For Marisol Dela Cruz, serving a mother in need began with having tea.

In this case, the mother was a pregnant refugee from Myanmar, completely unfamiliar with birthing culture in the United States. Dela Cruz, a Catholic and onetime aspiring OB-GYN, was a volunteer doula at the University of North Carolina Medical Center. The two connected, and with the help of a translator, began forming a relationship as the baby’s due date approached.

“I can’t even tell you how many hours we spent together in her home,” said Dela Cruz, who is now in the midst of relocating to Illinois. “We shared tea together; she shared with me her personal experiences as a refugee; we gained trust.”

In turn, Dela Cruz took the expectant mother on a hospital tour, teaching her medical terms and the types of medications she might be offered, and prepared her for an American birth experience. The education went both ways, with Dela Cruz pouring over research about Myanmar culture in order to give respectful, culturally competent care.

Most of all, Dela Cruz wanted the mother to “know she has the ability to say ‘No’ or ‘Yes’ to all those options.” Knowing what an epidural was, or having a game plan for a VBAC (vaginal birth after cesarean section), was a way of empowering her and affirming her dignity, “especially as someone who’s experienced so much trauma, [when] all these things have happened to you.”

And when labor began, Dela Cruz was present, supporting the mother through a positive, successful VBAC delivery.

Helping Mothers Say ‘Yes’

Safeguarding women’s dignity, advocating for mothers and babies, and offering physical and emotional support through the grueling process of labor and delivery are all standard values for doulas, making the field a natural fit for Catholics comfortable with the world of childbirth and passionate about living out their pro-life convictions. It’s an intimate role that walks with mothers as a companion, not a clinician.

And for some, like Dela Cruz, the call to serve draws them to vulnerable mothers and babies on the thinnest of margins: incarcerated women, teen moms, refugees, families in poverty, women with trauma or other underlying issues that make them more susceptible to birth complications, and more.

“This is absolutely a pro-life ministry [and] an act of justice,” Dela Cruz said, citing statistics on infant and maternal mortality rates for women of color. According to the Centers for Disease Control and Prevention, for instance, Black women are more than three times more likely than white women to die from a pregnancy-related cause. Likewise, Black babies in the U.S. are more than twice as likely to die before their first birthday than white babies.

It’s a statistic that lights a fire under Dela Cruz and other Catholic doulas like her, especially considered in light of high abortion rates in the same communities at high risk of birth complications. Can doulas help staunch the wound of both tragedies?

“Mary said ‘Yes’ to birthing Jesus,” she said. “By me focusing on vulnerable populations more susceptible to abortion, I’m giving them the option that they can say ‘Yes’ to their own children, that they’re capable of overcoming birthing barriers.”

Dela Cruz received her doula training through Doulas of North America before connecting with the University of North Carolina’s volunteer doula program, Birth Partners. She also has her own practice and has often been the sole support person for laboring women, sometimes meeting them for the first time at the hospital. The incarcerated women, she noted, were only allowed a security guard to accompany them; other mothers have included teenagers, clients with psychiatric needs, or other refugees and immigrants.

She’s convicted that this is her vocation and says she tries to balance out her volunteer or “pay-as-you-can” services with clients who can pay full price.

To stop “would be saying ‘No’ to Jesus, and that is very difficult!” she told the Register. Dela Cruz, who herself is raising two young children, went on to reflect on how her mother, an immigrant from Mexico, experienced homelessness, abuse and extreme poverty. “It would be idiotic to take everything I have for granted. I believe Jesus gave me these things so I can give.”

Needed Care for Moms

The American Pregnancy Association cites research correlating the presence of a doula with decreased cesarean rates by 50%. Likewise, a recent study of women on Medicaid in three U.S. states showed a 64% reduction in postpartum depression or anxiety among those who received doula care during labor and delivery.

Laura Kiefer has seen the human side of those statistics, after beginning her journey as a doula in her old Fort Wayne, Indiana, neighborhood, whose zip code has one of the highest infant mortality rates in the state. Following the birth of her second baby — a healing experience, after what she describes as a traumatic first birth — she felt drawn to walk alongside mothers in her own community whom she knew faced a high risk of birth complications.

In addition to running her own doula practice, Kiefer works for a Christian nonprofit based in that same zip code that provides birth support for women and their families. The majority of women served are either Black or refugees or immigrants from Myanmar; they’ve also had pregnant women referred to them who were formerly sex-trafficked.

Kiefer is grateful that the center’s network includes doulas of color and those who share the culture and language of the women they serve.

“It’s so important to have doulas who are part of their community,” she said. Her own clientele is largely made up of women who have experienced previous birth trauma or other types of trauma that might manifest during labor and delivery.

“Maybe it’s someone leaving a domestic-abuse situation or an assault victim,” she said. “I want you to feel that you have a voice. And if for some reason things don’t go as you hoped, I’m going to be alongside you … [and] give you the hands-on tools to process it so your body doesn’t retain it as trauma.”

Serving women during pregnancy and birth has also drawn her closer to God. For Kiefer, who converted to Catholicism in 2015, “one of the most transcendent experiences is seeing someone give their own body for someone else. To be witness to that, to the creative power of God is so amazing and awe-inspiring. It never, ever, ever gets old.”

In Mary’s Hands

In Baton Rouge, Louisiana, two women want to exponentially multiply the positive impact of the doula model, harnessing the Catholic Church’s dedication to a culture of life and training other women to serve as doulas in an impoverished region.

Madeline LeBlanc and Heather LeGrange only met a couple of years ago, but they’re eagerly anticipating training their first 22-member cohort of volunteer doulas for a new initiative, Mary’s Hands Network, this spring. Their summer session is already half-booked, and they anticipate having 50 doulas trained by the end of the year.

Louisiana has the second-highest infant mortality rate in the country. In Baton Rouge, all three crisis-pregnancy centers are in the northern part of the city, a poverty-stricken area that faces high crime, food and housing scarcity, and a burdensome commute to the public hospitals on the opposite end of town.

“The wound is too great, and the dose of medicine is too small,” said LeBlanc. Their goal is “to saturate the market with doulas,” so that no mother feels she has no other option than to be alone.

The entire training, which aligns with standards from the International Childbirth Education Association, is provided free of cost for the volunteer doulas, thanks to the Diocese of Baton Rouge, which will sponsor two trainings a year. The doulas will be assigned in teams of three, each team partnered and on call with a mother referred from the pregnancy centers. Volunteers commit to serving at least two mothers a year, and after their training, they will be prepared to take the ICEA’s doula certification exam.

The outlook is promising. They’ve had eager buy-in among the local medical community, with all three of the city’s hospitals, as well as the Baton Rouge Birth Center, sending labor and delivery nurses, pediatricians, physical therapists, lactation consultants and other representatives to their doula training in order to build bridges of trust and communication between the doulas and medical professionals. That openness to learn from each other and invite knowledgeable people to the table is integral to the program’s success, they believe.

“We don’t want to be the smartest women in the room,” said LeBlanc, who teaches labor and delivery nursing, is working towards her Ph.D. in nursing, and put together the training.

In addition to the sheer number of volunteers already committed, LeGrange, LeBlanc and their diocesan liaison, Deacon Randall Waugespack, director of the Office of Life, Peace and Justice, are encouraged that more than half of the initial cohort are women of color, many of them not even Catholic.

“It’s very important, as a room of white people, that we’re able to bring in doulas of color who turn around and serve these women,” said LeBlanc.

While Mary’s Hands Network isn’t officially under the umbrella of the diocese, the training was reviewed to ensure it aligns with Catholic moral principles, and Deacon Waugespack will be at the sessions to answer possible questions on ethics and the faith.

He sees the network’s openness to volunteers and clients of any faith — or none at all — as an opportunity that “hopefully gives them a desire to know where we learn to love, and that will be our opportunity to share the faith.”

LeGrange is unabashed about how her faith drives her passion for this work.

“We lovingly like to imagine Mary as a doula to her cousin Elizabeth,” she said, adding that this effort reflects “what it means to be pro-life. And it’s a lot more than just voting.”

For her and LeBlanc, it’s about literally walking with mothers through pregnancy and birth, surrounding them with community, and doing the often tedious work of connecting them with services for health care, food, housing and more.

“That is our faith in action,” LeBlanc said. “That is Mary’s hands reaching down and touching these moms.”