Good Mother: How Harm Reduction Doulas Are Changing Parenthood

Overdose and suicide are among the leading causes of maternal mortality in the United States, with Black and Indigenous communities disproportionately impacted. Yet internalized shame, stigma from medical providers, and fears of baby being taken away can prevent many from seeking help. Evidence shows that if just one support factor had been different, like a doula, many of those deaths would have been preventable.

Harm reduction doulas like Ash Woods and Chelsie Porter step in before the point of crisis. They are the co-founders of the Harm Reduction Doula Collective in Seattle, a loose collective of volunteers who provide non-medical, non-judgmental support for pregnant people who use substances.

They continually, doggedly ask: Doesn’t everyone deserve at least a chance at raising their kids? And what happens when parents who use drugs are supported instead of punished?

This could look like providing transportation to a methadone clinic. Ensuring consent for urine toxicology screenings at the hospital. Celebrating baby’s birth with a cupcake. Advocating for chestfeeding. Connecting parents with resources like a legal clinic or warm line during postpartum when they’re most at risk for overdose or suicide. Creating a treatment plan. Letting parents know they’re doing a good job, that they’re not alone. And more.

Every touchpoint increases their client’s ability to parent if they choose, crucial to maternal mental well-being.

Since its launch in 2019, the Harm Reduction Doula Collective has successfully supported hundreds of parents. Woods told us, “Oftentimes we’re all our families have.”