What All Laboring Parents Can Learn From The Work Of Deaf Doulas

by Lisa A. Goldstein

“I want to see how both of you are doing,” doula Brittany Noschese says to an expecting mother. “How do you feel? Excited?” This question could be asked of any doula client, but this particular scenario is different. Noschese, along with her partner Ally Balsley, are Deaf doulas who communicate via American Sign Language (ASL), and cater to clients just like them.

Together, they run a business tailored to those clients, Hand Waves Birth Services, but hearing loss isn’t required in order to learn from this unique service. After all, everyone has the same goal once she’s in labor: to deliver a healthy baby. The journeys may vary, but the strategies are universally applicable.

You can see Noschese and Balsley at work in season 2, episode 4 of “Romper’s Doula Diaries,” in which they helped a second-time mother, Niesha, through a home birth. Although Niesha had an ASL interpreter present at her first birth, she wanted an advocate present the second go round.

Noschese herself did not have an interpreter present at any of her three births; she says she learned “the hard way” about everything from birth to breastfeeding to postpartum. In her work since, she has learned to tune into the needs of laboring people. For deaf or hearing women, the pre-frontal cortex dims its control during labor, and the limbic system takes over, as Pregnancy to Parenting Australia explains, resulting in instinctive, uninhibited behaviors. A birth advocate needs to know how to communicate with a mother in this altered state of consciousness.

Birth Partners Need To Understand Non-Verbal Communication

Even if you have a thoroughly researched birth plan and a practiced Lamaze partner, all bets are off once labor begins. “Communicating non-verbally is universal,” Balsley and Noschese say. Non-verbal communication is often used in exchange for words, including when eyes are closed. This type of communication is expressed in three ways: touch, facial expressions, and body language.

Body language — nods, gestures, moving from side to side — are some examples of communicating.

Tactile communication includes tapping, rubbing or squeezing certain body parts like an arm, leg, or back. If the birthing person has her eyes closed, blowing on her shoulder or somewhere on her body can help remind her to breathe.

Facial expressions like raising eyebrows or wiggling the nose can be an easy way to convey messages. Similarly, body language — nods, gestures, moving from side to side — are some examples of communicating.

Think about all the wordless transactions you have daily; this is no different. Well, aside from also expelling a human baby from your body.


Deaf people tend to be more visual and tactile, and they’re cut off from communication when their eyes are closed, so touch is especially important. Where and how this occurs boils down to comfort level and personal preference. “Discussing communication styles in prenatal meetings is recommended for everyone,” Balsley and Noschese say. Talk to your partner and doula or midwife about this!

You Deserve To Have An Advocate Present, No Matter Your Needs

Deaf individuals face various challenges in labor, from getting limited information to limited access to communication, and more. Because everyone deserves to make informed decisions and provide informed consent, it’s essential to be a full partner in the birth experience. As Deaf doulas, Balsley and Noschese understand the deaf experience and can advocate for families. They provide resources, explain and even expand upon anything families need to know in their primary language of ASL, and empower them to ask questions that lead to better understanding.

If you feel that your healthcare providers aren’t doing their jobs communication-wise, find someone else.

There are other lessons to be learned here: If English isn’t your first language, don’t hesitate to request an interpreter. If you feel that your healthcare providers aren’t doing their jobs communication-wise, find someone else. This is your birth experience; take ownership of it.

And go one step further. Be an advocate for others. “Try to understand that we live in a society with a system of oppression, and this unfortunately happens in the birthing world, too,” Balsley and Noschese say. “Persons with disabilities, of color, and/or within a social identity group and more are denied language, education, and opportunities on a daily basis. Be educated on informed consent and advocate for access for ALL.”

You Deserve To Be Given All The Information

Balsley and Noschese are often asked by other doulas how to best meet their deaf families’ needs. Their first response is “Representation matters.”

It’s important that the doula community understands that deaf families should have deaf doulas or should be offered the choice. If a doula knows any deaf doulas in the area, offer to refer the deaf family to the deaf doula. If there aren’t any deaf doulas, doulas who know ASL are the next best thing. If that doesn’t exist either, Balsley and Noschese encourage doulas to familiarize themselves with the deaf community and be involved while being mindful of their space.

“We also encourage them to ensure their families have access to communication and information, so that they experience birth as a new family welcoming a baby rather than as a deaf person/family welcoming a baby,” they say.

Hand Waves does more than just “doula,” as they also advocate for accessibility and better care and empower their families to know their rights. They truly value reproductive and birth justice within their community. And this, frankly, is what everyone should stand for as well.

“Our hearts are in what we do,” say Balsley and Noschese. “We love what we do-ula.”