The Turtle Women

Although a doula had been with Pat Welch when her daughter was born, she hadn’t been able to afford a doula two years later, at the birth of her son. When the pushing stage of labor triggered an episode of post-traumatic stress disorder, Welch decided that she was not ready to push and that she wasn’t going to do it. “I remember being yelled at, and at that point, you’re like, ‘Yeah? Well, make me!’” Welch recalled.

The child’s father and another friend were present, but they weren’t able to talk her out of that fear. At just the right time, a friend of 20 years showed up. “Martha got very close to my ear, and in a very firm but soft voice said, ‘You better start pushing, and you better start now.’” Welch was then able to move ahead with her labor. “What I needed was that person I trusted.”

Because of that experience, Welch was convinced of the importance and power of doulas. She was also aware that some people who most need a doula aren’t able to afford one. According to Jennifer Nunn, former president of Doulas of North America (DONA), the average cost of a doula is between $400 and $500, and in parts of the country costs can run as high as $1,000. Although an increasing number of health insurance policies cover the service, a vast majority of them do not, Nunn added.
Pat Welch saw a need and took action. She received a grant and founded the Turtle Women’s Project, a culturally specific program providing free doulas for American Indian mothers and operating out of the American Indian Family Center in St. Paul, Minnesota. More than five years have passed since the birth of this project, and it has grown and merged with other local doula programs that it originally helped inspire. Now the American Indian doulas, called Turtle Women, work through the Family Center Community Doula Program, which also offers culturally specific services for Hmong, Latina, African, and African American women. Jessica Atkins, coordinator of the Community Doula Program, said it serves several hundred mothers every year, from those who have recently discovered that they’re pregnant to those whose babies are two months old. The Turtle Women work with 10 to 20 of those mothers, she added.

A Culturally Specific Program
Pat Welch created the Turtle Women’s Project to be culturally specific, beginning with its name. Because in most American Indian tribes the turtle symbolizes creation, instead of using the Greek word doula, meaning “woman servant,” the program calls them Turtle Women. These Turtle Women receive DONA training for doulas, but they also have the knowledge that comes from being American Indian.

“All the Turtle Women are American Indian, and there’s just a sense of really knowing that you don’t have to explain anything,” Welch said. For example, a laboring woman wouldn’t need to take her focus off her own experience to tell a doula why she wanted to smudge a hospital room. (Smudging, the traditional practice of burning sage, is done to cleanse the surroundings.)

Tara Rasmussen, who gave birth to her third child accompanied by a Turtle Woman, said it made her happy that the hospital room had been cleansed with burning sage before her child was born. It was a smell that she had grown up with, and one that she enjoyed. It also gave her a sense of peace. “I felt it was good for my baby to come into the room smelling sage,” she said.

Smudging, playing traditional music, and having another native woman present can help make birth a ceremonial experience for mothers, said Jennifer Almanza Lopez, a Turtle Woman who has since left the program to pursue training in midwifery. Almanza Lopez wants to help acknowledge birth as a precious time when the spiritual becomes tangible.
Turtle Women can also help bridge communication barriers during birth. Betty Day, another Turtle Woman, said that mainstream American culture differs from many American Indian cultures around such issues as when it’s appropriate to touch, speak, make eye contact, or use humor. For some mothers, dealing with issues of cross-cultural communication might be a distraction during labor. As someone who is attuned to those differences, Day is able to help mothers relax and focus on childbirth. “When you go into labor, you need to go into a place where you can just take care of yourself,” she said.

Jennifer Almanza Lopez added that she often works with very young women, who usually don’t trust the medical authorities but are often reluctant to speak up for their needs. “Culturally, they’re very quiet when it comes to communicating with people they’re not familiar with,” she explained. In meeting with women before birth, Almanza Lopez tries to prepare them to speak up for the birth they want.