Less than twenty-four hours before Ameya Menta, A23, M28, attended her first live birth, she sat through the funeral of one of her closest mentors. 

A few months earlier, Menta, a medical student at Tufts University School of Medicine, had undergone training to serve as a doula, a person trained to support a birthing parent with the non-medical aspects of their childbirth journey. Her client wasn’t due for another month, but after that emotional day, Menta received a text alerting her that labor had begun. She rushed to the hospital and began supporting her client through an early, but thankfully uncomplicated birth. 

“It felt like the most circle of life thing I had experienced—I went from seeing one of life's lowest lows to life's highest highs,” says Menta. “It was so impactful to me to kind of zoom out a little and be like, ‘Wow, this is what we're doing this for.’”

The experience cemented Menta’s excitement about her medical career and the ability to support individual patients, an act she sees as an essential underpinning to larger public health goals. Menta signed up for Tufts’ Medical Student Doula Program within a month of starting her medical school career. She’s now a co-chair of the program, which accepts up to 30 Tufts students each year to be trained as doulas. 

Those students undergo a three-day intensive training at Tufts Medical Center offered by Allo Doula Academy, a Colorado-based provider of doula certifications. The training teaches birthing positions, physical exercises that can help birthing parents, and other techniques to assist during labor; but students in the program say the biggest tool they’ve gained is knowledge on how to be there in the way clients need. 

“By far, the [technique] that I think we use the most is being present, being supportive, checking in,” says Nafisa Munawarah, A23, M28, another medical student and co-chair of the program.

After medical students complete the training, the student-run program pairs each new doula with a client who they will support throughout pregnancy, free of charge. Doulas check in with clients regularly and attend the birth. They also follow up with clients in the postpartum period to ensure all is going well. Since the program began three years ago, the group has trained 45 doulas who have attended 23 births, with five more expected this summer.

Unlike medical doctors, doulas do not give medical advice. They play a support role, helping clients with understanding information shared by their doctor, advocating for their needs, or determining what they want their birth to look like, among other tasks. 

In the United States, the maternal mortality rate is relatively high compared to other wealthy countries. And those rates are three times higher for Black birthing parents. They are also heightened for people with lower incomes. Doulas can help change those outcomes for both birthing parents and their babies. 

“Many studies have shown that patients who are supported by a doula do have better outcomes,” says Jennifer Roberts-Barry, the OB Nurse Navigator for the Tufts Medical Center OB Teleflex Program and the administrator for the Medical Student Doula Program.

One study of nearly 2,000 mothers found that the group who had doulas showed 7.8% fewer cesarean-section deliveries than the national average and a 5% drop in premature births. Other research suggests that mothers supported by doulas are much more likely to attend childbirth classes, less likely to use pain medication during a birth, and more likely to breastfeed.

Still, many birthing parents are not aware of doulas or the services they provide, and it has taken time for physicians and doulas to navigate their roles in the delivery room. Menta believes the perception of conflict between the two is largely a misconception. She feels that training as a doula during medical school can help ease any potential tension and foster better collaboration. 

“With our overlap of being medical students and also doulas, we're hoping to remove some of that stigma around doula care in medical settings,” she says. Students work on “being as aware as we can of the medical system and their roles, and also the doula role, and how those can be separate but also coexist at the same time.”

Individual Interactions, Stronger Bonds

Neither Menta nor Munawarah have decided on a medical specialty, but both have long been interested in public health. As an undergraduate at Tufts, Menta began working in the Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, which, as part of the Center for Black Maternal Health and Reproductive Justice, focuses on eliminating inequities for Black women when giving birth. She continues to work in the lab and says it has been a personal mission to become a doula. 

Munawarah grew up in Bangladesh, in a culture she says contrasts with America’s individualism. After receiving her bachelor's degree from Tufts, she worked as a child developmental specialist, supporting families with young kids and helping them access community services they may need. The type of help she was able to provide, she says, felt more closely aligned with the collectivist vision of community-oriented health that she grew up with. 

Now, rather than working solely within policy and advocacy, both Munawarah and Menta hope to provide specialized support to individual patients as physicians. “My motivation is very much to learn from the smaller individual interactions that we have with our patients and let those experiences inform the bigger changes we can make in public health,” says Munawarah. 

Both say the doula program has reinforced the significance of the bond they can build with a client, while demonstrating the importance of slowing down and focusing on ensuring that patients feel heard and supported. Working so closely with clients as doulas, Menta says, makes clear the importance of a physician’s work. 

“A lot of times, the first few years of medical school can feel a little bit detached from the side of medicine that you initially came in for,” she says. Doula work, on the other hand, is extremely rewarding: “Even if you're spending 12 hours at a birth, those 12 hours can actually be so restorative to you, replenishing your passion and your drive to keep doing this and keep pushing forward, because you see the actual impacts of what you're working for.” 

Despite those passions, it can still be difficult to juggle such responsibilities with the constraints of a medical school schedule. “Med school is really hard, and it can get all-consuming at times,” says Munawarah. 

To support each other through the program, medical student doulas meet once a month in a group, and one-on-one when needed. 

Ultimately, both Menta and Munawarah say the program has significantly changed how they expect to approach their careers as doctors — recognizing what Munawarah calls “the power of support” alongside more traditional medicine.   

“We're so caught up in providing the best care possible,” says Menta, “sometimes that means just showing up to be by someone's side, which can make the biggest difference in the world.”