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More than half of Nevada counties are considered maternal health care deserts. This series explores maternal health care gaps, the patchwork of resources, and the role of doulas in rural Nevada.

Rural doulas act as a lifeline for expectant parents looking for advocacy and education

A woman and her two children are walking in a field toward a herd of cows. She is carrying one of her children while the other walks next to her.
Kat Fulwider
KUNR Public Radio
Morgan Daniels and her two children feed cows at their ranch in Fallon, Nev., on Oct. 27, 2023.

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What role can doulas play for expectant parents in rural communities? For some moms in Northern Nevada, they’ve been a lifeline. The fourth and final installment of the series The Long Road to Maternal Care shines a light on those relationships.

A woman is holding one of her kids while standing near a fence. Her other child is standing next to her while looking over the fence at a horse trough.
Kat Fulwider
KUNR Public Radio
Morgan Daniels and her two children feed horses at their ranch in Fallon, Nev., on Oct. 27, 2023.

Morgan Daniels and her 2 ½-year-old and 1-year-old fed hay to herds of cows and three lively horses at their Fallon ranch. The horses also got apples to munch on – it’s the family’s nightly routine.

The farm has belonged to her husband’s family for eight generations. Their baby boy is slightly too young to help, but he’s keeping a close eye on his mom and big sister.

“Brother says I got this. ‘I’m gonna be the best ranch hand ever,’ ” Daniels said about her youngest.

The journey to get here with her family wasn’t easy. Daniels was in labor for 52 hours with her oldest. She tried a home birth with a midwife but ended up needing to go to the hospital – where doctors performed a cesarean section.

For her second pregnancy with her youngest, she hired a local doula. She wanted a natural birth, and she wanted someone to advocate for her at the hospital. For nearly nine hours, her doula, Natalie Doyen, helped her through the contractions.

“Rather than sit there in my pain and just try to ride it out, she got me up, she got me moving, we were outside walking,” Daniels said. “She had me trying to tell her all about every horse I had and every experience in life just to keep me busy and trying to push through all the contractions.”

Daniels waited until she was nearly fully dilated before beginning the hour-long drive to Renown in Reno. In the car were her husband and oldest child. Doyen followed closely behind.

But when she arrived at the hospital, doctors told her they would need to perform a C-section. Daniels felt defeated, but her doula gave her the strength she needed.

“When I met her, it was like a friend that I had known forever, even though I didn’t know her. I just felt like she was on my side,” Daniels said.

A young child is crouching in front of a pile of hay while looking toward his mom and big sister in the distance, who are pointing and walking toward him.
Kat Fulwider
KUNR Public Radio
Morgan Daniels and her two children at their ranch in Fallon, Nev., on Oct. 27, 2023.

They met while Daniels was about halfway through her pregnancy. Doyen, a childbirth and postpartum doula and childbirth educator based in Fallon, has helped nearly three dozen clients over the last two years.

“My goal is to always make sure the mom feels taken care of first. There’s a whole team for the baby, and they’re doing all of the necessary checks, and the mom’s like, ‘Hey, I just had this whole experience and everybody abandoned me.’ So to stay with the mother and to say how strong she is, and just really affirm that she accomplished something huge is very important to me,” she said.

Doyen is in a conference room, seated, and speaking and talking with her hands as another person looks at her.
Kat Fulwider
KUNR Public Radio
Doula Natalie Doyen (right) at a rural maternal care roundtable event hosted by KUNR Public Radio and USC Annenberg Center for Health Journalism in Fallon, Nev., on Nov. 6, 2023.

Doyen cares for parents throughout Fallon, Fernley, Carson City, and Reno; most are military service members. Many of her patients give birth in larger cities. Her role as a rural doula involves conversations about making those trips.

“They initially are in this sheer panic of, ‘Oh my gosh, I have this huge hour drive ahead of me,’ and they count how many contractions that could be. That’s very stressful for them. They think that they’re going to deliver on the side of the road. But I think just knowing that they have someone who’s experienced birth and can help them gauge and navigate, ‘Okay, this is a good time to go to the hospital,’ ” Doyen said.

However, Doyen won’t be in the community forever; her husband is currently stationed at Naval Air Station Fallon. Now, she’s hoping to build a community of doulas to fill her shoes.

A water bottle sitting on a desk. It includes an illustration of a pregnant person and text that reads, “You don’t have to do it alone.”
Kat Fulwider
KUNR Public Radio
Doula Natalie Doyen’s water bottle reads, “You don’t have to do it alone.”

“I would love for women to knock down my door wanting to do this kind of work. I think it is the most fulfilling thing you can do. I want other entrepreneurs, other women, to feel good about getting out and working again,” Doyen said.

Doulas are rare in rural Nevada, but they play a crucial role “because there’s nobody else out here,” said doula Destinae Waddington. She lives in Tuscarora, an hour-long drive outside of Elko alongside rolling hills.

“A couple of my other ranch mom friends are pregnant right now. They got to go the hour to a doctor to get 10 minutes of their time, and then they come outta there with questions,” Waddington said. “So having somebody that can be a listening ear. ‘They gave me this paperwork to go read and look up. What does it mean?’ And maybe some of these women don’t have access to the internet.”

Waddington wants expectant parents to know that there are doulas available in rural Nevada. She said that that means taking unconventional steps, like going up to pregnant strangers at Walmart.

“Just be a friend to people,” she said. “And making it affordable for women because sometimes I think they see us as a nicety to have for rich people, but really everybody needs a doula.”

Daniels met her doula while both were cheering on the soccer sidelines for their little girls. When she moved to Fallon from Reno, health care was the last thing on her mind.

“You just get whisked away by love and, ‘Oh, I’m gonna marry this farmer and live in a small town,’ ” Daniels said.

KUNR’s Lucia Starbuck reported this series while participating in the USC Annenberg Center for Health Journalism’s 2023 National Fellowship.

Lucia Starbuck is an award-winning journalist covering politics, focusing on democracy and solutions for KUNR Public Radio. Her goal is to provide helpful and informative coverage for everyday Nevadans.
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