Notes From The Salon: What is a Full-Spectrum Doula Anyway?

– Sarah W., BADP Doula and Blogger

The third BADP salon focused on what full-spectrum doulas do and why they do it.  The presenters were full-spectrum doulas Poonam Pai and Signy Toquinto as well as Ziska West who is working to complete a dissertation on the integration of mental health services in gynecological and women’s primary care.

Photo by Mary Franck, Million Fishes Art Collective

Ziska opened the night’s presentations by discussing her own background, including working as the only onsite mental health provider at the Women’s Community Clinic.  She also shared some distressing statistics on the state of women’s health in both the U.S. generally and San Francisco specifically:

  • In 2010 the National Women’s Law Center report, Making the Grade on Women’s Health: A National and State-by-State Report Card, concluded that women’s healthcare needs are inadequately addressed in the United States in general, and in every state. 
  • According to 2010 US Census data, women in the US, and specifically those in San Francisco, were more likely than men to be below the poverty line.
  • In San Francisco, women head 92% of low income single parent households, which make up 48% of all low-income households in the city (DeNavas-Walt, Proctor, & Smith, 2011). 
  • In California, 45% of nonelderly adult women are uninsured (Kaiser Family Foundation, 2009). 
  • On an annual basis, women pay more than men for overall healthcare, including primary care, specialty care, emergency services, and diagnostic screenings (Bertakis, Azari, Helms, Callahan, & Robbins, 1999).


Next, Signy talked about her experience as a birth doula, focusing on issues of access to the proven value of doula support.  Birth doulas provide various non-medical types of continuous support for someone giving birth.   As she described it, “As a birth doula you are there to support this individual no matter what.”  That means even if the birth doula doesn’t personally like choices the birthing mom is making, or would have made different choices herself, she continues to offer unconditional support.

The importance of this kinds of support can be measured in several different ways.  Signy shared statistics published by DONA indicating that doula support decreases likelihood of cesarean section, use of vacuum extractor or forceps, use of analgesia or anesthesia, and dissatisfaction with a birth experience.

Signy argued that access to this kind of support should be available to all birthing women.  The volunteer doula program at San Francisco General Hospital is an example of one way that doulas are working to bring their services to underserved populations. 


Poonam then talked about her work with the Doula Project in New York, a group which started in 2007 with just two doulas in one hospital and has grown to now encompass 40 doulas working in four abortion clinics, as well as providing support for other pregnancy outcomes. 

The group in New York chose to call themselves “abortion doulas” deliberately in order to begin to bridge the gap between the birth community and the reproductive justice community.

Because women seeking abortions are often not permitted to bring a partner or loved one with them into the procedure room, abortion doulas can fill an especially critical support role when they are given access to those spaces.  Poonam described how her work involved everything from holding hands, wiping tears, and offering calming breathing techniques, to telling jokes, fetching hot pads, and making distracting small talk.

According to Poonam, full-spectrum doula work is about providing support for all pregnancy outcomes.


Ziska wrapped up the formal presentations by pointing out some ways in which different kinds of reproductive health workers can collaborate to provide increasingly better support for people seeking reproductive health care.  As a mental health worker she is aware of mental health issues that commonly present during unplanned or difficult pregnancy experiences, and she wants to work together with doulas and others to share knowledge. Ziska is available for consultation with doulas and other women’s health providers. Email her at

In light of this call for collaboration, it was therefore fitting that this salon featured a lengthy audience participation period, during which questions were raised and discussed about supporting people throughout the gender spectrum, the availability of doulas nationally, support for making the decision whether to choose an abortion, support for medical abortions at home, working with communities of color, and more.

It’s clear that all of us interested in women’s reproductive health – full-spectrum doulas, mental health workers, clinicians, patients… – have a lot to teach each other.  There was some mention of the possibility of the BADP salon series continuing beyond its initial four weeks.  Do you have knowledge to share at a future salon?  Or questions you want answered at one?  The BADP wants to know. 

And do be as generous as you can when we pass the hat.  Donations go directly to a tiny budget which enables the organization to maintain this website, print flyers, run the salons, and offer training for doulas who can’t afford it themselves. 

For now, there’s one more Salon planned.  Please join us:


All about the Placenta: The Science, Art, and Eating of the Placenta.

Wednesday, March 28, 2012

The title says it all! Come learn and play with us as we discover the beauty and science of the amazing placenta and the role it plays in women’s heath pre- and post- natal.

Barby Zeldovich has a PhD in Cell & Molecular Biology from UCSF where she researched placental infection in preterm labor. She will talk about the science of how the placenta is formed by the developing fetus, how it functions, and the role it plays in pregnancy complications.

Amber Dawn Hallet of Moon Belly Doula will present on the process of raw placental encapsulation. Amber is a birth doula and who studied Traditional Chinese Medicine in graduate school who offers placental encapsulation services to women in the Bay Area.

Kelly Gray of Nine Moons Doula will show a short film about the birth of a placenta and the creation of placenta prints. She will also display her own recent exploration of the creative process of placenta printing and will have reproductions of placenta prints for sale.

Million Fishes Art Gallery

2501 Bryant Street, San Francisco, CA

$10-20 suggested donation. No one turned away for lack of funds.  All proceeds go to the Bay Area Doula Project

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