Rose Castillo-Komoda
Stefania Curto

Converging design, birth work and advocacy, Kim Holden empowers women in the perinatal process, and seeks to improve the design of birth environments.

From a place of purpose and gratitude, Kim Holden intertwines the layers of her life as the framework to expand how she creates spaces in the world. Through Doula X Design she focuses on enhancing the design of spaces that support birthing people while simultaneously advocating for women’s health. We had the pleasure of traveling to Maine for her photoshoot, a place that’s allowed her to fully bloom into this new phase of her life. Kim is gracious and innately warm. There is an ease and a force about her all at once that is a blend of wisdom and experience. In our conversation, we talk about the importance of staying nimble, of stepping away from a life’s work to pursue another that brings a renewed sense of purpose and joy.

Editor's note: Kim typically uses the term birthing person when discussing her birth work. For the purpose of this interview, she uses female identifying terms.

Rose: Describe yourself in a few sentences. 

Kim: Nimble, empathetic, curious, resilient, hard working

Being nimble is critical, both in life and work. I am reminded of that each day as I help my clients navigate labor and birth.

What parts of your upbringing do you see as the strongest foundation to who you are today?

I come from a family of strong women. I was lucky in that I knew three of my great-grandmothers. I’m one of 4 sisters, and we all have daughters. We've always been a family of women. When I was growing up in the 70s and 80s my mom cared about causes and was outspoken, as much as she could be, given the time and circumstances. She would take us along to canvas with her but at the same time she was part of the era where you couldn’t get a credit card without having your husband co-sign. She wanted to have a career but there was a limited support system for her to pursue one. I really picked up on a lot of that and wondered ‘why does it have to be different for women?’

My dad had his own business which had a strong influence on my upbringing. I was able to see first hand the risks, the challenges, but also the rewards of being self employed. I learned that I could do anything I wanted to, that I didn’t have to follow a certain path and that whatever path I chose would have some bumps.

My family attended the Unitarian church in our small New England town (the 01776 zip code tells you all you need to know). I don’t remember learning much about religion, but recall exploring fables and stories through arts and crafts, as well as performance and music, all while learning a lot about acceptance. The church community was a place where anyone who was considered “different” would congregate: the single mom, the biracial couple, the dual religion family. I didn’t realize until much later how impactful that was for me.

Attending Concord Academy in Concord, Massachusetts for high school was deeply transformative. The school was heavily focused on the arts and when I wasn’t studying I was in the darkroom or the dance studio. I was surrounded by people from all sorts of backgrounds - difference and acceptance were celebrated. All of these life experiences formed the foundation that allowed me to see that life isn’t necessarily linear and that I didn’t have to, or want to, fit into any particular mold.

What might someone new to you and your work be curious to learn about?

My background as a designer informs the work that I do as a doula. I saw an opportunity to bring birth work and design together as a doula, and eventually as a platform for greater advocacy.

I emphasize the importance of the design of the birth environment and also the physiology, and anatomy of pregnancy and birth—the female body is designed to grow and give birth to a tiny human. Having that knowledge will lead to a more empowered and positive birth experience. 

Many people don’t actually know what a doula is, so I share evidence based information about how and why working with a doula can lead to better outcomes for both the baby and the mom. Birth is an intense experience and whether your own experience is negative or positive or somewhere in between, it stays with you forever. There are so many women who have unnecessary trauma in their birth, even though there are many ways you can prepare to reduce the likelihood of trauma. Knowledge is power—understand your body, know how to advocate for yourself, exercise informed consent, and understand how to navigate our overly medicalized labor and delivery system.

As it relates to my background in design, I’m constantly looking at how we can improve the design of birth and women’s health environments. Why is it that in many parts of Europe, places of birth look more like yoga studios than a hospital room? How does that change outcomes? Why are there so few choices of birth environments in the US? Why do the instruments in women's healthcare look like medieval torture devices? Why have there been so many advancements in other areas of medicine but far fewer in women’s health? Why aren’t women “allowed” to eat during labor during a hospital birth? Why hasn’t the design of prenatal monitor belts evolved since the 1950s? Every time a laboring person moves or shifts, this archaic instrument of labor shifts and loses the reading, alarms go off to alert the nursing staff, anxiety is heightened, confidence erodes and labor can stall—there’s got to be a better way. I’m always trying to unravel and understand the reasons behind why things are the way they are. 

What inspired you to start Doula X Design?

The mission for Doula X Design (“doula by design”) came from my own experiences with birth. I worked with a doula and a midwife, and had my sister present, for the births of both of my daughters. My experiences would have been completely different, and not in a good way, had my doula and midwife not supported me and helped me advocate for myself. As challenging as my two births were, I came out of both of them feeling like a superhero and thinking ‘Why don’t more people have this kind of experience? Why is there so much fear surrounding birth?’ My births stayed with me and continue to have an impact on how I view and move through the world. I started Doula X Design to empower women and to ultimately improve the system, whether that’s through knowledge, birth support, or the enhanced design of environments—there is room for improvement at all scales. Including “design” in the name of my company ensured I had a framework and a goal to move towards.

In your evolution from being an architect to becoming a doula, what were the criteria that guided you to where you are now?

When I left SHoP in late 2017, I asked myself some questions. What is truly important to me? What am I seeking in my work? How can I do my part to make this world a better place? How can I have a more immediate impact? I kept going back to the same criteria, I wanted to have my own business and I needed flexibility to co-parent my daughters. I was also disgusted by the state of politics and women’s health issues—I felt helpless. I wanted to do something that would empower women and girls. I wanted to create a platform for greater advocacy.  

Did it take time for you to come up with these criteria and did it evolve over time?

That’s a good question. Some were there from the beginning, like being my own boss, that goes back to my dad. I knew that even if it meant I would struggle, I wanted to have my own thing. You have to weigh the pros and cons, of course. Flexibility to allow for parenting was a big one. The other criteria were based on current events and circumstances, politics, and what was happening with women’s health and family leave issues.

How did the idea of becoming a doula transpire?

After each of my two births, I briefly considered going back to school to become a midwife, but both times I returned to my burgeoning architecture firm to continue what I had started and nurtured. When I left SHoP and was figuring out my next steps, I knew I didn’t have it in me to go to midwifery school, instead the idea of becoming a doula popped into my head. I knew there was a lot of room to expand the notion of what a doula is and the services that a doula could provide. It ticked all of my boxes.

In January 2018 I traveled to Nepal with two friends to visit the schools that SHoP designed and rebuilt after the devastating 2015 earthquake. We spent part of our time in an orphanage in Kathmandu where we coordinated community health and hygiene classes for both the girls and the boys. I was struck by how thirsty the kids were for knowledge and how they marveled at what their bodies could do. There was no snickering or laughing. The classes armed the girls with knowledge about their bodies and gave the boys newfound understanding about and respect for the girls, whom they called their sisters. Witnessing this knowledge acquisition and empowerment happening in real time was exhilarating. The trip was pivotal, but I didn’t realize until later, the role that it would play in my decision to become a doula.

In contrast, when you look at architecture, there’s excitement along the way but projects can take years to develop and it can take a really long time to have an impact, while in birth work it is instant gratification—you see the benefits almost immediately, and that is really awesome.

Who introduced doulas to you as part of your birth support system? 

I had not heard of a doula until I was newly pregnant with my older daughter in 2002. A friend of mine who had recently had a baby introduced me to her midwife and doula, and talked to me about her own experience. Suddenly, I realized that I had options in birth and that it was important to explore them.

It wasn’t until my doula training in 2018 when I learned that doulas have existed since the beginning of time. A doula is defined as any woman who supports another woman giving birth or during the postpartum period—support in every way except medically. Historically, it was always a community of women who assisted with birth until the late 1800s, when birth was taken over by white male physicians and completely medicalized in the name of progress.

When we first met, we talked about this idea of mothering the mother which I wholeheartedly believe is vital. How can we be better at supporting new mothers?

It starts with understanding what happens to the mother after birth. Whether you’ve had a vaginal birth or a c-section, the wound in your uterus is the size of a dinner plate. Imagine that for a second. So, you’re not only healing from growing a tiny human in your body, if you’ve had a belly birth, you’ve also had major abdominal surgery in addition to the wound in your uterus. If that wound was visible outside of your body, I think that postpartum people would get a lot more care and respect than they do. I always say to my new moms “you have two jobs postpartum, one is to heal your body and the other is to nourish your baby. Let everyone around you help with everything else”. In many other countries there is an extensive lying-in period during which time family members and community surrounds the new family with support and logistical help, so that the new mom can heal, rest, and adjust to her new role.

When it comes to the birth partners, it is often hard to understand or visualize that role in advance. A doula can help a husband or partner be the best birth partner they can be. Again, it all goes back to education and understanding what is happening. Holding space for your partner, knowing their likes, dislikes and fears, being a good listener, anticipating needs, learning ahead of time how to change a diaper and care for a newborn, knowing that not every problem has to be solved immediately, but maybe just validated instead. Rather than asking ‘do you want me to change the baby’s diaper?’ just be aware, take the baby and go change the diaper unceremoniously. Or, if you notice that mom’s water bottle needs to be refilled, go refill it. Order dinner, provide snacks, do the dishes, take the baby so mom can take a shower, tell mom she is doing a great job and make sure that she has breaks and even just a little bit of time to herself. Don’t ask, just do. That’s really the mindset the partner needs to be in. 

Remember that the new dad or new parent needs support as well. They’re exhausted too, the family is adjusting to the newness of it all and that can take a toll on the relationship. Cradling the new family and doing as much as you can not only benefits the mom, the baby, and the new family unit, but ultimately benefits society as a whole. In this country, we are very short sighted, women are expected to go back to work so soon and with such limited support. There’s very little support for new families, and the recognition of how crucial it is to support new families is just not there. How can we alleviate this burden on the mother, the partner, the family? 

You’ve beautifully given us an outline on how to support new moms along with ways to help the family as a whole. This reminds me of something a friend said that when a child is born the maiden dies, the baby is born and the mother is born.

The baby is born and the mother is born and the maiden dies. I haven’t heard that before but I love it. Yes, there is some grief there when you leave your old life behind. There needs to be more acknowledgement of that.

"Remaining nimble and adaptable are so crucial because that’s the only way you are going to weather the changes and learn from them."
Architecture in many ways serves communities, but as the years went on it seems like you outgrew this profession that once gave you purpose. It’s wonderful to see how you’ve evolved your work by continuing to be in service of others, now at a more intimate level, that reignites this sense of purpose.

Absolutely, it became harder and harder to see, to feel, a sense of purpose. I would have never thought, in a million years, that I would have been able to grow a firm from 5 to over 200 people and to work on the scale and the breadth of projects we did. But ultimately yes, I was looking for a sense of purpose. Was I not being true to myself initially? I think I was being true to myself at the time, but once I started on the path of supporting birthing people and families, it was more gratifying than I could have imagined. I also wonder if November 2016 hadn’t gone down the way it did, would I be here? I think that was a real catalyst, a real motivator.

What surprised you the most in your evolution from an architect to a doula?

How much more fulfilled I felt.

What did you fear most during this journey as you evolved?

The fear of having to start over in every facet of my life. I had known this one mode of life for twenty five years; professionally and personally. It was my whole identity. I was turning fifty and the thought of having to start all over again was daunting. Where was I going to get the energy and motivation?

Once I made the decision I was like ‘Ok, I just have to figure it out’. What helped was looking back at my accomplishments, those became my anchors. And my priority was my daughters. I knew I could do this. I had to do this.

When you decided to make this pivot, did you give yourself some time in between to recharge?

The first thing I did was get a puppy! My girls had been asking for one for years, but I just didn’t have the bandwidth. Best decision ever. Shortly thereafter, I left for the Nepal trip. I traveled with my two friends, one in her 30s and the other in her 40s. It was life changing in all the ways. We were each grappling with life’s curve balls. At the end of each day we would come together, share a meal, and talk about the day and about life from each unique generational perspective. 

When I returned from Kathmandu the first thing I did was reconnect with friends and colleagues. Because of the intensity of work and parenting in the preceding years, I had not allowed myself the time to nurture my relationships in the way I would have liked. I indulged in many meals and much conversation. As I was reconnecting I was also networking, fact finding, trying to figure out where my path would lead me. I kept saying ‘I’m gonna know when I know what my next step will be.’ 

One day a few months later, while sitting on the rocks on the Maine Coast, the lightbulb went off. Doula work met all of my criteria. With that I was off and running. I parallel tracked my doula training with developing my company and brand. I launched Doula X Design in January of 2019 accompanied by an interview in Madame Architect.

How have you embraced these seasons of change, especially ones where profound transformations and growth have occurred?

When I realized that problems and change are just an inherent part of life, my whole attitude shifted. Remaining nimble and adaptable are so crucial because that’s the only way you are going to weather the changes and learn from them. Normalcy is change and challenges, and if you don't realize that, life is going to be more of a struggle than it needs to be. I have to constantly remind myself to keep moving forward, even if you don’t know where you are heading, because if you stagnate, your ship is going to leave without you (laughs). Gratitude is important too. I am grateful that I’m in good health and have amazing family and friends. The world is just a shit show, our country is a mess. Whatever problems I have are really surmountable.

Was there any grief in leaving behind the identity of being an architect?

Leaving architecture forced me to reflect and redefine myself. SHoP and architecture was my identity not only professionally but personally too, being that I was married to one of the other partners. Am I still an architect? If I'm not, what am I? How much do I want to separate myself from that world, and do I need to in order to start the new chapter and move forward? And I think I did need to distance myself, in a way, and am now trying to find a way to tie it back in. 

When you have your own firm, you're always worried about something - a project, the staff, landing work, making payroll, staying relevant, adhering to your brand— there’s always some sort of crisis. It was a relief, in some ways, to not have to worry about all of that constantly. The bigger the firm got, the worries grew exponentially and it was a lot, so I think relinquishing that anxiety helped to balance the grief a little bit. 

For 20 years I lived and breathed SHoP, it was my first baby. What I missed when I left was being part of something larger than myself. I missed the people—I really loved the staff, aka SHoPpers. When I think about the firm, that's what I miss the most, the incredible people. I loved mentoring, especially the young women. But it was time for something new. That being said, I always thought I would be there forever; I assumed that I would be there until the end. So there was some grief and some fear in that sense. The pride I have in the people, in the firm, and all of our accomplishments together helped to temper my grief.

What did you have to surrender to allow for this next chapter to begin?

Any sense of ego and expectations. It’s all been very humbling. I am a fairly humble person, which isn’t the norm in architecture (laughs). Divorce is humbling, a series of humbling events laddering up to the change.

What does grace mean to you and how has it shown up in your life?

For me, grace means kindness, patience, compassion and empathy. Grace means holding space for yourself and for others. I really didn’t understand the concept of holding space until I became a doula. That is what I do for my clients—I meet them where they are and I hold space for them, and allow them to hold space for themselves. I realized that I didn’t hold space for myself in my previous chapter and that’s on me. Holding space could look like many different things—allowing yourself or someone else to process something, modifying physical space so you feel safe and calm, setting up boundaries, giving yourself some wiggle room, and not being so hard on yourself. I used to feel guilty just sitting down. I always had to be doing something either at home or at work. And now I realize that’s just not sustainable. It’s ok to just sit down, read a book, take a rest or just do nothing. I’ve learned that it is in those moments when the best ideas present themselves. 

I have a friend who had a huge job in the restaurant industry and her new chapter coincided with mine. She left her company and studied mediation in India for 3 months, while her husband stayed with her children so that she could embark on her new path. We were on our journeys simultaneously and were able to process and validate a lot of the same feelings. We inspired and encouraged each other along the way, and we continue to do so. This to me is grace.

With the gift of perspective, in what ways have you surprised yourself?

That I’m stronger than I thought I was. I am more independent, I take more risks, I don’t temper my convictions or shy away from situations that used to make me feel insecure, and I try to keep imposter syndrome at bay!

Throughout this process, my girls have been with me every step of the way. You never quite know what’s being absorbed, what they’re picking up on or what’s having an impact; but I do think it has definitely had an effect on them. As challenging as this period has been for everybody, that’s been one of the silver linings. Life is messy. I had to navigate it as many people do. Perfection isn’t normal and it’s been so important to show them that. And some of it has been figuring it out together, asking them what they think. 

One of the first trips that the girls and I took together, just the 3 of us, was to Edinburgh Scotland. The whole trip was an exercise in problem solving. The take away was not if you got it right or wrong, but rather, did you have fun and laugh a lot while trying? Figuring out little things like how do we buy train tickets, what our budget was for dinner, what happens if we miss our stop or get separated, it made them feel empowered, confident and accomplished. They realized that they could do things that they were intimidated by and that maybe things weren’t as scary or difficult as they thought they would be. And I realized that too.

At this phase in your life with all your incredible achievements and an open road ahead of you, how do you define success?

Differently than I used to. I used to think being at the top of your profession, having a lot of financial success, being well recognized for your body of work, appearances, all defined success. Those aren’t as important to me anymore, and that’s come with age and life experience. In the past few years, two very close friends died way before their time. It makes you realize what’s important. It helps you prioritize. One of my dad’s favorite lines is “Life if not a dress rehearsal”. I always used to laugh when he said that, but now I get it—he’s right.

Does the word success have as much weight to you now as it did early on?

No it doesn’t. Anyone would say that SHoP is successful; I was part of that so I proved to myself that I could achieve “success”. So is it easier for me now to say ‘Been there done that I’m good with whatever happens?’ Maybe? It’s interesting to contemplate how much of that might inform my perspective now.

Where are you on your journey?

It’s been five years since I left SHoP, but I do feel like I'm still at the beginning. Maybe not the not the prologue, but perhaps approaching the meat of the chapter and definitely not knowing how the chapter is going to end. 

But I’m confident that I’m going to figure it out. It’s not scripted, I know generally that I want to bring together the two sides of my professional work, design and birth work. I have this incredible community both in architecture and the birth world and I'm starting to see more areas of crossover and opportunity. I'm finding all of the threads and weaving them together—I don’t know what the final product is going to be, but the people I’ve met along the way and the conversations that I’ve had, it’s all very inspiring, energizing and affirming.

What fuels the work you do?

When I can see that I’m having an impact and making people’s lives better. And I'm not the only one doing the work, I'm helping them help themselves. I can see that my clients are having more positive birth experiences and better outcomes than they would have without me. It isn’t so much about whether you have an induction, a vaginal birth or a c-section, or a myriad of interventions that determines how you remember your birth. Rather, it’s about whether you felt informed, heard, and safe during the process. Were you treated with dignity? Did you feel respected? Thus, I am giving my clients the tools to put in their tool kit to navigate life’s future challenging situations. My hope is that my clients will share their knowledge of the perinatal process with others who will in turn demand a better way. If enough people are demanding change, that’s what’s going to change our very broken system. It gives me a sense of purpose. I know I'm on the right path and I just have to keep on keeping on.

There’s one thing that I want to go back to when we were talking about my daughters observing the changes and the work I do. I get a little charge every time that I see that one of their friends has started following me on my Doula X Design Instagram account. I know that they will see and learn that there is a better way to give birth. That’s the best part of social media. I think about the next generation and the boundless possibilities. It’s all about normalizing, demystifying, knowledge, and education. Keep sharing stories—that is how the knowledge of birth was handed down throughout history.

How does chasing sunshine manifest in your life?

On a very real level, being able to live in Maine near my parents and my sisters and be part of their everyday lives, especially as my parents navigate the challenges of aging. I love the raw beauty of where I live. I love being able to see, smell, hear, taste and indulge in the ocean whenever I want to. I love being able to walk to a ballet or yoga class, just as I did in New York. I love the slower pace.

Moving away has allowed me to breathe. Really, really breathe and expand. Breathe as a euphemism but also that feeling (takes a deep breath). I have a little yard, a garden and a porch. My dog Clover can run around outside freely. I can see the stars and hear the gulls. Little things like that can really make a difference. I go back to New York every six weeks or so for work or to see friends. Each time I hit the ground running, soak it all in, wander as much as I can until it is time to head back.

What are some touchstones or principles that continue to guide you?

I keep going back to this, but be adaptable and be nimble. Be true to yourself. Guard your joys fiercely. The things I loved to do as a child I sort of lost along the way, but I’ve recently come back to them and I’ve derived so much pleasure from that. Kindness, it’s so easy to be kind, accepting and generous.

Wisdom to share to those who are in pursuit of what makes them uniquely whole.

All of the above—I don’t know that we are ever fully whole. Constantly find pieces that you didn’t even know were lost and shed ones that don’t quite fit anymore. Be true to yourself. Don’t concern yourself with what others think. Relish problem solving. Embrace the messiness. Keep moving forward, and not necessarily in a straight line, just keep meandering in a, generally, forward direction. Hold tightly to what brings you sunshine.