoning subculture that’s repackaging ancient childbirth practices in trendy new wrappings.

Harinam is a doulah who makes house calls. On a hot August morning, she’s sitting in the Silver Lake living room of Amy and Mo Morrison, who run a live-event production company and whose first child is due in a month. By the end of this initial consultation, the couple will decide whether to hire her. Mo, 48, has already agreed to be present at the birth and likes the idea of being part of a team effort. “I’m trying to stack the deck with as many people as I can,” he tells Harinam. “If there are three more of you to help, fine.”

The 51-year-old doulah appears quite capable of handling things herself. Her manner is gently authoritative. Wearing no makeup, flat sandals and a flowing yellow dress that bares her fleshy upper arms, she is the reassuring picture of an earth mother. Without getting all sloppy about it, she communicates that she would be honored to share one of life’s most ecstatic moments with this couple.

“When you go into labor without labor support,” Harinam explains, “it’s like going to an amusement park and taking the scary ride. Things are coming at you. Don’t worry. I can guide you through it.”

The name “Harinam” is Sikh, given when she became involved with the religious sect 25 years ago, and replaced a name she’d never liked as a girl in Atlantic City, N.J. Though she no longer covers her hair with a turban, she says her spiritual roots are still in the Northern-Indian religion. Although she’s never been certified as a nurse-midwife, she’s assisted at several hundred births and chooses to function as a labor coach at deliveries where a doctor is in charge.

The use of doulahs has grown steadily in the last five years, according to the Doulahs of North America, which certifies and trains them. The Utah-based group had 750 members in 1995, 3,300 this year, an increase that could be credited to attitudinal shifts, to fractured and scattered families and a strong economy that has given many couples the means to employ a personal labor coach.

The natural childbirth movement that arose in the 1960s was an outgrowth of the era’s emerging feminism and the politicization of health care. Women rejecting the influence of the male medical establishment advocated a return to old-fashioned birthing methods that substituted natural pain-dulling techniques for drugs.

Harinam asks the Morrisons how they’d like to have their baby.

“Quickly,” Amy answers, with a smile. “I’ll see how it goes without drugs, but I’m not completely opposed to them.”

The doulah explains that she can teach Amy, 38, how to pace herself through a long labor but that if she gets to the hospital and opts for pain relief from drugs, Harinam would neither question her decision nor pass judgment on it. After listening to the older woman talk warmly about her grandson and other children she’s helped into the world, Amy says, “With Harinam there, I’ll have someone who’s totally my advocate, whose only focus is looking out for me and my baby.”

Harinam explains that she’ll put the couple through at least two “dance rehearsals,” practice sessions that concentrate on relaxation, breathing and pushing techniques. “I call it the dance of life because it is--the baby’s moving, the mother’s moving, the father’s moving with the mother. They’re dancing,” she says.

Once labor begins, she’ll show up as soon as Amy summons her. Since she’s trained to measure how dilated a woman in labor has become, that knowledge can be used to keep Amy safely at home longer, where she’s likely to be more relaxed.

Perhaps it’s the way Harinam describes how she’ll bathe the baby at the hospital, in a deep tub she’ll bring along, that clinches the deal. “There are plenty of maternity nurses who are pretty fantastic,” she says. “But they have a lot of other things to do besides give one-on-one care to a family. One day a Mom and I were walking past the hospital nursery, and while the nurse’s intentions might have been wonderful, she could have been washing a pot instead of a baby.”

Some women don’t want a doulah because they fear their husbands might be elbowed out of their place at the birth. Her presence doesn’t preclude a father’s involvement, Harinam assures. “Even dads who see a few birth tapes in childbirth education classes and tell me, ‘Thank God you’ll be there,’ usually rise to the occasion. Fathers who choose a more passive role are the best, because any comfort they offer really comes from their hearts.”

Although Harinam has been too busy with deliveries lately to be available for postpartum care, she is a lactation specialist and promises she won’t leave Amy after the birth until everyone has agreed that nursing is going well. It’s easy to believe that she’s seen it all--babies who won’t nurse and those who won’t stop.

Predawn feeding crises and the arrival of a new life being the unpredictable events they are, Harinam, who lives in Venice, is always near her beeper, pager and cell phone, on call around the clock. Every other month, she teaches a class in new-baby care at the Golden Bridge, a Hollywood yoga studio. She assisted one birth in April, seven in May and one in June. To avoid scheduling conflicts, she normally works with no more than four expectant mothers a month.

“I had three births in a row in early July, plus some moms who needed help with lactation and after-care. I get calls in the middle of the night all the time. When a Mom’s in labor, I can stay up for 30 hours by taking 15-minute catnaps. There’s a normal, incredible, universal force that comes with birth, and sometimes I feel that supports me.”

At ease talking to a couple about childbirth, Harinam feels out of place in social situations with her peers. A regular participant in real scenes of heightened emotion, she finds small talk eludes her, and she doesn’t own a television. How could “ER” compete?

A Trend Toward Traditional Delivery

Childbirth is as vulnerable to changing trends as education or exercise. Take drugs; don’t take drugs. Have the father attend the birth; bar the delivery room door. Parents who would once buy a crib and stick it anywhere in the baby’s room where it wasn’t in a draft are now told to hire a baby feng shui expert who can determine a spiritually optimal furniture arrangement.

The case could be made that the road to doulahs starts at the feet of the ever-visible Madonna, a fervent yoga practitioner whose well-toned body got quickly and impressively back into shape after the birth of her daughter. It detours to Cindy Crawford, Reese Witherspoon and some other famous mothers who studied yoga and were pleased to show the world they could be both pregnant and sexy.

Inevitably, between stretches, women who followed the famous into yoga classes would hear someone on a neighboring mat extol the virtues of a good doulah.

As director of the Chapman Family Center in Santa Monica, an education and counseling facility, Judith Chapman teaches six childbirth classes a week. A few years ago, when she’d explain a doulah’s role, she was imparting new knowledge. “Today, almost all the couples in my classes are familiar with doulahs, and many of them have already interviewed several by the time they attend class,” she says.

The Chapman Center has a roster of 30 labor doulahs and 20 postpartum doulahs. The women charge from $150 to $1250, with most in the $600 to $800 range. Those who command higher fees usually have more extensive training, like Chapman, who’s a doulah, a certified nurse-midwife and a registered nurse.

Even stores and Web sites that cater to free-spending and fashionable expectant mothers have become doulah referral services. At Naissance, a maternity clothing store in Calabasas, women commune as much as shop. “They’re craving, along with chocolates, information and contact with other women going through the same things they are,” owner Jennifer Noonan says. She noticed that total strangers would sit in the store and talk, discussing doulahs with the sort of affection formerly reserved for beloved nannies.

In October, Noonan and partner Harriet Fleming will open a second shop on Melrose Avenue that she envisions as an “alternative Mommy center.” In addition to “Boys Tell Lies” maternity T-shirts and other Naissance designs, the new store will offer lesbian Lamaze classes, baby yoga sessions, bootie-knitting tutorials, birthing henna belly painting and swaddling demonstrations. In order to recommend doulahs, Noonan is collecting recommendations from customers.

The Doulahs of North America (https://www.dona.com) has a certification process requiring completion of a doulah training course, a written exam or essay and evaluations from doctors, midwives or nurses.

The prevalent medical opinion on doulahs is that they are a nice luxury. “Women have had babies for years without doulahs, and it works out fine,” says Dr. Robert Katz, an obstetrician who delivers at Cedars-Sinai Medical Center. “The doulahs I’ve met have been good because they’re able to give personal care that’s soothing, and they don’t have any medical involvement.”

Harinam knows she isn’t the leader of the birthing team. Often, she’s been hired by older, professionally successful mothers who are used to picking consultants to help them get a job done. She understands that to them, the doulah is simply a wise assistant, one who knows the steps to the dance of life.