Debra Pascali Bonaro

Debra Pascali Bonaro

Sitting down with Debra Pascali-Bonaro was really coming full circle for Nat as she was her doula trainer and a big inspiration for her coming into this work.  Debra is perhaps most well known for Orgasmic Birth, her documentary (and book), that highlights birth as a pleasurable experience. Debra also leads doula workshops around the world and has just launched Pain to Power, an online Childbirth Education course which uniquely explores birth as part of our sexuality, as well as shares all the ins and outs of a pleasurable birth experience.

Here is Debra on how birth has changed through the generations and the lessons she has learned from her lineage’s birth stories, her goal for all women to have doulas, and how 30 years in all things birth have shaped her life. 


How I was born is really tied into how my mother was born and how her mother was born and how her mother was born.  My great grandmother birthed 8 children at home (because that is what you did in the early 1900s) and it's so amazing to be sitting here at 126th St. in NYC because her first babies were born on 110th St. and Amsterdam.  As a little girl it was wonderful to hear her stories of her 8 children being born at home and when you are little, and someone is in their 80s, they seem so old to you! So this tiny little Italian lady would talk about working on the farm and moving around until she couldn't, and then she would lean over the kitchen sink and have a baby! And so I grew up really thinking, "How amazing! You just walk around, lean over the kitchen sink, and out slides a baby!" But it probably was that ease and simplicity that made me never really have fear of birth.

My grandmother gave birth to my mother in NJ, but at that time in America we didn’t have enough caregivers in every community so instead of coming to your home, you went to them, and so really it was probably what I see now as a birth center but we didn’t call it that.  In America we called it sanitariums, but basically you were giving birth in someone else’s house. The birth was attended by a doctor now not a midwife, and she was put to bed.  It was the beginning of medicalization and being put down and not having the freedom you have in your own space to really listen to your body.  

and, HOW about you?

My mother had me in a hospital. I was born in 1957 and at that time birth was entrenched in the medical model. And there was no longer options for sanitariums, home birth or birth centers, it just didn't exist. When labor began she was living with her mother and lived next door to her grandmother and so she had this circle of women around her - the missing ingredient today, and the role that doulas fill.  They were still connected enough to know the power of a woman's support and so they were with her in early labor and kept her moving.  They couldn’t understand why you would go to a hospital for a healthy event and they wouldn't let her go for the longest time.  Those were also the days when everything was pressed and ironed and my grandmother kept pushing my mother in the shower and when she would say, "I think I need to go" my grandmother would say, "Not yet because your dress isn’t ironed" and so literally she kept my mother at home with this great circle of women until it was almost too late for her.  By the time she got to the local hospital she was fully dilated.  And that was her gift to bypass all those interventions that would have been, even today if you get there early and have the time, and especially back then, I mean she would have really been put down in so many ways.

Can you explain more?

They used to at the time, routinely give scopolamine that would have really erased her memory of birth and disconnected her from mind, body and the spirit of birthing. So how blessed was I that my grandmother kept ironing!  My mother had to go into labor looking beautiful in her pressed dress. It was of the times!

LOVE IT! SO then what?

My mother was starting to push, but it was during the time that medical science really took over - and I know it came from a place of wanting to help - but even though my mother was doing great and coping beautifully they convinced her that she needed an epidural. Their standard policy back then was using a saddle block which was really like an epidural in a sense but given lower so it really just blocks the pelvic area. They believed that pushing a baby out was this really difficult terrible pain, which, how wrong they are because it's so satisfying and can really feel good!  And so my mother has always had great sadness that she didn’t know she could refuse [the saddle block]. It wasn’t a matter of people asking, "Do you want this?" Instead you got in and the wheels of the machine took over. But the good news is that I was born 20 minutes after they arrived so it barely even took hold.

The other practice of the time was that they wanted to take me to the nursery and start this "every 4 hours you get to see your baby thing." Mom knew enough that something was wrong with that and really listened to her wisdom and at that point she refused and really took on the system.  She wanted me and wanted to breastfeed, which at that time was not common.  They were just giving women shots to dry out their milk without even telling them what they were doing because formula was the "sophisticated" or "wealthy” thing to do.  They belittled her for wanting to do this more "peasant" thing or something, but she really advocated for herself and I was breastfed for 2 years.

I realized, even as young girl, that I was the first baby in the family, ever, in this huge long line of human history, to be born in a hospital and that really had me realizing how the others, especially how my great grandmother talked about birthing and power and joy and how she smiled with it, and my mother had to fight for it and I think that really gave me the fire when I was pregnant with my first son. I wasn’t going to turn my body over to medicine blindly.  I really wanted to understand my options and know that in the end it was my choice. It was my body, my baby and my birth and that really sent me on my path today.

BEAUTIFUL! And what are you birthing these days?

When I initially became a doula, my vision was that all women could be doulas and all women could have doulas in a sustainable way. I'm in New York today for a Healthy Women Healthy Futures (one of the community doula programs I've been working on since the beginning) workshop which trains women from all 5 boroughs to serve the women in their communities. We try to match language, ethnicity and all of that to the community she serves and it is fully funded by the city council. I really had years where I thought my vision would never happen in my lifetime -the barriers just kept piling up. But today was amazing because I was sitting there in this training looking around the room and thinking, "It’s happening" and it's happening all over the world. It just makes so much sense and it's bringing back all that wisdom -whether you have your great grandmother to tell a story or not- it doesn’t matter because you'll have another woman to tell a story and what we need to do, as you are doing -which I give you kudos for- is bring those stories together.  And if they are positive and powerful to embrace and learn from it, and if they are difficult and challenging to embrace and learn from it and ask, "What can we do differently?" I really love your questions because every birth story is such a beautiful gift and a real opportunity to learn by listening. So it has been a really special and emotional day for me because I'm not training today so I've been able to sit back a little bit and really watch 30 years before my eyes and go, “Wow".

Sounds like the project is moving out of infancy! ;) Any new gestations?

My newest baby that I've birthed is an online childbirth class. I wish everyone could come to an in-person class -you know the connections and the discussions will never be the same online- but seeing that so many people can't and how instead they are getting their info from TV or websites that really aren’t accurate, I birthed Pain to Power to bring really good, not only evidence-based information to people, but also my belief that birth is part of a woman’s sexuality and that we are not talking enough about sexuality and enhancing it before pregnancy, healing it if it's not healthy and bringing it to birth in a way to really connect fully and reclaim our bodies. So Pain to Power has been this interesting blend of me being an educator for 30 years, speaking about birth as pleasurable, and my documentary Orgasmic Birth interwoven into one. It has been my longest gestation and it has been a great birth. We are just beginning, but already getting people from around the world who are finding it valuable to have these discussions online, especially those who wouldn’t have access to that information in person.

So exciting! speaking of Orgasmic Birth, will there be an Even More Orgasmic Birth?

I think I'm ready to do something new. Through my work, I get the opportunity to travel the world and wherever I go, I get to learn and to attend births.  I listen to local women and local caregivers and there are definitely places in the world that are doing better than we are in the US, that are really honoring women and have healthy birth models, and then there are places that are doing far worse.  I'd love to show the places that are really doing a good job. Many times it's a health system, but many times it's a community of people that say, "We aren’t taking it anymore. We are going to create our own model and get out with our wheelbarrows and shovels and we are going to build our own birth center." And so I think there are really some beautiful stories. Anyone who says it doesn’t exist and, "Im just stuck in the system" is not realizing that it only takes one or two people to start bringing the change needed to create a healthy model.

Any specific communities you want to highlight?

I think the problem is that I know too many places! There are so many good models that exist even in the middle of bad models. One I just love is in Brazil.  There's a little community that literally built its own birthing center/maternity hospital and is doing amazing work.  Women from the poorest of poorest communities have dedicated themselves to being doulas and they are providing doulas to every woman that gives birth there -and they are doing 10,000 births a year! It was a community who felt their hospital was not providing them with their needs and took it into their own hands. They even have samba classes there! The CEO, the doctors and the midwives are dancing together. It's just a different relationship. It's a story that has to be told.

There are so many good things happening! And it frustrates me that we are in the city of so much possibility and, in so many areas it is, but in birth we are doing worse than most of the third world.

BB: It's a tough topic. Most of us are afraid of birth because it is so unknown. Unless you go through it, most likely you know nothing save for what you see on TV or the stories friends share. Plus, what we are seeing a lot in our practice is this shift which has occurred with the prevalence of various birth control methods. So many of us are that are now in and entering our childbearing years, have been divorced from our bodies and cycles for years and years prior to conception. So it makes it really hard to trust birth as a normal physiological process when we've never experienced our bodies's innate abilities before. 

Right. And so from the get-go you are engaging in a medical, pharmacological model which then makes it more difficult to move into a more natural model from there. And I wonder, what happens to your body when you don’t cycle? I haven’t researched it, but I just wonder, what is it doing to us?  

That’s where I was blessed coming out of the 70s and 80s.  We had these clinics where you could get fitted for a cervical cap. Well, in order to get fitted for a cap, you had to really feel and understand your body because it literally fits your cervix, so you had to get up there and learn where your cervix is in your body.  And so having to get fitted made us learn our cycles because obviously you don't have to wear it if you know when you ovulate.  You are only going to wear it a few days before and after ovulation so by the time we left, I had this whole other understanding of my body and my cycle.


You've given birth to tiny humans as well as some pretty major projects.  Do you see a connection between the labors?

Great question because I always say we birth the way we live.  So whether it's a project, idea, new job, new home, we go through those patterns… I mean it's almost predictable -that fear and excitement and then the challenge sets in. With Orgasmic Birth I went through all of that, from literally having a dream in my sleep of making the film, to being excited and then fear sinking in of, "How am I going to do this?", "I don't know how to do this", I’ve never done this." Just like birth when you are first pregnant or thinking of becoming pregnant. And I remember sitting in the editing room one day really struggling and saying to my editor Chris, “Are we there yet? Is this transition?" and she looked at me and said, "This is definitely your first film because we are only 3 cm dilated" and it was still a couple of months before she turned to me and said, "We are starting to push!"

And that analogy and even the emotions… I try to say to people, these challenges are good! They are what allows us to stretch and grow. If we live life without going through the challenges we don’t get the growth and benefits of it. So I’ve learned to welcome that in projects. Not that I like it any better. I still complain and resist, but also persist and know there is a way to get through it. And you always gotta find the doula! Who is the doula for that project? The person that can believe in you and be there for you when you need someone else's eyes to look into -because we all lose faith and we all wonder. We need the people that circle us, that hold space for us. So I feel blessed to have a lot of life doulas that I can count on, and we can celebrate the joys together and can go deep into our challenges.

Any #BrilliantBits to share?

Birth shapes our lives. The way we are born is in us. It's going to impact our birth. And that’s an assignment I have been giving for 30 years. Learn your own birth because you have to clear your cobwebs. And there is hopefully joy in that, but if not, then it’s something to really look at because it is in your body. You’ve lived through it and you may find blocks in your own labor that are hitting those spots.

To learn more about Debra go to: to learn more about Debra's revolutionary Online Childbirth Class


if you're interested in becoming a doula go to to join debra at a doula or advanced workshop or retreat.

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Dr. Jessica Zucker

Dr. Jessica Zucker

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Abby Epstein