Doula

From a literature major in college to a first career in physical therapy, a random ‘shadowing’ experience led her to create and promote improved procedures to comfort women during childbirth. 

FAMILY BACKGROUND

Penny Simkin (PS) was born in Portland, Maine, the third of six children. Her parents owned and managed a hardware store.

CHILDHOOD

PS grew up in Maine. 

EDUCATION

Always a dedicated student, PS worked hard to understand her course readings and teacher lectures toward achieving good grades. Other reasons she hoped would be persuasive for admission to very selective colleges were her high percentile-ranked score on the SAT (Scholastic Aptitude Test) plus teacher recommendations based on her contributions to classroom discussions. 

A books lover, uncertain about her adult career path, BS majored in English literature at Swarthmore College. 

FIRST JOB OR CAREER IS NEVER A BINDING COMMITMENT

Having met her future husband while both were attending the same college, they were married soon after graduation. He proceeded to medical school while BS, newly interested in a healthcare due to her husband’s career path, enrolled in a graduate program to study physical therapy at the U of Pennsylvania. 

When her husband found an opportunity to continue his medical school studies in England for a year, they moved ‘across the pond,’ intending to return to the U.S. While in England, BS ‘shadowed’ several British physical therapists while they assisted women during childbirth. That experience sparked BS’ interest in maternal care. 

The newlyweds return to the ‘states’ coincided with increased attention upon the process of natural childbirth, by both pregnant women and healthcare professionals. Intrigued by such public discussions, BS began to focus her experience as a licensed physical therapist upon assisting women during childbirth – which adopted a word from the Greek language, doula.

DOULA – DEFINED

Doulas are not medical professionals. Their role is to provide comfort to women in the delivery room as well as postpartum care at home. That care might include providing snacks, massages or warn compresses but also more substantive assistance, like suggesting movements to ease labor pains or help with breastfeeding. 

The term ‘doula’ was embraced by alternative birth professionals within the U.S. (though the word’s origin is Greek for ‘female servant’) during the 1970s – 1980s.

By tradition, the activities of doulas are associated with childbirth but there are now ‘death doulas’ who assist both women and men with terminal illness. 

EXPERIENCE PROVIDES THE BASIS TO WRITE BOOKS

BS took no side during disagreements over whether pain-relieving strategies during childbirth were most effective at home or in a hospital setting; her focus was always on the comfort of the mother. 

As the author or co-author of six books regarding childbirth plus leading workshops and training organizations, BS helped to popularize the role of doulas and worked as a doula herself. 

Using her training as a physical therapist, BS created innovations to childbirth care which included a device called the ‘squatting bar’ which is attached to a hospital bed for the mother to hang onto and squat, a position that opens the pelvis and allows gravity to help with the baby’s delivery. 

BS surveyed thousands of women about their birth experiences to better train doulas in preparing women for childbirth. “How will she remember this?” she exhorted her students. 

Early in her career, BS assisted a woman who was traumatized during her baby’s birth and who described the experience as if it was a rape. BS learned later that the woman had been sexually assaulted. That knowledge spurred BS, with a psychotherapist colleague, to research the experience of pregnancy by women who had been abused and how that abuse affected their feelings about giving birth: how the birth process – being on display in a room full of strangers, for example – might be intolerable and how it could be made less so. 

BS and her colleague wrote a book to help others involved in similar circumstances: “When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on the Childbearing Woman.”

BS was a founder of DONA (Doulas of North America – since renamed DONA International), which became the largest such organization in the world.

CAREER SATISFACTION

Peer-reviewed research has recognized how doulas contribute to better birth outcomes – decreasing time in labor and lowering the rates of cesarean sections, among other benefits. 

“Birth never changes,” said BS, “but the way we manage it and the way we think of it, has.”

By BS’ estimate, she prepared 15,000 individuals – mothers, their partners and other family members – for childbirth. 

Dr. Neel Shah, chief medical officer at the Maven Clinic, the world’s largest virtual clinic for women and families, and a former professor of obstetrics and gynecology at Harvard Medical School, who advises policy-makers and institutions on maternal care, recalled the moment over a decade ago when a midwife handed him a copy of BS’ “The Labor Progress Handbook.” 

As this medical leader still recalls, the book “blew my mind. It wasn’t all cotton candy and rainbows. It was like, Here are the positions you can do in labor to help it progress that make sense anatomically and physically.” He added,” It used to be that if a baby was born unscathed, with all its fingers and toes, that was considered a successful birth. But that’s a low bar. Penny’s biggest gift was daring people to imagine the childbirth care we all deserve.”

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This career story is based on multiple sources including an obituary written by Penelope Green, published by The New York Times on April 27, 2024 plus internet research.