Labor of love

A handwritten thank-you note dangles on the wall of the Charlotte Street office where Chelsea Kouns spends most of her time. When the 27-year-old isn’t clocking in at her two part-time jobs, she’s there working for free on her labor of love: Start From Seed, an Asheville nonprofit organization that provides free birth and postpartum doulas to high-risk, low-income mothers.

“I’m a big dreamer,” she says, tracing the handwriting on the note with her index finger. “I’m pretty determined, and when I have an intention or vision I’ll go toward it.”

A humble beginning

Two years ago, Kouns completed a three-day training course under the direction of Cheryl Orengo, a local doula and childbirth educator who developed and coordinated the Buncombe County Health Department’s volunteer doula program for 12 years before retiring from public health.

Although Kouns has never given birth herself, she felt an instant connection to doula work. Birth doulas provide emotional and physical support to women during labor and childbirth, a role that is distinct from the medical care provided by midwives or doctors.

“When I went, it was pretty immediate that I was in the right place. I just got that feeling,” Kouns says.

Orengo — who now works as a birth and postpartum doula with Peaceful Beginning Doula Services — recalls that Kouns was “a natural,” adding, “It was just a joy to see her clearly in her element.”

However, the greatest inspiration for Start From Seed came to Kouns during her first birth as a doula. The mother was just 16 years old.

With Orengo serving as Kouns’ mentor, the teenage mother delivered a healthy baby boy to term.

In that moment, Kouns realized she wanted to create a center that would provide prenatal and postpartum care to teenage mothers. So when Orengo approached her about starting a volunteer doula program for high-risk, low-income mothers, Kouns could not refuse.

“I was seeing a huge lack of support for these young mothers, not just in our community, but in society in general,” she says, adding, “The way that they looked at these mothers — they didn’t give them a chance to be as good of mothers as other women.”

A step closer

With Orengo’s help, Kouns created Start From Seed last August. Operating under a community-health model, clients are referred to the nonprofit from Mountain Area Child and Family Center, Mission Hospital, Western North Carolina Community Health Services, Nurse-Family Partnership, MAHEC and Mary Benson House.

Orengo, who serves as Start from Seed’s program advisor, says this allows not only for a steady flow of clients, but also for an extension of services.

“Most agencies can’t provide someone to be with a woman through her entire birth. Sure, they can send someone, but it isn’t the same as sending a doula — someone who is there to empower and support that mother. And you never know how long it’s going to last — a birth can last anywhere from eight to 35 hours,” Orengo explains.

A dedicated team

Irene Carrizosa, who trained with Kouns, works solely with Start From Seed clients as a volunteer birth doula. The program currently has eight volunteer doulas doing what Carrizosa says she loves most, “empowering women.”

“As a doula, you're there completely for the mother and that's so empowering and comforting to the client,” Carrizosa says.

Empowerment, Kouns stresses, begins with education and can make all the difference when working with Start From Seed clients. The nonprofit offers women at least two prenatal meetings with a doula to discuss options for labor and delivery, comfort measures, labor positions and a review what will happen on the day of labor and birth.

These talks often include childbirth education to explain what is happening biologically during and after pregnancy.

A different approach

Because these women do not always fully understand the birth process, Kouns has learned through experience what works for communicating birth concepts to teens without being condescending or judgmental.

“We’re working with 15-year-olds that are mainly concerned about their water breaking at school,” Kouns says. “Their needs are just different from those of a 35-year-old, or 40-year-old woman, who are also high-risk, who has that life experience. But at the same time, teens are so fearless. They’re tenacious little beings and they can be truly amazing mothers.”

A constant source of support

Constant support is the most important thing doulas can provide, Orengo says.

“For most of these women, they’ve never been a patient in a hospital before and then all of the sudden they’re there for hours with machines all around them and people in scrubs. Especially for very young women, it can be very scary,” she maintains.

Being able to calm fears and be fully present with these mothers is why Kouns says she wanted to create the nonprofit doula program. Usually, doula services can cost anywhere from $500 to $1,000 dollars in Asheville. By providing these services for those who can’t afford it, Kouns sees possibilities opening up for these mothers.

“With these births, they’re starting from a fresh place and from nothing. They’re not thinking about their past, what their mothers were saying; they’re not thinking about that abuse and all of these fears and traumas and whatever they’re bringing into this birth. But they’re starting from this point, that seed,” she says.

— Send your health-and-wellness news and tips to Caitlin Byrd at or


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