Penny Simkin, a childbirth educator and author often described as the “mother of the doula movement,” died April 11 at her home in Seattle. She was 85 years old.
The cause was pancreatic cancer, said his daughter, Linny Simkin.
Ms. Simkin, a physical therapist turned birth educator, has been a pioneer in helping women have a better experience during and after childbirth. Doula is the Greek word for “handmaid” and was adopted several decades ago by alternative birth professionals to refer to someone who supports mothers during labor. In books, seminars and training organizations, Ms. Simkin has helped popularize that role and has worked as a doula herself.
Doulas are not medical professionals; their role is to provide comfort to women in the delivery room and postpartum care at home. Such assistance might include snacks, massages, or warm compresses, but also more substantial assistance, such as suggesting movements to relieve labor pain or helping with breastfeeding.
Ms. Simkin's innovations included a device called a squat bar, which is attached to a hospital bed for the mother to hold on to and squat, a position that opens the pelvis and allows gravity to help with birth.
Her work grew out of the natural birth movement of the 1970s, when alternatives to standard hospital births were explored. But she was agnostic about home or hospital births and pain relief measures. Her attention was always on her mother.
Ms. Simkin has interviewed thousands of women about their birth experiences, to better train doulas to prepare women for birth. “Like she'll remember this?” she urged her students.
Early in her career, she assisted a woman who was traumatized during the birth of her baby and who described the experience as if it were rape. She later learned that the woman had been sexually assaulted, and that knowledge prompted Ms. Simkin, along with her colleague Dr. Phyllis Klaus, a psychotherapist, to research the experience of pregnancy of women who had been abused and to examine how that abuse had affected their lives. feelings about giving birth: how the birth process – being on display in a room full of strangers, for example – might be intolerable, and how it might be made less so.
Their book, “When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on the Pregnant Woman,” was first published in 2004.
In 1992, Ms. Simkin was the founder of Doulas of North America, or DONA, one of the first organizations to train and certify doulas. Today it is the largest organization of its kind in the world, said Robin Elise Weiss, the current president; it was renamed DONA International in 2004. Ms. Simkin's co-founders were Dr. Klaus; Annie Kennedy, maternal health advocate; and two pediatric researchers: Dr. Klaus' husband, Dr. Marshall H. Klaus, a neonatologist, and Dr. John H. Kennell, a pediatrician.
In the 1960s, Marshall Klaus and Dr. Kennell researched the mother-infant bond, demonstrating how newborns thrived on contact with their parents. That work changed the way hospitals handled births, which for decades had taken newborns and bar fathers out of the delivery room. The two researchers continued to study the role of doulas in childbirth and were among the first to recognize how doulas contributed to better birth outcomes, decreasing labor time and lowering cesarean section rates, among other benefits.
“Birth never changes,” Simkin told the Chicago Tribune in 2008. “But the way we handle it, and the way we think about it, has.”
Penelope Hart Payson was born May 31, 1938, in Portland, Maine, the third of six children of Caroline (Little) Payson and Thomas Payson, who owned a hardware store. She Penny grew up in Yarmouth, Maine, and studied English literature at Swarthmore College in Pennsylvania, where she met Peter Simkin, a medical student. They married in 1958, when she was a junior.
After graduation, she studied physical therapy at the University of Pennsylvania, and when she and her husband moved briefly to England for her medical studies, she shadowed local physical therapists who applied their work to childbirth. That experience sparked her interest in mothering.
In addition to her daughter Linny, Mrs. Simkin is survived by two other daughters, Mary Simkin Mass and Elizabeth Simkin; her son, Andrea; nine grandchildren (she attended eight of their births); and five great-grandchildren. Dr. Simkin, professor emeritus of medicine at the University of Washington in Seattle, died in 2022.
Ms. Simkin was the author or co-author of six books, including, with Janet Whalley, Ann Keppler, Janelle Durham and April Bolding, “Pregnancy, Childbirth and the Newborn: The Complete Guide,” first published in 1979, which it has sold over a million copies. By her estimates, she has prepared 15,000 people – mothers, their partners and other family members – for childbirth.
“Penny's work has inspired everything I do,” said Dr. Neel Shah, now medical director at the Maven Clinic, the world's largest virtual clinic for women and families, and a former professor of obstetrics and gynecology at Harvard Medical School.
Dr. Shah, who advises policymakers and institutions on maternal care, recalled the moment more than a decade ago when a midwife handed him a copy of Ms. Simkin's “Labor Progress Manual” ( 2000). At the time he was a chief resident at Brigham and Women's Hospital in Boston.
“It drove me crazy,” he said in an interview. “It wasn't all cotton candy and rainbows. It was like, here are positions you can do during labor to help it progress that make sense anatomically and physically.
“One of the reasons we do C-sections,” she continued, “is because the labor isn't progressing. Humans have been giving birth for a long time and walked around while doing so, until hospitals took this away. Penny pointed this out and basically wrote an entire book about how to support people going through the most amazing experience of their lives. Things I never learned in medical school.
She added: “In the past, if a baby was born unharmed, with all fingers and toes, it was considered a successful birth. But this is a low bar. Penny's greatest gift was challenging people to imagine the birth care we all deserve.”