An Usher of Blessings

While not yet common in the United States, utilizing a childbirth doula is on the rise. A birth doula, a term that’s not quite familiar to everyone, is a trained professional who provides educational, physical, and emotional support to women and their families before, during and after birth.  Among the long list of services that a birth doula will provide to an expecting mother include, prenatal and childbirth education, breastfeeding education, postpartum education and support during labor and birth. Some doulas have specialized training or further training in things like perinatal mental health (PMAD) providing additional support, especially to those with a history of mental health conditions.  Another doula may offer services more focused on postpartum care in which the services center more on the recovery and healing process of the mother. Postpartum doulas sometimes provide physical support around the house like making meals, doing dishes, giving breastfeeding education and many other services.  Whichever specialty or service a birth doula may offer on thing that is for certain is that they play an important role in the support and education of an expecting woman, and sometimes to the family altogether, providing as much education and comfort as possible to prepare them for the blessing ahead.    

Zainab Ziegler of Greenwood Indiana told me, “I was in the middle of my pregnancy when I suddenly lost my insurance.  I thought my only option would be to have a home birth so I looked for a doula who could help.   I also had a 15-month-old baby at home and was trying to prepare for another baby while unexpectedly faced with the insurance issue and needed some informational support as well as emotional.”

In the state of Indiana, resides only two Muslim birth doulas. One of whom is Mariama Bah of Indianapolis, Indiana, a birth doula for 4 years with her business called Rahma Maternal Services.   

Mariama’s family is West African, but she was raised here in Indianapolis.  She is a Pike High School graduate and continued her studies at IU Bloomington where she double majored in International Studies with a focus on global health & Near Eastern Languages and Cultures and studied Arabic simultaneously.  Bah took advantage of many interesting and educational opportunities. She says, “I was privileged to study abroad to a couple of countries.  After my freshman year, I went on a public health trip in Asia.  In Japan, Thailand and China, we met with public health officials discussing their healthcare system, challenges at that time and improvements made.  A year later, I had the opportunity to go to public health brigades with the university chapter of Timmy Global Health.  We went to Nicaragua and worked with other universities from the U.S.  to aid locals by building septic tanks and lay water pipes for communities.”  In addition to the global opportunities, while studying Arabic during undergraduate studies, Bah had the opportunity to study abroad in Morrocco for 11 months through the university and the American Council and interned with locals working at a pottery shop.  She studied Modern Standard Arabic (Fusha) as well as the Moroccan, Darija and Egyptian dialect (Masri). 

How does this adventurous student of the world choose to become a doula? Bah explains, “Upon returning to the U.S. in 2020 when the pandemic started, I was blessed to have a job working at an international development organization based in D.C.  Although it was working remotely, it was a great opportunity to continue pursuing my interest in the health sector.  Working for this organization, I was in the global health department working on USAID projects with efforts in eradicating Malaria in West Africa.  I loved my time there, but I always looked for a way to get into the maternal health field.  After a few years, I decided to leave the organization and look for something in the maternal and child health field.”

Bah did her training through DONA International, both for birth doula but also including breastfeeding education and childbirth education.  Created in 1992, DONA International is the world’s first, largest, and leading doula certifying organization.  She further explains, “I was always interested in public and global health. In college I took many courses that focused on women’s health, which I loved. But what really made want to become a doula is finding out that the profession exists and that the United States has the worst maternal and infant mortality rate amongst the western world and lastly, Indiana is ranked as one of the worst states for infant and maternal mortality rates, rating them at a D- from March of Dimes. This is particularly alarming for the black population, who experience a disproportionate rise rate compared to their counterparts. Additionally, coming from west Africa, I witnessed the health disparity and challenges faced by many and especially women and infants. I had the urge to do something about it. I want to be amongst the professionals that are helping make a difference here in Indiana and share my knowledge and experience in other parts of the world like west Africa and other places in the future Inshaa Allah.”

Along with the doula certification with DONA International, Bah is also infant safe sleep certified through the Indianapolis department of health and is CPR trained and certified.  Adding to those credentials, she’s also a trained childbirth educator through LAMAZE International, one of the most recognizable childbirth organizations.  The list continues as Mariama is also a trained perinatal mental health professional through Postpartum Support International

Working as a part time doula Bah has attended more than 30 births and recently started providing virtual birth support as she realized people are looking for this option.   The virtual birth doula option offers support and check-ins during labor by telephone or video.  She explains, “For example, a client could call me and I’m on the phone with her while the nurses are talking with her or doing something so she could feel comfortable having her doula on the phone or by video. I can help guide them through questions they have or provide emotional support, guide them to help advocate for themselves too and feel empowered just as if I were there in person. “

I asked Bah about her philosophy on birth and parenthood.  “I’m there to support my client and their family in their choices. I support them in whatever they feel they need. How I view it is that it’s not my position to tell them what to do and give medical advice because as a doula we never give medical advice. We stay within our scope of work. However, if they ask me about something specific and want my opinion, I can provide my answers in a way that’s not persuading them to do something specific that I think is correct or right. Rather I’ll guide them to also help answer their own questions and provide them with evidence-based information so they can do further research and come to their own conclusions. Everyone has an idea of what type of birth they want and it’s my job to work with them to help them achieve their goal, with or without medication. “ 

I then asked her about her doula style.  “I would say my style is just going with the flow. As I said before, I work with clients to provide the experience they’re looking for. Whether it is natural, medicated or see how it goes. I work with them to achieve their goal but still advise them to keep an open mind and flexible in case something else happens because birth is unpredictable. It’s not my place to give an opinion that’ll persuade my client to do or not do something that they originally wanted to. For example, I educate my clients on immunization based on my limited knowledge. However, there some clients who are strongly against vaccines and said they will not vaccinate their kids. In a situation like this, it’s not my place to convince them otherwise. “

Izabella Banka of Indianapolis shared with me that she chose to use a doula while pregnant with her son.  “I lost my mother when I was young, and I really wanted a female presence with me along with my husband for support. The nurses are there for medical support, but I wanted that emotional support that a female presence typically provides.  While my husband was good about many things, it was different to have the female presence and Mariama was just that.  She was knowledgeable about childbirth and knew what to do to help provide comfort in a way my husband couldn’t.”

A birth doula does not only offer services during the childbirth process.  Bah offers prenatal education, breastfeeding education, infant safe sleep, and preparations for a baby on the way.  She assists during birth, providing coping techniques for comfort measures until the time of delivery and then typically stays for about an hour after when she believes the mother and baby are doing well.  She does offer postpartum care as an option of the packages that she offers. 

As each birth experience is different for different women, so is the day in the life of a birth doula.  From meeting clients going over prenatal education to being called in for birth, to providing support for a scheduled c-section, a birth doula’s day is all but predictable. Bah is prepared to drop whatever she is doing at any time to provide comfort to her clients.  “The life of a doula could be hectic at times because sometimes you have back-to-back clients you’re supporting and it’s amazing but also exhausting at the end. So, it’s important to take the time to recover and rest well before jumping back in, otherwise, you’ll risk being burnt out.”

I asked Bah what is the most rewarding thing about being a doula? 

“It’s really gratifying when I support someone providing the tools, education and techniques to help them achieve their goals and in the end it really shows. Even if they may have not necessarily achieved the goal fully, but partially and yet still they are very grateful and express how much it meant for me to be by their side every step of the way, or what I worked on with them helped them become successful overall. This could be as simple as helping them feel comfortable, instead of fearful going into birth, feel confident and the ability to advocate for themselves throughout, and especially for those who have had a traumatic birth previously.”

Although I was sure that she would have special connections and memories with each of her clients, I asked if she would share a special memory from her experience being a doula with me.

“There are many, but I’ll share one or two. A moment I remember is when one of my clients gave birth naturally and I mediated. This was her first pregnancy, and she was determined to have an unmediated birth. So, she was very enthusiastic about having a doula, a Muslim doula too since there weren’t any in the city. In fact, even today, I was of 2 Muslims Doulas in the entire state. A friend who’s a doula and childbirth educator living in Bloomington. Anyhow, I worked with her and her husband and when she finally was in labor, she did well laboring at home until she was ready to go to the hospital. I met her and her husband there and found out she was 8 centimeters so, I worked with her the rest of labor to alleviate her contractions and before you know it, she was ready to push. Everything went so well, it was amazing to see. Till this day, I see still am in contact with her and her daughter is now 2 years old. It’s nice seeing children that I helped come into this world, growing up, playing with them and speaking to them, Masha Allah.”

How do Bah’s religious values align with her values as being a birth doula?  “My religious values align with doula work because it’s a sacred job. I’m literally witnessing someone coming into this world. It’s a reminder of the many Miracles of Allah SWT. For my Muslim clients specifically, always first and foremost anchoring our self to Allah and his Decree. I also start my sessions by making dua and invoking the name of Allah throughout. For example, when helping a client in labor, starting with BismiAllah.

How do you incorporate Islam into your doula services?

For my Muslim clients, I do incorporate Islamic values and practices. For example, when working with them and preparing them for birth, I always make sure to emphasize that first and foremost we are Muslims and because of that, no matter what happens, it was decreed by Allah SWT. We can plan and prepare for our birth and feel very confident and ready. However, things may not go as planned always and it’s the Qadar of Allah. I remind them that Allah has already chosen how their baby is going to arrive into this world, what’s going to happen during the labor process and afterwards. Still, we prepare and do our job and do our best to achieve the goal, but if it doesn’t go as planned, then to remind and find solace in the decree of their lord. I also encourage Sunnah practices during pregnancy, during labor after the birth, of course keeping in mind that if they are well and healthy and so is their child. Other ways I incorporate Islamic values into my practice is catering the birth plan to fit my client and their family Islamic practices. For example, some people may want to say the Athan right away after the birth of their baby, and so I work with them to make sure that’s something to put on their birth plan and encourage them to self-advocate info, informing their doctor about their wishes and preferences.  There are so many other factors that’s included throughout the process. As for myself, I ensure to put in my contract stepping out for breaks. That could mean going to do my prayers or just resting and resetting for a few minutes.

I asked Bah to share a few Sunnahs when it comes to childbirth.  She shared a few.  “One example that comes to mind is doing the Tahnik for the baby after birth. Tahnik is when either the father or a righteous person chews a small piece of date and softens it, takes that paste and rubs it on the roof or gums of the baby’s mouth. The prophet SAW did this for newborns. The benefit of this practice is that it helps regulate the baby’s glucose levels. What’s interesting is that when babies are born today, the medical staff performs a glucose test after birth to determine the infant's blood sugar levels. The purpose of that test is to ensure that the infant is adjusting well to life outside of the womb and can maintain safe blood sugar levels. This helps identify if a baby has hypoglycemia (low blood sugars).

Another Sunnah practice is naming the baby on the 7th day. With that comes sacrificing an animal, usually it’s a goat or sheep (2 for a boy and 1 for a girl) and preparing meals to share with family and community members and announcing the name of the baby. It’s recommended to give the child a good name. It’s the right of a child for their parents to give them an appropriate and good name.

Lastly, I asked Bah what she would like people to know about birth doulas?

Birth doulas are a part of the patient care team. Doulas work with doctors and nurses to provide the best support possible for their client. But even with working well with the medical staff, for doulas, our clients come first. Many people in our community do not know about doulas and what they do. What I want them to know is that a doula is one who truly provides nonjudgmental educational and emotional support throughout the pregnancy, labor/delivery and the postpartum period.

Mariama Bah is an engaged and helpful member of the Indianapolis Muslim community and can be found many times volunteering for different programs and attending events at masajid in and around the Indianapolis area.  She is a newlywed, (Mashallah) and enjoys nature, spending time hiking, exploring parks, biking as well as reading, traveling, visiting coffee shops and restaurants and spending time with family and friends.

To learn more about Mariama’s doula services, you can find Rahma Maternal Services on Facebook and Instagram (Rahma_Maternals).  She also has a Whatsapp Group called Pregnancy & Postpartum Support.