A Guiding Presence: An Interview with Maya Eleazer

Maya Eleazer is a mom, birth doula and student, focused on psychotherapy and Indigenous studies. She currently resides in the Pacific NW with her husband and two teenage children.  

What prompted you to become a doula? 

My introduction to doula work was very unexpected. It began in 2000 when I was twenty-one years old. A friend invited me to her son’s birth because she and the baby’s father were going through a rough patch in their relationship, and she didn’t feel she could depend on him for support.  Back then, neither my friend nor I had heard of birth doulas, and I knew very little about birth, so my support role wasn’t defined in that way. I was just very excited to be invited to witness a birth and help my friend out during her labor, and witness a birth. 

What an amazing opportunity and gift. What was life-changing about the experience? Could you describe it?

I remember it was really early in the morning and still dark out when my friend called to tell me she was in labor. She said that things were picking up fast, and she was headed to the hospital. I jumped out of bed and must have made it there in less than 15 minutes. I don’t know what I was expecting from a hospital birth, but what I found was my friend in a bed, with lots of tubes and wires coming out of her body, looking forlorn. She was working very hard to not make a sound or move during her contractions. Her brow was furrowed, and she was clearly distressed. I remember I wanted to help her, but because I knew so little about what she was experiencing, I was afraid of doing something wrong and unintentionally causing her even more pain. As I wrestled with these thoughts, I noticed beads of sweat forming on her forehead. I asked the nurse if I could have a wet washcloth and some water for her. The nurse gave me a cup with ice water and a couple of wet washcloths, and those were the only comfort measures I had. For the rest of her labor I stayed by her side, breathed with her, wiped her brow, and gave her sips of water.

Although he wasn’t actively involved, the baby’s father was in the room with us. After a while, he got tired and fell asleep. Many hours passed like this. Then out of nowhere, my typically quiet friend opened her eyes and roared at me, “He’s coming, help me!” I wasn’t sure what to do because I wanted to respect her modesty. The baby daddy bolted up when he heard her voice, and ran down the hall to find a nurse. In the meantime, my friend continued yelling for me to help. I asked if I could lift the sheet and she screamed “YES!” so I did. What I saw about knocked me over. The baby was crowning, and his head was almost completely out. I asked if she wanted me to catch him, and again she yelled “YES!” so I cupped my hands, and gently supported him as his slippery warm head popped out, followed by his body, onto the bed. Just then the nurse ran in and took over from there. I don’t think I did much for my friend in that moment, but the experience did a lot for me. 

That day definitely changed the trajectory of my life. I remember being immediately inspired to change the focus of my studies from fine art to midwifery. As fate would have it, I found out a few weeks later I was unexpectedly pregnant with a baby of my own. I believe the experience of that first birth did much to convince me to keep my baby, even though I was very unprepared for motherhood at that time.

How does your role as a mother inform your work as a doula and vice versa?

That’s a really loaded question for me. I had two very different pregnancy and birth experiences with each of my children. During my first I faced a lot of adversity for being a young, single mother. Those experiences of prejudice empowered me to find support and good care during my pregnancy. Through reading and research, I learned about doulas and midwives. I was fortunate to find a newer doula willing to help me for free, and a midwifery group that accepted state insurance and offered evidence-based care that was supportive of natural birth. 

My daughter’s birth was very fast, under five hours total. My mom and doula were both present, and did their best to help me, but her birth was like a runaway train. It was a profoundly spiritual and transformative experience for me, which I didn’t even know was possible. During labor I had a vision I was connected across space and time to all the others who had given birth. I felt that connection and kinship as a guiding presence throughout my labor. It was almost as if I was being led into each labor position by an unseen force. It’s hard for me to put into words how intense this feeling was, and how much it impacted me during my labor and afterwards.

Just before my daughter was born, it was discovered her cord had prolapsed, which is a true birth emergency, as it cuts off the flow of oxygen and the blood supply to the baby. My midwife acted quickly to resolve the issue, and I was very, very lucky my daughter was born without any lasting trauma. I learned so much from that first birth. It taught me I had within myself an incredible amount of untapped strength and resilience. I also learned the importance of surrendering to the process, and that birth, like the rest of life, is truly out of our control; even in the hospital, with all the technologies available to us. These lessons served me well in my work with others throughout the years.

After my daughter was born, I told anyone who would listen how incredible her birth had been. I was surprised so many mothers I spoke with were so negative about their own births, or even natural birth in general. Most of my friends were too young to want children, so I felt pretty isolated. At the same time I was also extremely proud of my accomplishment and I absolutely loved being a mother. 

I eventually realized I needed a different sort of community, which I found through attending La Leche League meetings. This group was a lifesaver for me as I made friends with other breastfeeding parents who could relate to this new stage of life. The group was so important to me that by the time my daughter was a year old, I was training to become a La Leche League leader. For the next five years I led monthly meetings, offered phone support and did outreach with teen and incarcerated mothers. 

When I was pregnant with my daughter, I began dating my current partner. By the time she was a year old, I became pregnant with my son, and he and I were married shortly after. During my second pregnancy, my infant daughter suffered an extreme vaccine reaction to the DTaP shot that resulted in ongoing illness and grand-mal seizures. These were extremely stressful, scary times full of ambulance rides and nights spent in ERs. Because of all the stress and fear I was experiencing, I did not feel emotionally equipped to welcome a second baby. My daughter’s illness made it so I had little time for self care or movement. I spent a lot of time holding her and driving her to and from doctor’s appointments. The result of all of this was that my son settled into a sunny-side up position in utero, which he was still in when labor began. I didn’t know any of this at the time though, or even that having a sunny-side up baby could pose an issue for physiological labor. 

I had planned to have a home birth so I could attend to my daughter’s care. Unfortunately my labor stalled 8 centimeters dilation for over 12 hours, and nothing my midwife and I tried would get it going again. I decided to be transferred to the hospital for intervention. Once there, I was given an I.V. with pitocin, and experienced hours of excruciating labor without much change. The attending doctor kept checking my progress via a rough, non-consensual vaginal exam, saying my baby was too big to fit, and that I just needed a cesarean. I refused, but did finally ask for an epidural after over 24 hours of labor. When the anesthesiologist came to administer it, he was only able to start the epidural before I suddenly felt the fetal ejection reflex, and my son was born. My son was almost 10 lbs and came out sunny-side up, breaking my coccyx in the process.

My son’s birth taught me so much about what can cause a labor stall. It took me a long time to acknowledge the reasons for his malposition (lots of sitting on the couch and car bucket seats, not moving or stretching, stress) and to acknowledge my ambivalence about having another child likely had a big impact on his entrance into the world. For a long time I felt I “failed” because his birth was so difficult. This feeling combined with all the trauma of my daughter’s health complications showed up as postpartum depression and anxiety. I didn’t get help at the time because I didn’t realize anything was wrong. In 2003 I think postpartum mood issues were still sort of taboo, and even if I did know what was going on with me, I don’t think I would have known where to go for help. 

In hindsight I realize these life challenges have become major lessons that have aided my work with others. In my doula practice I am very focused on supporting pelvic balance through exercises and body work, so that babies have space to move into an ideal position for birth. I spend a lot of time learning about any challenges my clients might be struggling with, and encourage them to seek therapy and healing so these emotions do not interfere with their births or postpartum time. I help people find support and resources, and to build community so they do not feel alone. I had to work hard to get through those tough situations, but I recognize this is not ideal.  It is also a healing practice to help others through this time. 

My work has shaped my family and parenting in many ways. Birth work is not just a job, it’s a lifestyle. It’s a major commitment not just for birthworkers, but for our families as well. I’ve been on call for most of my kid’s lives. They understand I can get called to a birth at any time and I may need to cancel plans. There’s a lot of family trips, holidays and parties that were missed or rescheduled. This can be frustrating at times. However, I think they have also gained a lot from this life experience. Both of my children grew up seeing babies be breastfed, hearing about birth, seeing placentas in our kitchen. There’s no mystery for them about the realities of birth and parenting. My daughter has even been fortunate to attend a few births with me during her childhood and adolescence. Since the beginning, these two aspects of my life have been inseparable. I learn from working with so many families and seeing how they interact with one another. 

How does being a woman of color shape your work?

My family of origin is bi-cultural. My mother is of Mexican descent and is the first person in her family born on this side of the border. My father’s family is originally from Europe and his roots can be traced back to the Oregon Trail settler-colonizers. 

My mother’s culture was dominant in my home because for the most part she was a single parent. The food we ate, our holidays and traditions, religious beliefs, language, and roles all came from her upbringing. But I never felt comfortable claiming to be Mexican identity because I am white-passing, do not speak Spanish well, and was raised mostly in white neighborhoods. I’ve always said I’m half. I know I’m not alone in these feelings and that this is an issue that many children from mixed families struggle with. 

In the last decade I’ve been learning about historical trauma. This inquiry has provided me a deeper understanding of how colonialism motivated my family’s assimilation into white American culture, and how mental illness, addiction and abuse became part of my family legacy as a result. This realization led me to ask my grandmother more about our hidden and forgotten stories and traditions. Through these efforts, working with plants, and connecting with other Indigenous birth workers, I am beginning to connect more to the positive parts of my family history. 

Just this last year my grandmother shared with me her own grandmother had been the midwife in the village she grew up in. That my grandmother chose to keep this from me for so long only further impressed upon me how much there still is to discover about my family history and that perhaps my ancestors have been guiding me into the work I do.

I feel compelled to provide support and encouragement to families from underserved and marginalized communities. I understand too well how issues like racism, discrimination, and limited access to resources can have a detrimental effect on birthing people and their babies. I attract a very diverse client base because there are still not a lot of doulas from diverse backgrounds.  

How do you envision your role in this work, i.e. what do you personally bring to this work that is uniquely your own?

I try my best to show up authentically in my work, and focus on my client’s needs, preferences and goals. I think it’s impossible to do this work for very long without being your authentic self. I don’t pretend to be a “birth expert” or promise any specific outcome. I just try my best to commit to showing up and supporting them in whatever way they need. 

I have a lot of experience with birth at this point; at last count I have attended well over 300 births. Experience is a good thing, but not the most important thing I have to offer. Sometimes I feel like I know less about birth now than when I started! And that’s ok with me. I think showing up with what Thích Nhất Hạnh refers to as “don’t-know mind” really helps me to be non-judgmental and supportive to my clients. I think of my role more as a companion and sometimes a guide, rather than someone trying to control or change the birth environment.

I work with people from all demographics, in all sorts of ways. Sometimes that’s going with a client to the welfare office to apply for food stamps and medical insurance. Or it might be giving them information on the risks and benefits of a specific medical intervention. During birth I am all about helping people trust this process, and their own intuition. In the postpartum time I work to help families successfully breastfeed their babies, help them integrate their birth experience, and teach them about the importance of attachment and bonding for optimal development. 

As anyone who has been in this role long enough has discovered, birth and death are intrinsically connected. I believe it’s the same doorway. So I also have adapted to my client and community’s needs by offering grief and death doula care. My work has become more full-spectrum as these needs have arisen for my clients and community.  

There are a lot of people out there with a very limited understanding of the differences between the role of a doula, midwife, and an OBGYN. Could you please define the work of a doula, from your own perspective, and any misconceptions you’d like to clear up for the general public?

The origin of the word doula is Greek and I’ve read the literal translation is “female slave” which is awful. I personally want to get away from that term. I think birth worker and birth keeper are nice, but unfortunately don’t offer a lot of info on the difference of roles. We use the word doula to describe a person who is knowledgeable about pregnancy, birth, and the postpartum period, and who provides non-medical information and support to birthing people and families during this transition. Hiring a doula does not replace the care of a trained midwife or obstetrician, but is complementary to it. Doulas offer all sorts of services. There are doulas who offer massage, baby blessings, placenta encapsulation, meditation instruction, nutritional support, yoga, birth hypnosis, and birth education. A doula can offer any kind of non-medical support or service to their clients. Everyone brings their own set of skills and talents into this role. Some doulas are very hands-on during birth, and others use a more detached approach. Some doulas do birth support, others do postpartum support, and others offer full-spectrum support, including abortion and pregnancy loss. Death doulas assist people with end-of life preparations and ceremony. 

It’s hard to answer this question concisely because there are so many different kinds of midwives and OB’s. In general, midwives in the United States are skilled medical care providers responsible for the health and wellness of the mother and baby. There are a lot of different types of midwives, and each state and country has different laws and regulations that dictate the education and licensure requirements for midwives to practice. In some states, licensure is considered optional. Some work in hospitals and medical centers, and others work in birth centers and/or homes. The way I interpret the midwife model of care versus a conventional OB/Gyn approach is that midwives are typically looking at wellness from a holistic bio-psycho-social kind of approach, where most OB’s are focused on the physical health of the birth parent and baby. 

What forms of activism do you participate in regarding reproductive rights? Are there any forms of activism you are working towards that you aren’t currently partaking in at present?

I’m involved in a few different local efforts right now. I am part of a group working to create a state-funded doula reimbursement program for Medicaid recipients. It’s still in the very early stages but I’m really excited to see this happen as it would greatly increase access to doulas for many that would really benefit from this care. I’m also concerned about barriers and ethical concerns of requiring doulas to obtain certifications to qualify for reimbursement, and about specific organizations working toward monopolizing this effort. 

I am also part of a birth workers of color group, Birth For the People. We are working to increase representation, education and training opportunities, and community here in the greater Seattle area.

Have medical professionals been more welcoming to your presence in delivery settings?

I’ve definitely seen a shift in the acceptance of doulas in the hospital setting over the last 18 years. For a while I felt like every time I went to a hospital birth I would spent a lot of my time and energy deflecting aggression directed at me by doctors and nurses. I got really good at hiding my emotions and responding in my sweetest, most non-threatening voice. I kept my head down, and continued my work. But it was exhausting and draining. After years of this scenario playing out again and again, I just couldn’t do it anymore. I was dreading going to work, and was seriously considering other occupations. But I also knew deep down I really loved this work and didn’t want to stop. So I trusted my heart on this matter and instead set some healthy boundaries around what birth environment I was willing to work in. I stopped accepting clients planning hospital births, except for people with high-risk pregnancies due to medical complications. In these situations a hospital birth is the best option for safe, evidence-based care. I also find in these scenarios my clients are often treated most respectfully and competently by hospital providers and staff. 

I have been conducting my practice this way for 7 years now, and have recently become more flexible on this rule. I will take an occasional client planning a hospital birth, with a provider they feel philosophically aligned with, and who respects their preferences. I do this mostly to stay current on local hospital standards of care, but also because I realize it’s always good to challenge my assumptions. I do feel like most OB’s, nurses and CNM’s (Certified Nurse Midwives) are more welcoming of doulas now, but I still end up spending my time and energy advocating and negotiating for my client’s preferences to be honored when I could be working towards encouraging and supporting a normal labor process instead.

For these reasons and others, about 90% of the births I go to are attended by out-of-hospital midwives. This environment is ideal for me because I am able to openly discuss options and collaborate on my client’s care with the midwife, and my clients who receive midwifery care are able to labor and give birth in a calm, non-adversarial environment.

What did you learn through the Indigenous studies program that helped you decolonize your own work around birthing?

I just graduated with my Bachelor’s degree from the Native Pathways Program at The Evergreen State College in Olympia, Washington. I learned an incredible amount during my time in this program about all the ways in which Indigenous people across the globe are connected in our experiences. I spent the majority of my time in this program researching the subject of historical/generational trauma. The more I learned, the more I understood about the root causes of the familial and societal issues I’m seeing my clients struggling with today. 

I’ve shared a lot of what I’ve learned with my clients, and many of them have told me it helped them understand their family of origin differently. I believe the first step toward healing the harm of colonization is acknowledging how and why that hurt and grief has been passed on through generations. Once we face this, we can start adapting our behaviors, and seek ways to change how we relate to our own families. I’m integrating this philosophy into the work I do. 

What’s your learning/continuing education experience (in either doula training or Indigenous studies) been like as often it occurs in very white spaces?

I’m forever grateful to have found my Indigenous Studies program. We met for classes in the longhouse built on the college campus, surrounded by forest and native plant gardens. There was a big focus on healing and community building, which created a safe space for learning and sharing with one another. The program was not only focused on Indigenous studies, but geared to the teaching of Indigenous students, using Indigenous practices. Most of the program faculty are Indigenous, and those who aren’t are allies who never tried to oppress or colonize our perspectives. 

As far as my birth education and training have gone, most of that took place in very white spaces. I definitely felt during my doula training course my perspective on birth (I had already attended a couple dozen before taking the training) was very different from that of my “doula trainers.” I did my doula training workshop in 2009, and it left me very underwhelmed. Much of the focus was on marketing and business. Which is important, but not really what I was hoping to get out of it. I’m also critical of the idea anyone can “train” and certify someone to be a doula through a short workshop or online course. Every indigenous culture had knowledgeable people to assist and guide birthing people during this very special time. This knowledge was traditionally passed down through apprenticeship and hands-on teaching methods. Western culture first tried to stomp out traditional birth knowledge by moving birth into hospitals and into the hands of doctors. For many generations birthing people in this country had limited options for compassionate, traditional care with midwives and birth keepers. We are finally recognizing the importance of these traditional support roles, but at the same time there is an equally strong interest in certification and regulation of doulas. This is a big conversation among Indigenous birth workers: how we will continue to defend and protect our right to this work, and increase access to educational opportunities by and for our own communities.

Could you elaborate on your work with non-traditional birthers, such as trans or nonbinary birthers?

I have yet to have a client who openly shared they identified as trans or non-binary. I live in an area where there is a fair number of queer/non-binary/trans doulas so I assume these are the doulas trans/non-binary folks are seeking out and hiring, which is ideal. If any Queer/POC reading this right now wonder if they should become a doula or midwife the answer is a firm yes. Diversity is still sorely lacking in the birth community.

What exciting trends or developments are happening in the doula field that you’re excited to let others know about?

I have witnessed a major shift in the birth community’s focus being almost solely on white, heterosexual-partnered women to becoming more inclusive of POC, trans, gay, and single parent families. There is A LOT of work to do but I am seeing much more diverse representation and inclusive language, reproductive justice and cultural competency are big issues in birth work right now.

What certification organizations do you recommend for those wanting to break into the field? 

First, no one needs to have a certification of any kind to do this work. It is a personal choice, and one many people in the birth world feel strongly about. Many doulas start out by attending the birth of a friend or family member, and then going on to training or apprenticeship opportunities from there. Many trainings will offer a certification of some sort, and usually require membership and approved continuing education workshops people pay to attend. The benefit to certification is many people feel it lends some credibility to this role, and can help people move on to other roles within non-profit organizations. However, there are a lot of ethical issues with the idea that certification makes you a doula. The most experienced and skilled doulas and birthworkers I know have never attended a single training with a certification component. I believe the big preparation and learning for this role comes through work on yourself, attending births, and becoming a trusted member in your community. So the question then is, how do we do that? I suggest volunteering for organizations working with underserved and marginalized populations. Find out who is doing the work in your community, and reach out to see how to support them. Ask for learning or apprentice opportunities in your community. Everything you can learn about social justice, barriers to care, and community health is going to assist you. Show up, be humble. Have your intention be service rather than acknowledgement or praise. This work is not about money or ego. It’s truly holy healing sacred work even if those around you might not know it.