Ana Paula Markel became a doula because of her own experiences giving birth to four children. She gave birth to her first child at 21, with a compassionate doctor in a calm hospital room in Brazil. Then she moved to Los Angeles, where her second birth was "rushed, cold and scary," as she remembers. For her next two pregnancies, she and her husband hired a doula — a certified professional who provides mothers and their partners with emotional, physical and informational support. That made a world of difference to Markel.
"It felt like moving from the Middle Ages to the Renaissance," she says. "Even though I was an educated, well-traveled woman, I had no idea how my own body works. Having a doula gave me confidence to trust my body and communicate my wishes to the medical staff."
That gift meant enough to Markel that she became a doula herself. Her Los Angeles clientele includes well-known actors and performers who speak gratefully of her service, along with women from diverse walks of life. She teaches popular childbirth and doula training workshops, and she has helped the profession develop international training networks.
Now Markel has joined the faculty of the Simkin Center for Allied Birth Vocations at Bastyr University, helping the training program expand in Southern California. She will teach Birth Doula Skills workshops (open to the public) at the Simkin Center's new San Diego campus.
"I want to offer women what I had been given, and also what I didn't have with my two older children," Markel says. "Having the support of a doula impacted me tremendously as a mother, because it gave me tools for self-growth. It helped me learn to speak up and communicate with others with confidence and kindness."
She views her work as "making the voice of the mother matter," whether women give birth at home, birth centers or hospitals. Mothers and their partners shouldn't be tied to one outcome, she says, but they can expect to have an active, informed role in their births. Markel gave birth to her first two children through cesarean section, and her second two vaginally, and she says the method was less important than how she was treated during labor.
"If birthing women are treated with respect and kindness, they will be transformed regardless," she says. "That's less important than choosing between 'natural' or 'conventional' methods. To me, the important questions are, 'Were you informed?' and, 'Were you treated with respect?'"
Markel's knack for communicating a lively, clear, affirming message has helped her become a public advocate for birth professions, appearing on CBS News, The Ricki Lake Show and elsewhere. Her Twitter page includes the pithy line "Pizzas are delivered! Women BIRTH babies!"
"That line has become very popular," she says. "People ask women, 'Who delivered your baby?' I tell women that they give birth to their babies. They may need medical assistance, but even if they have to give birth by cesarean section, nobody births a baby but the mother herself."
She borrowed the pizza quip from The Business of Being Born, a documentary series in which she appears alongside clients such as musician Alanis Morissette, who describes Markel's warm hands feeling like a balm during labor.
She has also provided birth support to Penelope Cruz, Christina Applegate, Laila Ali and Alyson Hannigan, according to media reports. Markel doesn't bring up her famous clients, whose privacy she respects. When asked about them, she says only that well-known women have the same wishes as any expectant mothers – to be treated with decency and kindness during a vulnerable time.
"People working in the public eye have a whole set of anxieties and fears that most people don't know they have," she says. "They have a true fear of the media, of being exposed, and it's not a frivolous thing."
Some well-known clients who want to promote the doula profession encourage Markel to use their names, such as Morissette. For all of them, she protects their privacy by not displaying doula stickers on her car — so she's not identified by paparazzi when visiting their homes. She says she's never been asked to sign a confidentiality agreement, because her clients learn that all certified doulas respect their clients' privacy.
"Once they learn that confidentiality is part of the rules of conduct of a doula, they feel very safe," she says.
Markel's training program, BINI Birth, also offers free childbirth education classes and links low-income expecting mothers with doulas going through certification. It also provides doula-training scholarships for low-income women.
At the Simkin Center, Markel will work with leaders she's come to know through DONA International (formerly Doulas of North America), the leading certification organization for birth and postpartum doulas. She will teach the Birth Doula Skills Workshop July 25 to 28 in San Diego along with Simkin Center instructor Sharon Muza, CD(DONA, PALS), LCC.
"I really respect the Simkin faculty," Markel says. "I know most of the trainers and admire their work and methods of teaching. I'm also excited to co-teach with somebody else, since I've always taught by myself."
The Simkin Center is named for Penny Simkin, PT, CCE, CD (DONA), widely considered the mother of modern childbirth education, who still teaches at the center. Simkin Center director Annie Kennedy, CD (PALS), met Markel through DONA International (which Kennedy co-founded). Kennedy was impressed by the breadth of Markel's international teaching experience, in Brazil and elsewhere. She was also struck by Markel's passion in The Business of Being Born.
"She spoke from the heart about what she does and what she cares about," says Kennedy.
Learn more about birth professions training from the Simkin Center in Seattle and San Diego.