Our Interview with Accompany Doula Care Co-Founder Alejandra Garcia, MPH

“I’m feeling so proud of what [Accompany Doula Care has] built, that it’s working, it's working well, it’s growing, it's very successful, and it has all the tools that it needs to continue the work.”

Alejandra Garcia, MPH, co-founded Accompany Doula Care in 2017 and served as the organization’s Board President until 2024. Hailing from Venezuela, Alejandra is fluent in English, Spanish, and French. Since 2016, she has also proudly served as a doula, enriching her understanding of maternal health and furthering her commitment to making a difference in healthcare.

We spoke with Alejandra about her background, her drive to improve maternal health outcomes, her passion for doula support and more. Read our full interview below!

Can you please tell me a bit about your background and work experience?

My background is in biomedical engineering, and I have knowledge of operations. From that experience working in the hospital and in the operating room, I got to witness many, many, C-sections. Among one of them was one of my friends, who asked me to join her C-section because she knew that I could enter the operating room. 

That’s when I learned about women experiencing trauma in childbirth. In preparation for the C-section, she told me about [doulas], and I invited a doula. That’s when I learned what a doula was. That was a life-transforming experience for me. The experience of having a child with a doula in the room is totally different. At this point, I’d already seen over 50 C-sections, and the differences were very, very palpable, and powerful for my friend. She was able to transform a traumatic experience into a positive one and experience motherhood again with a totally different lens.

From there I was like, “Okay, now, I have to do something about it. I can’t just ignore this problem now that I know that it is there.” Once you see it you cannot unsee it, right? That’s when I learned more about doulas. I did my doula training in Venezuela, and I set up a program in the hospital where I was working to have conscious c-sections, increase breastfeeding rates, and decrease traumatic experiences in giving birth. After creating that program, I wanted more tools to do this better. That’s when I decided to pursue my Master in Public Health and get more into the knowledge of doula work, and maternal and child health. I came back to Boston and pursued my MPH at BU (Boston University) and did doula training with DONA.

In the program, I met Christina, and then I met Lorenza, and then I met Vanessa, Angela, and Chelli. That’s where we started brainstorming and put our dreams on the whiteboard and that’s how Accompany was born. 

How have you seen Accompany grow since its founding?

I am so proud of what we have achieved today. Just personal backgrounds and interests, I like to build things, create things, put them together, and make it work. When things are working, I’m like “Okay, perfect. I’ll let you be.” 

I’m feeling so proud of what we have built, that it’s working, it's working well, it’s growing, it's very successful, and it has all the tools that it needs to continue the work. Then, I’m like “Okay, perfect. You’re fine.” Of course, I don’t think I will be disengaged from or ignoring Accompany ever. I am just so proud and passionate about this work that I am always going to be involved, but I don’t need to be in the every day or anything. I trust immensely in the people we have put in leadership, and in the talent we have attracted in the recently-expanded Board. We have amazing new members that started a couple of months ago with Accompany and I’m like “Okay, continue.”

When you think about some of the most significant challenges facing maternal health in Massachusetts or even beyond Massachusetts what do you think they are?

I think we still have to do a lot of education around this. Even from six years ago, when we started this, a lot of people didn’t know what a doula was. I had to explain it all the time. Now I drop it in conversations and people say, ”Oh yeah I’ve heard about it.” So, I’m glad that the profession has had more exposure and that people are more interested in it. 

I also think it varies with age, right? I think people that are 50 plus, back then it wasn’t that popular so they don’t know about it. People around 30 or 30 plus, if they are really into learning about maternal health, they have had some exposure. Also, it’s a challenge because teenagers or 20 plus, they aren’t necessarily surrounded by people that are having babies early on. It’s just a topic you don’t worry about until you are in the situation. So, maybe bringing more education early on so that you are prepared when you are in the situation. That’s in a global landscape I think. 

Now, we still have a lot of work to do with how to treat women of color, listen to their needs, be there for them, and dismantle some of the preconceptions and biases that are in the industry and in the space. One of our main missions in Accompany is to integrate our work with the healthcare system. I think that’s one of the most important things because if we gain that marriage, then we will have more access for the people that really need it and also try to lessen the medicalization of the ritual of giving birth, allowing the process to be more natural and bringing the wisdom of the body.

What’s your perspective on how important doulas are to improving maternal health?

Essential. I think that was recognized during COVID for a lot of institutions. Also, we were doing the previous work by working with the institutions and doulas. They like our work ethic and how we blend well with their team. When the pandemic hit, they were like, “Yeah, we will recognize Accompany doulas as part of the essential team.” 

But, in other hospitals, or in other states, they were not recognized, and that hurt the process. I think it's essential. I brought up education as the main topic because doulas are essential, but not necessarily every family is a good fit for a doula or needs a doula or wants a doula. So, that’s also our mission, “A doula for every person that wants one.” It’s not something to be imposed either. 

But it brings so much value for the parents that really need it. If the doula presence is not needed during birth, that’s okay, but I think its always needed at least previously or afterward for the knowledge of what to expect during birth, or during pregnancy, or how to prepare the body, or the support the family needs for breastfeeding, for your mental health, for your sanity, for your laundry, for anything.

I’ve heard a lot of people describe doulas as “advocates” as well. I’m wondering what advocacy means to you as someone in public health, as a doula, and as an Accompany board member. What does advocacy mean?

As a doula, I think I have noticed parents – and it's a generational thing, an educational thing, perspective, values – [think] the advice of a doctor is the law, right? So, if the doctor says you need a C-section, you need medicine, you need whatever, a lot of the patients are like “Okay, that’s it.” I think if you educate yourself about the options that you have, you can bring the advice of the medical field into question and really think if that is the best option for yourself. Maybe it’s the best or the recommended procedure, protocol, or policy, but maybe it's not the best that works for you, your family, your situation, or your body. 

Having the knowledge to advocate for yourself or to have the support of the doula to advocate for yourself is important. Then we put on another layer. If the families are immigrants, then the doula can support not only the medical aspect of it, but navigating the medical field, and navigating all the other layers that can be affecting the situation in their life: implicit bias, or discrimination for your race, sex, your ethnicity, anything. Also, advocating with family members is a strength, a skill, or a positive a doula can bring into the picture. 

Then, the macro-level in advocacy is to make the changes to be able to achieve amazing policies, like the Massachusetts bill that was recently passed – it has been a while now, but it’s still very recent -, but in other states. Also, a couple of years ago, like when I couldn't believe we were still talking about Roe v. Wade and having others decide how your body is affected. So, that's why I’m so proud of the doula profession and the public health profession in general.