#328 - What a Doula Really Does: LaToya Southwell on Trust, Advocacy, and Healing

Hello friends 👋

In this episode of The Incubator Podcast, Ben and Daphna sit down with certified birth doula and lactation counselor LaToya Southwell for a wide-ranging conversation about the role doulas play in supporting families before, during, and after birth. LaToya shares her personal and professional path into birth work, and how her experiences shaped a culturally sensitive, trauma-informed approach to supporting laboring people—particularly those from historically marginalized communities.

The conversation covers what doulas do (and don’t do), how they differ from midwives, and how they advocate for safe, informed, and emotionally grounded birth experiences. LaToya talks candidly about how she prepares clients for unexpected outcomes, including C-sections and NICU admissions, and how doulas can collaborate with healthcare teams rather than be in conflict with them.

She also introduces the Baby Café initiative—an informal peer support network she co-founded to reduce isolation and provide postpartum support for new mothers—and explains why preparing families for postpartum is just as critical as planning for labor.

This episode is a practical introduction to the real work of birth doulas—and an invitation to rethink how care teams can work together to improve outcomes and experiences for parents and babies alike.

Link to episode on youtube: https://youtu.be/Q5IpcPkTlxY

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Short Bio: Latoya Southwell is a Certified Birth Doula, Trained Lactation Counselor, CPR Certified, and a Certified Reiki Practitioner. She serves families across the Lower Hudson Valley, Rockland County, Connecticut, Westchester County (both upper and lower), the Bronx, and Manhattan. She currently serves as the Doula Assistant Manager at the Children’s Health and Research Foundation (CHRF)/Lower Hudson Valley Perinatal Network (LHVPN) in Westchester. She also co-hosts a biweekly virtual Baby Café support group for Westchester County.

Her professional background is diverse: she studied nursing, culinary arts, accounting, and theology, and worked in the banking industry for over 14 years. She has experience working in a pediatric hospital ward and has explored multiple pathways in healthcare, including training as a nurse and ongoing interest in midwifery. Her work is grounded in a deep commitment to education and empowerment—especially in helping families prepare for pregnancy, birth, and early parenting. She believes that education, support, and healthy boundaries are the foundation for living a more intentional life.

Originally from St. John’s, Antigua, and later from St. Thomas, U.S. Virgin Islands, LaToya brings a culturally inclusive, island-rooted perspective to her work. She now lives in New York with her husband, four children (ages 5 to 22), and Vinny, their tuxedo cat.

Her favorite saying:

“Life will either make you or break you… choose your hard. Look for gratitude in the chaos.”

And her reminder:

“Your story is yours to tell. Don’t hand that power to someone else.”

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The transcript of today's episode can be found below 👇

Ben Courchia, MD: Hello everybody, welcome back to the Incubator Podcast. We are back this Sunday with a very special interview. We have the pleasure of hosting LaToya Southwell, who is a certified birth doula. LaToya, thank you so much for joining us this morning.

LaToya Southwell: Thank you for having me.

Ben Courchia, MD: Daphna is in the studio as well. Sorry, Daphna, I skipped you—which is unusual. How are you?

Daphna Yasova Barbeau, MD: Here. Yeah, don't forget about me! I'm doing well, buddy. Thanks.

Ben Courchia, MD: LaToya, thank you again for being with us. You're a certified birth doula, a trained lactation counselor, and a certified Reiki practitioner. You serve families across the Lower Hudson Valley, Rockland County, Connecticut, Westchester, and New York City. You are the Doula Assistant Manager at Children's Health and Research Foundation (CHRF) of the Lower Hudson Valley Perinatal Network. You also co-host the Westchester County Baby Cafe. You have a background in nursing, banking, and various other fields, but you're passionate about education and empowering families on their journey to parenthood.

You're originally from Antigua and St. Thomas, and you bring a culturally inclusive approach to birth that reflects your appreciation for community, support, and resilience. You live in New York with your husband and four children, and you have a tuxedo cat—is that correct? Vinny?

LaToya Southwell: Yeah.

Daphna Yasova Barbeau, MD: You do?

LaToya Southwell: He's literally a tuxedo—black with a white V-neck. That's why we named him that. And he has his collar too.

Ben Courchia, MD: Uh-huh. Very formal. Very cool. So LaToya, I want to start with the basics—for myself and our listeners. For those of us who may not be familiar: what exactly does a doula do, and how does that differ from a midwife or a delivery nurse? Can you explain the role you serve?

LaToya Southwell: Sure. As doulas, we are non-medical professionals, so we don’t advise in any medical capacity. However, we inform, educate, and advocate for our clients. The doula role varies from person to person. For me, when I meet a woman—or a family, if they have a partner or support system—I like to meet as a group first. That way, I can introduce myself, build rapport, and understand their background. Unfortunately, we have so many women coming from different parts of the world, and many have endured various forms of trauma—from childhood trauma to relationship issues, or even birth trauma. So it's important for me to understand where they’re coming from in order to best support them.

In the hospital setting, I help them labor and manage pain, but I also try to shift their focus away from pain. I explain to my clients that the same hormones used during orgasm are used during labor, so it’s possible to shift from pain to pleasure. I also educate them on how to set up the room—because hospitals are full of lights, sounds, and distractions that can feel tense or stressful. A lot of women fear hospitals, but they also don’t trust themselves enough to labor at home.

If I get to them early in their pregnancy, it’s ideal—because then I can work with them through some of that trauma. I often share my own story, if they’re willing to hear it, and that usually helps. Some of my clients have been as young as 14, and when I’m working with young girls—or even older women—who don’t have their mothers involved, they often have a void that needs to be filled.

So I mother them in a way. I’ve had voids in my own life that I had to work through, so I understand what they need. It creates a deeper connection and allows them to be more open and vulnerable—which is important, because labor is such a raw, exposed state. You're giving so much of yourself. You feel very naked. Because it's such a pivotal moment in their lives, I try to make it as rewarding and memorable as possible. That’s important.

Ben Courchia, MD: I think that’s incredible. I’ve met you before and heard you speak, and what really stands out is that while you’re achieving all of this, your number one priority—kind of like an airline pilot—is safety. You surround your clients in a safe environment, and that often means navigating what can be a hostile hospital environment. You make sure that your clients are not placed in situations where they feel distrust or lack of control. Correct me if I’m wrong, but for many people going into labor, entering the hospital feels like stepping into a foreign place. It doesn’t feel like home. No matter how much these hospitals brand themselves as “birthing centers” or “hospitality units,” they can still feel like very stressful environments.

LaToya Southwell: Yeah. It is, because they really don't give you the time you need. So I encourage my clients to labor at home. Home is a safe space for the majority of people. That way, when you're going through labor—because we have different ways to refer to it—some people even use a safe word because the word labor triggers them or puts them into fear. But I'm a very straightforward and honest person, so I ask them directly. I also work with them on their birth preferences or birth plan. I want to know how I can make her day the best day for her. How does she envision it? The reason I do that is because I assign a little “homework.” I give them three assignments. If they want to birth vaginally, I ask them to describe their perfect date. If you could have the perfect birth experience, whatever you want, however it looks—describe that and write it down. Then, the second thing is: if you had to compromise, where would you be willing to compromise? If you want a completely natural birth—no drugs, free movement during labor, intermittent monitoring, and a hep-lock instead of a full IV—we include all that in the birth preferences. But we also identify where you're willing to compromise. Maybe you’ll wait until you're in active labor and then decide to get an epidural. If that's your compromise, then I know where your flexibility lies. Or maybe you're okay with monitoring but not with induction or epidural.

I also explain that while some things are within your power, ultimately the goal is a safe mommy and a safe baby. Because when you're actually in labor, you never know what will happen. We can all say what we want to do, or what we would do—but until you're in that situation, you never really know. So I work with them ahead of time to prepare.

And then the third thing is: what if you need a C-section? Just in case. Thank God I haven't had to deal with that situation much, but the reason I have that conversation is that many women don’t. If it ends in a C-section, and they’re in pain or overwhelmed and don’t remember what we talked about, they might feel blindsided. That disconnect increases the chance of postpartum depression—because it didn’t turn out the way they expected. So I like to cover every possibility, just in case.

That approach usually works really well. Then, of course, we continue the conversation. I encourage them and check in regularly—make sure they're hydrating, eating, exercising, and just staying motivated.

Ben Courchia, MD: Yeah. I mean, it’s not always the person you'd expect to quote in these situations, but that Mike Tyson quote—"Everybody has a plan until you get punched in the face"—is so relevant. Because it's true: once the stress ramps up, decision-making and processing information becomes hard. We see this when we do neonatal consults—it's very, very difficult.

Before I hand it off to Daphna, one quick question: What’s the biggest misconception about doulas that you encounter?

Daphna Yasova Barbeau, MD: I thought we were going to work up to a question like that!

LaToya Southwell: You know, I think the biggest misconception is that doulas deliver babies. People don’t understand the difference between a doula and a midwife—which you asked about earlier. What I like to say is: a midwife is like a doctor, and a doula is more like a nurse. Midwives go through medical training. Doulas don’t. And it can be a little complex for doulas who already have a nursing license. If you're a nurse, birth doula work isn't really the best fit. It's very hard to separate your medical training from your doula role, and that can cause problems. Because you may want to take a natural approach—but in medicine, there are protocols and responsibilities. It becomes complex. So if a nurse wants to become a doula, I always recommend working in postpartum care instead. Postpartum is best because you still get to love on the babies and the moms, and you still get to support them—but you don’t risk overstepping boundaries.

Daphna Yasova Barbeau, MD: By conflating the two fields—or overstepping in some way. Interesting.

LaToya Southwell: Yeah, exactly. It becomes really difficult. It's like you're playing with your moral compass. It’s hard to sever one side of yourself to fully embrace the other.

Daphna Yasova Barbeau, MD: Yeah. Well, I have another, I guess, pointed question to follow up on Ben’s, since we’re diving right in today. Our listeners are, for the most part, neonatal professionals. So I guess the elephant in the room is, we don’t see much of what’s happening on labor and delivery, admittedly. We come in near the end. We're popping in and out beforehand, maybe a little bit afterward. Other than our own prenatal and delivery experiences, which like you talked about are so personal and individualized, we really don’t know what goes on there.

So we might be making some assumptions or judgments about what’s happening. And I can imagine that there are listeners who’ve had experiences where a baby ends up in the NICU, and maybe the birth didn’t go as anticipated—and a doula was part of that scenario.So they may have a different perspective on doulas.

I want to make sure that people get the most out of this interview. I want to address that head-on: I recognize that some listeners may have biases about the role of doulas. But what you’ve highlighted so well is that a doula—when properly trained—is not trying to replace medical advice. What I really took away from what you said is that a doula can almost serve as a translator for families—regardless of their spoken language—because medicine itself is kind of a complicated language. And what you talked about around anticipatory guidance is so important. We hope everything goes as planned, but if it doesn’t—how can we prepare moms for that? I completely agree with you. Especially for our NICU parents, who are coming in with such grief when things don’t go the way they’d hoped, what you can do during the prenatal period to prepare them is really remarkable.

Ben said we wouldn’t get into the numbers too much, but I did want to share some data. There was a Cochrane review on doula support, and some of the findings were really striking. Women who received continuous labor support—not even getting into prenatal or postpartum support—were more likely to give birth spontaneously. They were also less likely to use pain medications or have cesarean births, more likely to be satisfied with the experience, and had shorter labors. Postpartum depression was lower in women who were supported in labor. And the babies—babies of women who received continuous support—were less likely to have low five-minute Apgar scores. Their well-being was better assessed at birth and shortly after. And actually, I think the devil is in the details: a number of states are now investing in doulas through Medicaid because they’re seeing cost savings, mostly from reduced C-sections and preterm births. So this is incredibly relevant for us as neonatologists.

And I want to underscore what the literature has shown clearly—that Black women and other minoritized women may benefit even more from doula services compared to the population at large. You mentioned culturally competent care briefly, but I’d love for you to speak to that more directly, so we can understand how this additional level of support benefits babies, moms, and families.

LaToya Southwell: Well, regarding Black and Brown communities—unfortunately—I work both privately and in an organization, and what I’ve found is that they often don’t know what a doula is. So they’re not as receptive to the idea. There’s this mindset of, “It’s my business.” So what I’ve found is that they will accept certain types of care to a certain point. But then when labor begins—which is such a critical moment—they don’t call. And that’s the part that matters so much, especially given the disparities we see today. Medicaid clients are often the ones receiving doula services for free, but they may think it’s just about information. And then there’s what I call “white coat syndrome”—where it’s “Yes, ma’am, no, ma’am, whatever the doctor says.” They don’t trust themselves. They don’t trust their bodies.

For example, a doctor might say, “We have to induce you because your baby is a little too big.” And it might be the woman’s second, third, or fourth baby—but the provider may not take her history into account. So I always ask: What was the gestational age of your last baby? Were you early, late, right on time? All of that information is important—because the body has memory, and each birth builds on the last. The next birth is usually faster.

But a lot of women internalize other people’s stories. They hear about a friend who had a C-section and think, “Well, I’m overweight,” or “My mom had a C-section,” and then they assume that’ll be their story too. They carry those fears even into breastfeeding: “I didn’t breastfeed last time, so it probably won’t work this time.” But that’s not their story to take. Even their own previous pregnancies are not predictive—because every pregnancy is different.

So I do my best to encourage them to trust their body. Yes, listen to the doctor—but also know your rights. It’s okay to ask questions. If something doesn’t feel right, ask. Don’t just say yes and go home upset—or carry that frustration, because the baby picks up on that too. People don’t always think about that part.

Ben Courchia, MD: Yeah. I think that’s super interesting and very compelling. And we have to frame this against the reality that African-American women and other underrepresented minorities are experiencing appalling mortality rates around the time of childbirth. That doesn’t exactly make it easy to ask these communities to trust hospitals—when the data shows that outcomes may not actually be better. So I think the role of a doula—as a catalyst to make that experience safer and more successful—is critical.

And one of the most important aspects of your role is what happens when things don’t go as planned—like you said at the start of the episode. It’s not uncommon for doulas to accompany their clients into the operating room for a C-section. Some people might think, “Well, she’s not laboring anymore—we don’t need the doula.” But that’s not true. Can you talk about how your role extends into a situation where a patient undergoes a C-section? And how does your presence or assignment shift when the birth experience changes so dramatically?

LaToya Southwell: Yes. So I do a few things. First of all, before I go to any birth—especially if it’s a C-section, even though that’s rare unless it’s scheduled—I always pray. That’s very important to me.

When I arrive, if it’s a C-section, I can usually tell what’s going on. I trust my instincts a lot. I once had a client who was very afraid but didn’t verbalize it—I felt it. So I asked her, and she said yes, she was terrified. She asked me to be the calm in the room because she didn’t think her husband could handle it. So that’s exactly what I did.

In the operating room, I have a full conversation with them. We talk, we laugh. I pay attention to what’s happening so I can give her a sense of what’s going on—because no one usually talks to the patient. She’s just lying there. But when she knows what’s happening, it helps her stay balanced.

If I can see the baby, even better. I always bring my phone so I can take spontaneous pictures—and I share them afterward. They love it. They never expected me to do that, but I do.

Ben Courchia, MD: It’s one of those things where, in the moment, people say, “No pictures.” And then later they’re like, “Oh my God, thank you for taking those!”

LaToya Southwell: Exactly! Even during birth—they don’t expect it. They don’t know what’s going on, but I’m capturing those moments. Because you can’t turn back the clock. You can’t recreate that moment. And they’re always so happy afterward because they have those memories.

So yes, C-section is different—but I go in with them, I talk with them, I laugh with them, I encourage them, I pray with them—if that’s what they want. And most of all, I just love on them. I think that’s the most important part: to love on them during that time.

Daphna Yasova Barbeau, MD: Love that. This may sound silly—we have this concept in neonatology that is gaining traction called "two-person cares" for babies. And anybody can be the second person. What it means is the nurse is doing the medical stuff, the routine stuff, but one person is there just to focus on the baby—containing the baby and calming the baby.

It sounds like that’s mirrored in the work you’re doing. Everybody has their task, but the doula’s task is really to focus on the mom, help explain what’s going on, and anticipate some of those needs. Things are happening so fast sometimes—other times not fast enough—but in the labor space, that focus can get lost, right? Especially in a lot of the deliveries we go to—they become emergent or they’re way sooner than expected. And I see those people are especially suffering, as things are happening to them without them really understanding what’s going on. So I appreciate you helping me make that connection.

We’ve talked a little bit about what you’re doing in the prenatal role and of course the significant role during delivery. But doulas also play an important postpartum role, and certainly I’ve seen the data on how doula support has improved breastfeeding rates. I think that’s also of particular interest to our community in the NICU, where breast milk is so important. I was hoping you could speak a little bit to that.

LaToya Southwell: Yeah, of course. So postpartum, to me, is very important. You know, everything is important, but I feel like postpartum is the toughest point in a woman's life—in a mom's life—because you have a new norm. You're trying to figure out how to, if you're married, make sure your husband doesn't feel left out, how to love on your baby and be a great mom, and then also how to self-care.

So I tend to explain to my moms to prepare for postpartum—whether it's food, snacks. I go to their home and I encourage them: if you have a station for the baby, make sure you have snacks there. I really talk to the dads about that, because they want to know how they can support. I encourage them to set up a station wherever they think their wife is going to be changing the baby or breastfeeding.

If you can pre-prep some foods, that would be amazing. But if you have friends and family that are going to come and visit, don't let them come empty-handed. I encourage families to do a meal plan. It’s something that my group of friends—my village—started years ago in response to an unfortunate situation, but it turned into a beautiful blessing. Whether it's for birth or death or something else, we do a meal plan—it could be for two weeks or two months. I ask, "What restaurants do you want?" And if the mom or her husband can’t do it, I’ll happily do it for them. I set up the meal plan. They give me the list, and it sends reminders to the person delivering and to the family. That takes away the stress of “What are we going to eat for dinner?”

If your family’s coming to your house and you’re worrying about cleaning, that should not be a factor. If someone has something to say about your house, they either need to not come or put their hands to work—laundry still needs to be done, cleaning still needs to be done, shopping needs to be done. No one should come empty-handed because you don’t need anyone to hold your baby. That’s plain as day. You should be spending all the time with your baby. If someone wants to come and hold your baby, let them do some work first.

I also encourage families to wait two weeks to a month before people start visiting—because people don’t have boundaries. They don’t know limits. It causes stress. And then you don’t know how to tell people to leave. You don’t want to be mean, but sometimes you have to be. Get out.

Ben Courchia, MD: Yeah, some people are very good at following cues. Others sometimes feel very comfortable.

LaToya, we're getting close to the end of the episode. I wanted to ask you some questions about you and your background. You have such a diverse background. You have a background in nursing. I'm not exactly sure what your role in banking was, but I’m wondering how you were driven to this new role that you seem to be thriving in. And how do you pull from these past experiences to be a better doula for the people you care for?

LaToya Southwell: As you said, very diverse background—and quite a bit of trauma too. But it motivated me. I wanted to be a nurse since I was a little girl. My plan was: get married, be a mother, and be a nurse—with an undergrad in law. I did two years at the hospital and I loved it. I did pediatrics and loved it. But I couldn't leave until all the babies I cared for were asleep. I had a routine: I’d come in and greet them, hug them, love on them, read books with them, pray with them, sing to them, and put them to bed.

But I didn’t like how they were being treated. Since the nurses knew I was coming, the babies were being neglected—I’d stay way past my shift. Then one day, I worked in the NICU, and that was really hard. Most of the babies I took care of didn’t have anyone visiting. I think I saw only one or two parents during that entire time. These were such loving babies.

I was in the operating room one day, helping a doctor. I was holding the baby so he could insert a needle, and the baby looked me in the eyes and was screaming. I just threw my hands up and said, “I can’t do this.” He asked me, “What do you want to be again?” And I said, “I guess this isn’t it for me.” My first birth experience was when I was 19—it was my niece. It was the most beautiful experience I’ve ever had. Then I helped with my second niece—my sister was younger. During that birth, I brought games and we played the whole time she labored—boggle, cards, all sorts of stuff. And she had my niece and said, “Oh my God.” So I just kept helping the women in my family. I helped them with lactation, even before I had any formal training. It was something I loved.

Then when I had my fourth child—my daughter—my own birth experience wasn’t the greatest either. After my first son, I had a midwife. And I have to tell you—because of her, I wanted to become a midwife too. I still do. But I love what I’m doing now. It’s not work for me. It’s something I truly enjoy. I love being able to love on the moms and their families, encourage them, and witness life being born.

After I had my daughter, my doctor said, “This is your fourth child—you were the last one in, first one out. You need to go teach women how to give birth.” And I thought, “So I’m not crazy. I should go do this.” So I went to training—with my newborn daughter in tow—and I loved it. And I just kept going from there.

Daphna Yasova Barbeau, MD: I love that. What I’m feeling as I hear you speak — and I’m a mom — is that I think modern motherhood, or parenthood (I don’t want to disregard the dads either — they don’t get enough airtime either), can actually be quite isolating and lonely. That’s what I really feel from parent groups — the way our society has shifted. Motherhood used to be a communal event and the entire community came around. We still see this in the animal kingdom. Everyone comes around to support the mom and baby through the transition, for as long as it takes. Our society has become disconnected from that idea. Birthing people will say, “I had this thing happen to me,” and even if it wasn’t quote-unquote traumatic, it was still a little traumatic. Even if you had a great birth experience, it’s still a shift — a change in your role, your lifestyle. Suddenly this tiny person depends entirely on you. And what I hear you saying is that this is an opportunity for us to bring community back into the labor process. I feel like even our parents in the NICU are more isolated than the typical parent. So this really resonates with me — how this can change the birthing process for people.

LaToya Southwell: Yeah. To piggyback off that, Ben had asked about Baby Cafe. So that’s what Baby Cafe is. A few of us doulas got together and talked about how society has pulled us away from the idea that “it takes a village.” Now it’s all about doing it on your own. But you're stressed, and your child ends up basically raising themselves. Before, your neighbor would look out for your child. The person down the street would watch them. You didn’t have to worry — and now all the worry is on you.

So at Baby Cafe, we meet Tuesdays and Thursdays from 12:00 to 1:30. It’s a safe space for women to ask questions, talk, and interact with other moms. We also created a WhatsApp group — two, actually. One is the general Baby Cafe group, open 24/7. The other is After Dark — for women who have questions they’re unsure how to ask during the day, or worry about how others will respond. Those tend to be more intimate questions — about sex, about how to re-engage in sexual activity, or about body image. It’s all to encourage them to love themselves. I always tell them: “You gave life.” It starts with self-love, which many of us lack. When you begin to love yourself, you can love others unconditionally — the way people are supposed to be loved. And you can respect others from that same place. Baby Cafe has become such a beautiful thing. There are about 100 moms in there now, and it's just a beautiful community.

Daphna Yasova Barbeau, MD: I love that, thank you. My last question for today is for our neonatal professionals. We’re there to take care of babies, but we’re often in the room during moments of crisis. How can we better engage with doulas? How can we enhance that partnership from our side?

LaToya Southwell: I feel like doulas and medical professionals can work so well together if they allow us to help. When I go into a birth space, I ask the nurse, “Can I help?” If they’re changing sheets or if my client needs to go to the bathroom, I can assist. But I feel like many medical professionals think we’re there to take over — and that’s not it at all. It works so much better when everyone works together. When we do, the mom isn’t stressed. She feels welcomed. It turns into such a beautiful space. So I feel like if everyone welcomed and engaged with each other — and let us know how we can help — it would be such a beautiful thing.

Ben Courchia, MD: LaToya Southwell, thank you so much for taking the time to answer our questions and come on The Incubator Podcast. It was a pleasure to learn more about the role doulas serve in our community, and to hear how you do what you do. Thank you again for a great conversation.