When Rachael Stern, 33, and her wife were expecting their first child, they decided to hire a doula to help with the rigors of childbirth, and answer the questions and concerns they may have as first-time parents. Stern, who was director of public affairs for Planned Parenthood at the time, approached the process of finding the right person like hiring someone for a job. After meeting with a couple of highly recommended doulas, she felt something was off with the women she met. "I thought about it for a while and wondered if maybe it was just too much estrogen in the room for me with my wife as well," she admits. "I wasn't specifically sure I wanted a male doula, but the gender or the sex of the person wasn't as important as the right personality." Expanding her search, she came across Mac Brydum, a popular male doula they had heard about.
The couple ultimately chose a male doula because they felt Brydum was the missing piece to the puzzle for the birth plan they had in mind. Brydum is a queer transgender man and plans to use his body parts to gestate and birth a baby of his own in the near future, but, like other male doulas, has not yet gone through a birth himself (as other proponents note, neither have many female-identifying doulas). Regardless, the success he has had in his career challenges many assumptions society holds about gender and childbirth.
"After nannying for a single mom who was in a foster-to-adopt situation, I found that I was more than just her childcare provider — I felt like her therapist, parenting consultant, infant sleep educator, housekeeper and dog walker," says Brydum, 29, who runs That Doula Guy in Denver, Colorado. "Becoming a doula was the perfect fusion of all the things I was already doing and love, and what I'm naturally good at."
A doula (the very origin of the word in Greek means "a woman who serves") is a birth companion or coach who takes the role of the non-clinical entity responsible for supporting the birth mother and family during pregnancy and postpartum. Though the term was coined and first used in late 1960s, for centuries when a woman went into labor she was surrounded by other women and a local midwife, usually an elderly female, as men waited outside the room until they heard the first cry. As obstetrics moved births into the hospital setting, birth providers were overwhelmingly male. In 2018, over 60 percent of practicing members of the American College of Obstetricians and Gynecologists are female; the turning point was 2011, when women began to outnumber men. So women have passed parity as obstetricians, but the landscape of today's growing doula industry is still primarily female, and there has been some resistance to the idea of men assisting in the delivery room.
"I have absolutely been talked down to and castigated, and encountered passive aggressive female nurses who have done whatever possible to remove me from my position," Jay Rodriquez of Seattle, Washington, says. He doesn't think nurses feel threatened by male doulas per se; he says, rather, "I think it has more to do with the fact that they legitimately don't know how to utilize a male birth worker." Like any female in a male-dominated industry, the ones who are “othered” have the most to prove. For Rodriquez, who has multiple Bachelor’s degrees and is beginning Midwifery Apprentice School, he prides himself on his book-smarts and the knowledge he can offer his clients.
The few female students in the course got to spend most of their time observing deliveries, while the majority of students, the men, sat in the nursing station looking through books instead.
As a young boy, Rodriquez spent a lot of time watching his father, a general surgeon, attend to patients' every call or request, no matter the time of the day. "I think seeing first-hand a man who went above and beyond to care for his patients had a deep impact on me," says Rodriquez, 36, who considers himself an “old soul” and believes his Southern roots (think: common courtesy, hospitality and good manners) makes him an ideal candidate for what makes a man excel in the birth industry. Rodriquez, who has been married for eight years and doesn't have any kids, wears many hats. Outside of his doula work, he is a full-time paramedic, and teaches emergency medical services, first aid, CPR, and childbirth education courses.
It wasn't until he was required to spend hours in labor and delivery as part of his paramedic training 12 years ago that Rodriquez realized he was interested in the birth experience. "I knew there was going to be bias, as the few female students in the course got to spend most of their time observing deliveries, while the majority of students, the men, sat in the nursing station looking through books instead," he remembers.
Realistically, paramedics may need to help deliver babies in the back of an ambulance, but Rodriquez noticed they weren't being trained to handle birth complications. Wanting to ensure he had all his bases covered, Rodriquez waited his turn to observe a delivery but was not-so-politely shut out by nurses.
"It was such a turning point for me that I recall the nurse saying because you are not the father and you are not the doctor it's not appropriate for you to witness a birth," he says. (After repeated attempts, Rodriquez finally got in.)
Today, Rodriquez runs The Great Northwest Doula Service, having assisted with 12 births in two years, and hosts regular childbirth classes for fathers who want to be more involved in the process. "I think for many men it's a pretty common sentiment to feel helpless while they watch their partner go through this massive life-altering transformation, especially during first pregnancies. A lot of this has to do with the fact that they have absolutely no idea how to help," he says. The biggest fallacy about male doulas, Rodriquez points out, is that they do not take the partner's spot in the delivery room. "We're there to support the entire family, dads and all types of partners, too."
For those who are skeptical, I would just ask, 'Why can't a man be a doula?'
Doulas not only help parents-to-be become more educated about pregnancy, they help create birth plans, answer questions and give emotional support, outside of being present on the day of the birth to offer physical assistance and comfort and act as an advocate for the gestational parent and her medical team. Some doulas, like Brydum, spend a lot of time after birth with postnatal care, teaching breastfeeding, getting the baby on a schedule, or helping the parents with any of their day-to-day needs. Over his three years working as a doula, Brydum has assisted 26 families through birth and postpartum doula work, but says he's always been the only male in any doula-related training. "For those who are skeptical, I would just ask, 'Why can't a man be a doula?’" Brydum says.
Since garnering new clients comes mainly from word-of-mouth and referrals, Brydum knows that he owes his success as a male doula to his access to the LGBTQ community. "Couples I work with are looking down a long, expensive and emotional path to parenthood, as most queer families do, so families know they can expect a certain level of competence that not all doulas have," he says.
Couples like Rachael Stern and her wife realized the unique perspective he could offer. "I think I did like that Mac was transgender, because somehow it made me feel like he might understand what it's like to have body parts that I did from first-hand experience, though I don't actually know if that makes a huge difference in how he was able to help us through the pregnancy and birth of our daughter," she says. As Stern reflects, she says she doesn't think being a doula has anything to do with gender, or whether a male or female is more suited for the job. "Not all female doulas have been pregnant or birthed children, so there goes the theory that women make better doulas because they have 'been there done that,’" she points out.
In the last five years, DONA International, the largest accrediting body of doulas worldwide, has seen a 47 percent increase in doulas becoming certified, though the group doesn't track how many of those people certified identify as men. While there is no single governing body that regulates the practice (a possible loophole that opponents of male doulas like to point out), certifications require months of training and can be done in conjunction with holding down other jobs.
"We've noticed an uptick in doula certifications in general, but there still isn't a male present in each training session, so overall they're a minority amount," says Tara Brooke, co-founder of Doula Training International (DTI). In her 18 years of being a doula, Brooke claims she's always known of male doulas. "However I think today there are just more people identifying more broadly on the gender spectrum, something I wasn't aware of when I started out," she says. DTI currently has 20 doulas who identify as men and many more who identify as non-binary.
In 2014, the Midwives Alliance of North America (MANA) put out an open letter to the doula certifying bodies to explore using more gender-neutral language and began editing their core competencies documents and guidelines. "There was a huge backlash in the community, especially among elder feminists among us who had a lot to say about their own pride and their struggle fighting to secure the use of 'woman' to what they do," Brooke says. To omit the use of a mother or woman in the biological act of birthing a child went against everything that the early midwives and doulas had fought so hard to get acknowledged for, went the key concern. And as inclusivity picks up pace elsewhere in culture, she says that inside hospitals, male practitioners of the female-dominated industry still feel a stigma when they enter the room.
A male doula could offer a perspective that was possibly more open, especially since they hadn't gone through it [childbirth] before.
"I wanted to hire a doula who could assist with me getting a VBAMC (vaginal birth after multiple Caesarians), and Jay's background in emergency medicine set him apart from other doulas my husband and I interviewed," says Dawnann Netherton, 36, who has five kids. "My husband knew the challenges I was going to face with attempting a vaginal birth, and since he was kind of clueless how to help me, he knew by having a good support system going into this would not only help me but help him, too," Netherton says. "But most of my family kind of thought I was nuts," she adds.
"With what I was facing with a VBAMC, I knew that some females wouldn't be as supportive or nonjudgemental as I'd need them to be. But a male doula could offer a perspective that was possibly more open, especially since they hadn't gone through [childbirth] before," Netherton says. Since a female may have “been there and done that,” their personal experiences could actually hinder their perspective to offer fair and practical advice, rather presenting ideas based on what worked for them, she thought. So while Rodriquez wasn't quite taking the place of her husband, Bill, he was acting as the more-informed-and-seasoned birth companion that her husband knew he could not be.
"At the end of the day, Jay is a married to a woman! It wasn't uncomfortable or weird having him in the birth room — I didn't have anything he hasn't already seen!" she laughs. Her husband agrees and saw Jay as an extension of the medical staff, nothing more and nothing less.
"I'd highly recommend a male doula. What was most reassuring for me was knowing that I had two people — one slightly more educated in childbirth than my husband — that could help during labor," Netherton adds. "If it became too much for my husband, or he simply needed a break, I wouldn't be left alone or have a partner who is too weak to do any good."
Rodriquez, who can charge as much as $600 to $1,000 per birth, also works pro bono or offers discounted rates to those in need. He's aso become more in demand amongst the military wives community who more often than not are far away from their extended family, and during pregnancy and labor can benefit from a formal support system and the presence of a male companion in the delivery room.
The scarcity of men could reflect the widespread perception that being a doula is a woman's job. "There are plenty of male obstetricians. No one is questioning this. There are male nurses. Where are the questions there? And cis-female doctors are not always more nurturing," Tara Brooke adds.
A thread about male nurses on the "Love What You Doula" Facebook page, showcased concerns amongst its 12,000-plus members about the presence of men in the delivery room. "I don't want a male anywhere near me in birth unless he put the baby I'm birthing in there. It might be discrimination but I have no desire to be tended by someone who could never possibly know the emotions and sensations I'm feeling," said one such poster.
Other commenters raised the red flag that the presence of more men in the delivery room, once considered a sacred feminine space, could have a triggering effect for a woman who has been a victim of sexual assault. "If a woman has suffered past sexual trauma, it could be stressful for her to be supported by a man unless he is chosen specifically by her," says Julee Clerkin, a doula since 2010, who now lives in Ireland, where she doesn't know of any male doulas.
So why then, if a woman chooses to allow a man to accompany her during one of the most intimate and personal experiences of her lifetime, should we care, if at all? After all, the choice to hire a male doula is entirely your own, even if the loudest critics are against it.
Hiring a doula is becoming more mainstream. Websites like doulamatch.net allow users to find a doula to match their specific needs among its vast 9,000-plus applicants (with no accurate count of how many are male). And in New York state, Governor Cuomo has announced coverage of doula services by Medicaid, along with a series of initiatives aimed at addressing the disturbingly high rate of maternal mortality among black women (who are four times more likely to die in childbirth than white women in NYS, according to a study released last year). New York tends to be more progressive than other states, so legislatures elsewhere might see a push for the same type of aggressive initiatives to help women access better prenatal care. Which would mean the booming doula industry could become more flooded with willing participants who want to aid you as you breath, pant, and push your way through childbirth.
And like every bustling industry, there are outliers. Without a true governing body that oversees every doula certification training course (unlike MANA for midwives or ACOG for obstetricians), the people we are trusting the most not only with our bodies but our babies, may not always be who they seem to be. At press time, reports of a rising male doula being ousted as a predator who had infiltrated the birth room, preying on insecure or financially unstable women, were circulating among members of online, informal doula groups. "Someone like this gives those who want to see birthwork as a solely female endeavor a very valid reason for why men should not be allowed to enter their ranks," says Rodriquez angrily.
No industry goes untouched in the days of #metoo, and while no man in particular wants to be put in a position of defending his gender, it inevitably feels like a setback to male doulas who are trying to break through their own glass ceilings. And as society slowly shifts towards a more gender-neutral view of the occupations we once assigned specifically to boys or girls, male doulas will remain focused on the task at hand: the birth of something new.
CORRECTION: A previous version of this article incorrectly stated the year Rodriquez began paramedic training, and misidentified his services as being priced per session; costs are per birth. It has been updated to reflect these changes.