Who will be in the room during your labor? Your partner? Maybe your parents? As America’s maternal mortality rate rises, many birthing individuals of color are choosing to have a doula by their side.
According to the Center for Disease Control, the U.S. maternal mortality rate in 2018 was 17.4 maternal deaths per 100,000 live births. For Black women, the rates are even higher.
Regardless of income or education level, Black mothers in the United States die at three to four times the rate of their white counterparts.
“We can’t educate ourselves out of this,” says Jessica Roach, founder and executive director of the Columbus, Ohio reproductive justice organization Restoring Our Own Through Transformation (ROOTT). “We can’t just get enough money. [Black maternal mortality] is steeped in institutional, structural racism,” she told SELF.
In major areas like New York city, Black mothers are 12 times more likely to die–but 60% of these deaths are preventable, especially with better health care, communication, and support.
Birth Assistants Though History
For centuries, birthing people were supported through pregnancy and labor by skilled family members or older women in the community. In ancient Africa, midwives were revered as sacred carriers of birthing wisdom, traditions, and rituals. Their guidance welcomed new life to their villages and communities. After being stolen from their homeland, enslaved African women used their ancestral knowledge to counsel and encourage laboring women, and often delivered babies–both Black and white–across plantations. Until the 1700’s, “granny midwives” were the sole care providers for many mothers and their new babies in the rural South.
“[Black midwives] were wiped out through politics and policy that demonized them as being uncultured, uneducated, unclean, and dangerous,” said Nikia Grayson, Director of Midwifery at CHOICES, a Memphis Reproductive Health Center.
By the early 1800’s, male physicians had replaced granny midwives, and state laws prohibited the practice–but their knowledge and historical traditions live on though modern day birth workers.
A “Woman Who Serves”
Derived from an ancient Greek word meaning “woman who serves,” a doula is a non-clinical professional trained to provide physical, emotional, and educational support to parents. “A doula serves as an educator, advocate, and cheerleader for the laboring mother, while keeping the family calm,” says Latham Thomas, the celebrity doula and educator behind maternity lifestyle brand, Mama Glow.
Birth doulas can offer support throughout pregnancy, working with parents to create their birth plans and preferences, provide comfort measures during labor, and advocate for care by helping their clients articulate birthing preferences, questions, and values to medical staff.
“Remember that you have your own autonomy,” says Kemetra King, a Certified Nurse Midwife at CHOICES. “This is your body. Whatever you want to do, that’s what we support you in. We are your voice, your advocate. We listen.”
How Doulas Help
Doulas can help reduce the time spent in labor, ease parents’ anxiety, lower the rate of medical interventions (including C-sections), and improve parent-baby bonding post-birth. The American College of Obstetricians and Gynecologists released a statement noting that “evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor.”
Studies have also shown that parents who worked with a doula were four times less likely to have a baby with low birth weight, and two times less likely to have a birth complication–something that could save Black birthing individuals.
Improving Outcomes for Black and Latinx Birthing People
A 2006 Listening to Mothers Survey III found that 1 in 5 Black and Latinx women reported poor treatment from hospital staff because of race, ethnicity, cultural background or language, compared with just 8 percent of white mothers. Another 2016 University of Virginia study found biological myths about black patients still persist among white medical students, such as the notions that African Americans have less sensitive nerve endings, can tolerate more pain and have thicker skin.
“I have definitely had clients hire me because they had learned of birth outcomes for women of color,” says Jessica Easter, a member of the National Black Doulas Association and owner of Abounding Grace Birth Services in Nashville, TN.
Stereotypes, implicit biases, and systemic racism all contribute to the subpar treatment that many non-white birthing individuals experience during labor and delivery.
Thankfully, a doula can encourage parents to speak up for themselves,, ask questions and examine the benefits, risks, and alternatives of any actions they take during labor.
Between 2011 and 2012, 6% of birthing parents reported using a doula–up from just 3% in 2005.
“At the point a woman is most vulnerable,” says Dána-Ain Davis, the director of the Center for the Study of Women and Society at the City University of New York, “she has another set of ears and another voice to help get through some of the potentially traumatic decisions that have to be made.”
Did you or will you use a doula?
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