Mothering the mothers

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Shanie Emmer, who lives in New York City, flew across the country to Berkeley with her husband so she could have her mother close by when she gave birth.

When Miriam Ferris arrived at Berkeley’s Alta Bates Hospital as her 22-year-old daughter was in the throes of labor, she was simply doing what any Orthodox mother does — providing moral support.

But another key person was by Emmer’s side as well: Wendy Kenin, a doula.

Although couples, both religious and not, employ the services of doulas at childbirth, the trend is especially evident in the Bay Area Orthodox community. Since many couples live far away from the traditional support of relatives, doulas, or birthing assistants, are becoming the modern replacement.

Historically, the doula (which comes from the Greek word “servant”) functioned as the head female servant in a household, assisting the woman of the house with just about everything: getting dressed in the morning, completing her duties and, most importantly, attending and helping with childbirth.

Modern doulas — who have become increasingly popular in this country in recent years — are trained birth professionals who work with couples to achieve a positive experience for the mother, father and baby. Doulas do not take the place of the partner, midwife or doctor; instead, they help facilitate a smooth delivery by working with both the family and medical staff as an advocate for the family.

“I’m very close to my mother, but I wanted someone there who wasn’t related,” Emmer, chuckling, explains during a recent telephone interview from Brooklyn while her infant son sleeps. “Sometimes when it’s your mother, it can be very emotional. My mother didn’t want to see me in pain, and it was hard.

“I really encourage people to have a doula. It’s a real emotional support, and it’s great to have someone who knows what she’s doing, to help you work through the pain.”

There is a strong religious imperative as well. Under Jewish law, a woman in labor and her husband should not have any physical contact. Touching would defy laws of taharat hamishpachah (family purity) because women bleed when they give birth.

“Once you start bleeding, the husband can’t be there physically,” explains Miriam Ferris, the wife of Berkeley’s Chabad House Rabbi Yehuda Ferris and the mother of 10.

“A husband is not supposed to look at the birthing area. So, female support does come in handy.”

It is not unusual for Kenin, who is Orthodox, to work with religious families such as Emmer’s.

“I happen to be involved in a special pocket of the Orthodox Jewish community where just about all the moms have a doula and/or midwife for their labor and delivery,” says the mother of two children.

Kenin, of Berkeley, and Alison Jacobson, of Vallejo, are among the few Orthodox doulas in the Bay Area.

Although there are no available numbers on exactly how many local Orthodox women have used doulas, “there is an obvious market among observant Jewish women,” says Kenin.

As to the needs of conventional Orthodox versus Chassidic Jews, when it comes to using a doula, Jacobson says, “Ultimately, it’s one Torah and one halachah … Yes, Chassidic women might dress differently and have a different philosophy … However, the laws of niddah [women bleeding] are the same.”

In a demographic that boasts an above-average birthrate — and in which many women of childbearing age have babies nearly every year or two — more and more Orthodox women are hiring doulas.

Hinda Langer, the wife of Rabbi Yosef Langer at Chabad of S.F., estimates that anywhere from 25 to 50 percent of Orthodox women in her community have enlisted the help of doulas, especially for their first births.

“One of the reasons you might find that Orthodox women have a higher percentage of using doulas is that we have the expectation that we’re going to have a lot of kids,” Langer says.

Jacobson would agree with that: “Having six to 10 children is not unusual,” she says.

Also, she says, “Orthodox women need doulas even more than secular women because when the couple goes into the labor and delivery room, depending on how their rabbi rules, there’s a point when they don’t touch. Due to these restrictions, the woman really needs another woman there.”

And a doula can also ensure that certain beliefs — such as making sure that her privacy is maintained — are made known to the attending doctor or nurse and are upheld in the delivery room, says Jacobson.

There is some debate about the Jewish family purity law, however. Orthodox Rabbi

Yair Silverman of Berkeley’s Congregation Beth Israel points out that “there’s a prohibition to have sexual intimacy once there’s the onset of labor, which is wise, for obvious reasons.”

But some couples believe that because childbirth is an event in which “the woman is considered in need of medical attention,” touching is not prohibited.

Rachel Goldberg, who gave birth to two children in Berkeley and has since relocated to Richmond, Va., falls in the latter camp.

“For me, it wasn’t an issue at all,” says Goldberg, a former member of Berkeley Congregation Beth Israel. She was inspired to find a doula after reading Anita Diamant’s novel “The Red Tent.”

“My husband was born and raised in the Orthodox community, but he was holding my hand the whole time and rubbing my stomach. He held my leg, cut the cord, held the baby first.

“When a woman is giving birth, her life is in danger, and when a woman’s life is in danger, you’re supposed to comfort her and support her during this trauma.”

Both Kenin and Jacobson believe childbirth is a serious-enough situation that they would assist with childbirth on the Sabbath. (On the other hand, notes Jacobson, some Orthodox women choose a non-Orthodox doula to avoid conflicting the religious doula.)

Goldberg, who was pregnant with her third child at the time of her j. interview (and has since borne a daughter), was unable to find a doula in Virginia, so her husband filled in.

Even Orthodox men who have vowed not to touch their wives can be there for them in other ways, says Eva Roodman, a doula in Stanford. “They’re able to use other resources in a very powerful way, like using their voices and saying, ‘I love you’ and ‘I’m here.'”

But when that’s not enough, having a doula can relieve frustration for both partners.

Kenin agrees. “In many cases, the men also need to be supported through the process, and a doula is there to serve him as well.”

In fact, when Kenin went into labor with her second child in June, a doula helped her and her husband.

As she felt her first contractions coming on, she was driving to the airport to pick up her doula, a longtime friend who was flying in from Portland, Ore.

In the meantime, her husband, Aaron, was on his way to Walnut Creek to pick up a breast pump he’d found on Craigslist.

By that evening, Kenin was in full labor. “Because I’m a doula, I recognized my groaning and knew that this was pre-pushing time. I woke up my doula and husband. I said, ‘We better go now or we’re not going to get there.'”

“There” was all the way from Berkeley to the Women’s Health and Birth Center in Santa Rosa.

“At 3 a.m., we were at the toll plaza at the Richmond-San Rafael Bridge, and I could feel the head descending into the birth canal,” Kenin says. They pulled the car over so Kenin’s doula could examine her in the back seat.

That’s when her water broke and it was time to keep rolling. “My husband kept on driving and my doula was coaching me in the back seat.”

Although the Kenins had strictly followed halachic purity laws before and during their marriage, he jumped into action when they arrived at the birth center.

“My husband carried me into the room. And then both of them pushed certain pressure points on me. My husband had my left side and my doula had my right side.”

She pushed, and “he caught our baby, Millea Malka.”

For many, the doula’s role as advocate can be vital.

Miriam Ferris, for example, is a strong believer in all-natural childbirth “without any interventions.”

So on Sept. 18 at Alta Bates Hospital, after Emmer had been pushing and pushing without any success, Ferris spoke up when the midwife mentioned that a vacuum might be needed to extract the newborn.

Ferris says she wanted her eldest daughter to experience the ideal way to bring a child into this world — “childbirth without fear.”

In the end, they didn’t use a vacuum. In fact, “I delivered the baby,” Ferris says proudly.

According to Kenin, “Across the board today, American women are becoming conscious that the cesarean rates in our country far exceeds that of other countries, and they are empowering themselves to not fall subject to these statistics. Bringing a doula to their birth greatly increases their chances of a faster and more natural labor and delivery.”

Moreover, having a doula present at childbirth greatly decreases a woman’s risk of suffering postpartum depression, claims Roodman, who is also a clinical social worker. She decided to become a doula four years ago, after seeing women who’d become depressed after traumatic birth experiences.

About one in five new mothers develops depression and/or anxiety after childbirth, estimates Jacki Silber, a marriage and family therapist from Redwood City who specializes in pregnant and postpartum issues.

“There is a relationship between having a doula and a lower incidence of postpartum depression,” asserts Silber, who is Jewish and has worked with Jewish clients. “Women feel more relaxed and less frightened” when a doula is present at birth. This is also true during postpartum meetings between new mother and doula — whose “job it is to be present for you,” Silber says. “Most medical professionals now really don’t have the time to do this.”

Bay Area families find doulas by word of mouth or through hospitals or birth practitioners. Doulas of North America, one of the oldest, largest and most respected doula associations in the world, lists over 300 certified doulas in California (though doulas don’t necessarily have to be certified to work). Its Web site is www.dona.org.

Locally, doulas charge anywhere from $600 to $1,200 per birth. Postpartum doulas charge between $20 to 30 an hour to help out at home after the baby arrives. (For Orthodox women in particular, Jewish doulas can be especially helpful with certain practices, such as maintaining a kosher household.)

“I feel very strongly that women who choose to give birth in a hospital should not do so without a doula,” says Debbie Bamberger, a Jewish women’s-health nurse practitioner at Planned Parenthood in Berkeley. “It’s really important for a woman to have an advocate for her to help navigate the hospital setting.”