A life of the military doula.
When I returned to Okinawa with my family back in the fall of 2011, I had no clue we’d be where we are at today with a steadily growing birth network.
My husband is a Marine so Okinawa is one of the few of places we can be stationed at. The life of a military family has to be flexible to change. While some do get the luxury of staying at one duty station for an extended period of time, many will be living there temporarily. Then literally uprooting every aspect of our lives every 2-3 years. In some special cases, 1-2 years. It’s not a lifestyle for the faint of heart. Especially when being stationed overseas.
Okinawa is the largest island of more than 140 islands in Okinawa Prefecture. Its history is flooded with beauty, culture, people and delicious food. Okinawa also carries a dark past, it is known for a season of war. Placing a large battle between the Americans and Japanese. Which over time planted American military bases on this tiny island. The US military presence in Japan and on Okinawa began at the end of World War II.
Okinawa hosts more service members by far than any other prefecture. (Reference 1) According to U.S. Forces’ Japan headquarters at Yokota Air Base, as of February 2016, there were 47,200 service members based in Japan, including 11,700 aboard vessels of the 7th Fleet. In addition, there were 3,510 U.S. civilian personnel and 41,695 family members. Of the 47,200 service members, 17,400 were in the are Navy, 15,000 in the Marines Corps, 12,300 in the Air Force and 2,500 in the Army personnel.
Our first tour in Okinawa was from 1998-2005. My oldest two children were born at the old Navy Hospital on Camp Lester. Let’s just say, I am thrilled that today there is a brand new hospital for families. So when we arrived back in Okinawa in 2011, I was familiar with our location but not with the birthing community. I was quite young and not well informed about birth with my first two children. I’m embarrassed to say, I knew how baby’s came out, but that was about it. I was clueless about all those aspects of birth. Here I was, a certified doula, fresh from California, trying to obtain information and ready to get to work.
There didn’t seem to be much of anything network wise in Okinawa. Another doula was on island but she ended up relocating stateside not long after my arrival. I found myself alongside a couple of aspiring doulas and surrounded by several pregnant women.
They call this tour the “Two Baby Tour”. I attest to that from personal experience because I was one of them. Either you arrive in Okinawa pregnant and then give birth or more than likely you’ll have one more baby's before leaving. Some say it’s in the water, but I’d venture to say it’s those ornery typhoons and boredom that causes the influx of pregnant women on island. On average a 100 babies are born at the hospital on base each month. I’m sure down time is much appreciated.
With many expectant families here, our small group started holding a monthly support group called Birth Talk to support and educate people. We named our little tribe, Birthing in Okinawa. Over a couple of months, the word spread. We would just see more and more women attend. Then dads started coming. It was amazing. Everything was growing very quickly. At this time I was working full time as a birth doula, taking anywhere from 3-4 clients a month. Sometimes having the benefit of a back up doula but a majority of the time it was God working it all out. The other two doulas here would do what they could, when they could and I was very grateful for their help. Eventually there was becoming more of a demand for doulas. I was not able to take on more than what I could already handle. Plus, many women in the community were starting to inquire about how to become a doula including ladies on mainland Japan, stationed at smaller, more secluded places. The base was also starting to tell us we were not able to use their facilities anymore because we were not an organization. About this time, my trainer Gerri Ryan, founder of San Diego Birth Network & Nihizoni Midwifery Institute came over to facilitate the first DONA Doula workshop in Okinawa, Japan. We had 12 women in attendance. I was thrilled. Within a matter of two years, Linda Herrick, DONA Birth Doula Trainer from the Academy of Certified Birth Educators of Kansas City and Ann Grauer, DONA Postpartum Doula Trainer of Nurturing Doula Dreams, came over to provide more workshops for not only in Okinawa but mainland Japan. This has opened many opportunities for those wanting to provide services to families.
The Japan Birth Resource Network was officially established in 2013 as a Private Organization through the base in Okinawa. What started as a small group had flourished into something big. It’s taken a group of giving, committed women to make this grow into what it is today.
To understand exactly what it’s like to be a military spouse stationed overseas. It would have to takes either experiencing it or talking to someone who’s spent a few years away from what they would consider their normal home. While most of our base entities do their best to provide services for our expectant families, many are falling through the gaps and continuity of care is a much needed component for them. Because our life requires us to move, we see not only doulas come and go, but doctors, nurses, and breastfeeding support fall through the cracks. Other important aspects of our care the military should be providing are often absent. This is one of the main reasons where I feel our work and why it is so important to bring awareness to our military families and those stationed overseas. It’s taken several years of educating not only families but also providers here in Okinawa and at other base entities that we are NOT medical personnel. It is a constant continuum of education because people are always coming and going.
Whether you are a military family stationed overseas or stateside, eventually one will encounter deployments or trainings that take our spouses away for 30 days to 14 months. My husband was one of those on a long deployment. While he was home for the birth of our children, it was still one of those difficult seasons of our lives. Now just imagine a new momma delivering without her partner there and not the dad not meeting his newborn until he or she turns 1. It unfortunately it happens, I have met countless women who’ve delivered a baby while the dad was deployed.
We also look at the other aspects of our lifestyle. Currently the military implemented new guidelines giving active duty mothers 12 weeks of leave. This, I believe has been a huge step in facilitating a new mother to adjust and spend that critical time with her baby. For our women who have active duty spouses, they are currently authorized 10 days of paternity leave after delivery. In a perfect world, the dad could take leave and stay for an extended period of time. However, the reality is the majority have to get back to work, duty calls. If the mother’s or father’s family is close by, that seems to be an answer for helping the new family adjust. However, we find ourselves be taken far away from our family and bringing them to visit can be a costly journey especially for those overseas.
How have we fit in and made this a workable solution for local families. Seeing a absolute need for continual support and wanting families to have that option of care, Japan Birth Resource Network was created out of our group of birth junkies in the community. This was not an easy task as one may not understand the dynamics of base policies AND the challenge. On top of that establishing a rapport with our base hospital. In my first year back in Japan, there were times I’d assist 3-5 families a month. While there were a couple of doulas who helped as back up’s when they were available, it was a bit of a one man show for awhile. Initially the base hospital didn’t even really entertain the thought of our doula work. Understandably so, because a doula can sometimes be perceived as a nuisance in the labor and delivery room or when parents are when they encourage parents to ask questions about interventions or their care and doesn’t always sit well with people. It takes time to learn how to teach families to approach their provider in a manner that isn’t abrasive. I always encourage parents to put their birthing preferences in writing and have a discussion with their provider to help them make informed choices, BEFORE the birth happens. I do advocate for this because in our system, the chance of the expectant mother getting the same doctor to deliver her baby is small. This is just one of the things many families face unless they are in a location to choose a different route such as civilian hospitals, homebirth or birth centers. We’ve been able to have over 60 new doulas trained in Japan. As consistent with our lifestyle, many of them have departed to move to another location. So we are always on the go and working towards fulfilling those spaces.
Where are we at now? Since the official startup we’ve been able to provide families on Okinawa with access to doula support. Three Birth and Baby Fairs have been hosted on base with support from the Kadena USO. This event displays on base mother/baby businesses, doulas, guest speakers, break out sessions, giveaways and local birth resources. Monthly Birth Talks are planned to educate and inform our families with a variety of pregnancy, birth and postpartum topics. We are excited to expand into mainland where a few bases are located.
In 2016, Amanda Dodson was voted the Marine Corps Base Camp SD Butler Spouse of the Year. This opportunity took her to Washington D.C to meet other spouses and network. Her over all goal is to provide a resource specifically designed for our military families. A source where they can not only have reliable resources at their next duty station but a continuity of care provided through doulas, breastfeeding and other birth professionals. It is also her goal to help train and educate other birth professionals who do not normally provide support in military facilities and work with our military system.