SAN ANTONIO • Once Suzanne de Leon found out what a doula was, she was “totally hooked.” It was the same for April Todd. Doula, a Greek word meaning “to mother the mother” or “to be a servant,” is something more San Antonians are becoming familiar with, thanks to de Leon and Todd and their work with San Antonio Birth Doulas (SABD), now part of Catholic Charities.
    A doula is a woman trained to offer emotional and physical support and comfort to a woman having a baby, working with the mother before, during and immediately following the birth to facilitate early bonding between mother and infant. A doula is not a midwife; neither does she take over the role of the father or family members in the delivery room.
    De Leon, founder and executive director of SABD and now director of Guadalupe Home as well, started the local doulas program in 1999. “The whole reason why this got started,” she says, “was to address the high incidences of abuse and neglect that our young babies were receiving at the hands of their teenage parents.”
    Pointing out that these young parents are not necessarily “evil,” but just overwhelmed, de Leon noted people sometimes question helping pregnant teenagers, feeling it advocates teen pregnancy. “We don’t advocate that,” she said, “but once it happens, this is our future. These babies are going to be the future of San Antonio. Let’s give them a good start.”
    Giving these children a good start includes making sure the birth experience is as pleasant and memorable as possible for the young mother, enabling her to better bond with her infant, and teaching her (and her partner and family) good parenting skills.

    “Unfortunately, they’ve not had good role models,” she said. Sometimes there is no family support, with the girl’s own mother perhaps being totally out of the picture, alcoholic or on drugs. The doula then becomes the teenage mother’s role model.

    SABD got its start as part of the Martinez Street Women’s Center in a century-old home on Martinez Street near HemisFair Plaza. Within a couple of years, de Leon’s project had outgrown their small office, necessitating a move to 1405 N. Main, then the site of Catholic Charities.

    It was here Steve Saldaña, president of Catholic Charities, became acquainted with the SABD program and invited them to come under the Catholic Charities umbrella, with the merger taking place in July 2005. At that time de Leon also took on the directorship of Guadalupe Home, dedicated to caring for homeless, pregnant women 18 years or older, and April Todd was hired as assistant director of SABD, running the day to day operations from their office at Catholic Charities on French Place.

    Todd had worked in the clerical end of the medical profession until a few years ago when, discouraged by the treatment of patients at the hands of insurance companies and her inability to help them, she opted to find a profession where she could really make a difference in people’s lives. Searching the Internet for home-based business opportunities, she discovered one of the top ten was that of doula.
“I had no idea what the word meant,” said Todd, “but there was something that made me check into it.”
    Soon she was put in touch with de Leon. “And I knew the minute I walked into that room that is what I wanted to do,” she said. “I was like, ‘This is the most awesome job in the whole wide world!’”

    SABD served a record number of 95 clients this past year, either teens or low-income moms, and currently has 15 doulas in their program. Todd first meets with the mother-to-be and assesses which doula would be a good fit. “We feel it’s very important, when they go to birth, that they feel comfortable with them,” she said. Once assigned, the doula meets with the client for three prenatal appointments, though they have taken on last minute clients as late as a week before delivery.

    During labor, the doula works with the mother, assisting her with breathing and massage techniques and offering constant encouragement. “The doulas really become friends with these teen moms,” said Todd. “It’s hard when you’re young and expectant — and they’re scared.” Most know little about their bodies and the birth process, and it is the doula who basically walks and talks them through it.
    Todd related her experience with a young girl she had assisted just that week. “She literally threw herself on me when she had a contraction. I mean we were on the floor!” she said. “So it takes a lot to be a doula. It’s very emotional and very physically taxing.”

    De Leon recalled a 15-year-old she had worked with whose mother was so frightened by the birth experience herself that she was unable to help her daughter. At one point, close to delivery, the girl kept begging for help and calling de Leon’s name. “I was trying to do what she needed,” said de Leon, “and finally I said, ‘What do you want me to do?” and she said, ‘Hold me.’ I leaned down and held onto to her and she just cried.”

    Training for doulas in the program takes place twice yearly, the next session taking place May 4-7.     Participants come from throughout Texas, as well as other states. “I’ve never put an ad in the paper,” said de Leon. “They all find us.” “I really feel God brings them to us,” says Todd of the doulas they attract. “When I meet with these women, the quality of the women that come through our organization, I’m just overwhelmed!”

    After an internship that involves participating in three births for free, the doulas receive their certification through the Doula Organization of North America (DONA) and are paid on a scale ranging from $125 to $425 per birth. The mothers pay for the service on a sliding scale, based on their ability to pay.
    Doulas are encouraged to attend the eight-week series of childbirth education classes with their clients, enabling them to better bond with the young women. After the mother goes into labor, or thinks she might be in labor, she contacts her doula. “Doulas are on-call 24 hours a day, seven days a week,” noted Todd. Sometimes a call can save an early run to the hospital as the doula can advise them how close they actually are to delivery, based on the timing and length of contractions. “But if there’s any question, we always tell them to call their physicians,” she added.

    Once a woman goes into labor, her doula meets her at the hospital and stays with her throughout delivery, which can be as long as 36 or 48 hours at a stretch. A back-up doula is assigned to each case to ensure someone the mother is familiar with can be there if the primary doula is unable to.     Afterwards the doula assists with breastfeeding instructions and can refer them to lactation consultants if there is a problem.

    The doulas also refer the women to other services, such as Catholic Charities’ Adolescent Pregnancy and Parenting Program. The doulas themselves follow up with three postpartum visits. Here they can check on the mom’s emotional state, helping identify postpartum depression before it becomes a problem. They also help the new moms learn to bond and interact with their babies.

    “Not every woman falls in love immediately with her child,” notes de Leon. “And so we want to make sure that it does happen.” She adds, “We find that women who have bonded with their babies are going to be a lot more protective.” The doulas likewise work with the dads involved. “If there’s a partner involved, then we’re pulling him in,” says Todd. “He’s in the childbirth ed classes; he’s at the prenatal appointments and postpartum appointments.”

    In fact, the mother’s entire family is invited to attend the classes. And de Leon reminds that it is never a question of doula or family as far as supporting the new mom. “We work together,” she says.
    During the classes, the expectant moms earn coupons for attendance, keeping doctor appointments, eating right and exercising. At the end of the eight weeks, they are allowed to spend these coupons in a special “Doula Store” temporarily set up in one of the rooms at Catholic Charities. Here the coupons can be redeemed for donated new or gently used items, ranging from diapers and strollers to breast pumps and toys. The new mothers also receive a brand new layette, courtesy of the Assistance League of San Antonio, which additionally donates clothes and toys for older siblings up to six years of age.

    Also benefiting from the doula program is Guadalupe Home, a transitional residential facility for homeless pregnant women 18 years and older located in a former convent on South Trinity. With accommodations for just nine mothers and babies, there is always a waiting list here to get in and fund raising is in progress to acquire a larger facility.
    Underlining the need, de Leon noted that in the past year in San Antonio there were approximately 28,000 homeless people with only 3,000 beds available for them. Some of these homeless were pregnant women, and Guadalupe Home offers them a safe place to stay until their baby is born and the services of a staff social worker.
    The women at the home are also assisted in completing their education, either being enrolled in a program to earn their GED or in college classes or being helped to enter the workforce. “We need a larger facility,” she adds. “We could keep it full.”

    SABD also works with young expectant mothers in Bexar County Juvenile Detention. “They asked me to do two births for free,” said de Leon, “to see if it was something that they thought would be beneficial for the pregnant inmates. And after the first one, they said, ‘We’re working on the contract!’”
    Many of the young mothers de Leon and Todd have assisted through SABD remain in touch over the years, sending pictures of their growing families and wanting to get together with the doulas they bonded with at a significant time in their lives.

    De Leon points out that studies have shown a doula’s presence at a birth increases the chances for a better outcome. Doula-assisted births show reduced length of labor time and the need for fewer caesarean deliveries — though doulas will stand by moms during C-sections as well.
    “With a doula, women can get a healthier, more satisfying, gentle, peaceful birth experience,” said de Leon. She noted the importance of the doula program is its interaction with a woman before the baby is even born, “before there’s been an accident, before there’s been that neglect — to let them know that it’s important what happens during birth.”

    “It’s important what happens when this baby is brand new and how this baby is received into the world and into the family,” she said. “We’ve got so many great organizations that help out after the fact, after this child has been neglected or abused or whatever. We’re trying to prevent negative things from happening to babies and families.”
    She continued, “We get to witness birth and the sacredness of birth, and we try to instill in our clients just how sacred birth is — that this is a big deal.”