It’s Black Maternal Health Week, which is observed in 2024 on April 11-17th. Why is Black Maternal Health Week a thing? Because in the US, Black birthers face disproportionately more pregnancy complications and even death when compared to other peers. At the International Doula Institute, we hope to be a small part of the big changes needed to address these disparities.
As we commemorate Black Maternal Health Week, it’s imperative to shed light on the invaluable support doulas provide and how their presence can catalyze positive change within this critical sphere. While doulas are not the solution to this problem, they can help each of their clients work towards a better outcome despite the increased risks.
Black Maternal Health: The Role of Doulas
We know that continuous labor support, like that of a doula, is proven to improve outcomes on a population level. We know that having a doula can reduce the risk of certain complications and increase the likelihood of reporting a positive birth experience.
In the context of black maternal health, the education and continuity of support provided by doulas can add a protective layer against the disparities we see.
The unwavering support, guidance, and advocacy education black birthers receive from doulas before, during, and after childbirth can help each birther reduce risks. A professional doula brings a wealth of knowledge, compassion, and cultural sensitivity to the birthing experience, tailoring their care to meet the unique needs of everyone.
Statistics show the harrowing reality: Black women are three to four times more likely to die from pregnancy-related complications than their white peers. This continued disparity, despite education and awareness, is an urgent public health matter.
Until systems change, doulas have the unique opportunity to help support each birther as an individual, doing their best to help fight against risks.
One of the most profound impacts of doulas lies in their ability to mitigate some of the effects of institutional racism and implicit bias within healthcare settings. Through their presence, doulas can support clients in challenging policies, amplify the voices of Black mothers, and encourage patients and their families to advocate for their rights.
Doulas work towards supporting clients to have a safe and dignified birthing experience.
Why Are There Disparities in Black Maternal Health Outcomes?
To fully understand disparities, one must fully understand the history of the US and modern obstetrical care. It is impossible to delve into all the details in a short article. However, the basics of modern obstetrical care was founded through violence, slavery, and deplorable experimental procedures. These were done by Dr. Sims on enslaved Black women, and later, impoverished immigrants.
His work, done without anesthesia or analgesics on Black and poor women, were later done with pain relief on white women with means. This led to absolutely false beliefs that Black people experience less pain, a myth that has persisted for generations.
Being founded in violence, modern obstetrical training was not rooted in holistic, person-centered care. Unlike traditional midwifery care, the focus of modern obstetrical care and training seemed to be on a healthy infant, regardless of the means. A birthing person’s health, experience, etc., was not centered.
When we look at the violent start of obstetrical care, coupled with false beliefs about Black people’s bodies, it makes sense that we continue to see disparities. When we add that to additional issues such as social determinants of health (impacted by historical events like redlining), and ongoing stress related to systemic racism, it makes even more sense.
What is perhaps the most frustrating aspect of these disparities, we see them even when we think we would not. For example, even someone with as much means and celebrity as Serena Williams was ignored. She essentially saved her own life following complications from birth.
If a wealthy celebrity remains at risk, what hope do others have?
How Can Doulas Help Reduce Disparities in Black Maternal Health?
Let me be clear, it is not the responsibility of doulas to fix the broken maternal health system. However, as systems crawl towards change, doulas can help individuals have improved birth outcomes.
Doulas play a vital role in navigating birth inequities. They can become a bridge in the gap of care in modern maternal health systems. A system where continuity of care and patient empowerment can be lacking.
Doulas also work towards fostering holistic approaches to maternal health care. They emphasize the importance of mental, emotional, and spiritual well-being alongside physical health. While doulas are not therapists, midwives, etc., they are an invaluable resource. They connect families with education and services within the community to help address all aspects of pregnancy wellness.
Additionally, some Black doulas offer a unique connection to Black American and African diaspora traditional pregnancy and birth practices. For example, many traditional birth recipes are high in iron, protein, and other vital nutrients to aid in maternal healing. There is also often an emphasis on being active during pregnancy, while resting in the postpartum period.
Doulas cannot fix social determinants of health, systemic racism, or biases in care. However, doulas can help:
- Educate families about pregnancy wellness
- Inform clients of their rights as patients
- Encourage self-advocacy
- Educate about red flags where further medical care is needed
- Teach about signs of preeclampsia, preterm birth, postpartum complications, etc., as well as ways to reduce risks
- Help clients be active participants in decision making around their pregnancy and birth
- Educate about chronic and transient conditions in pregnancy. For example: morning sickness, hyperemesis gravidarum, gestational diabetes, PMADs, etc., and how to manage side effects and complications, while informing them when it’s vital to push their providers for appropriate care.
What Are Doulas Doing For Black Maternal Health?
At the IDI, we aim to educate as many as possible about their role in fighting against disparities. We do this through our Diversity, Equity, and Inclusion For Birth Workers course. This course covers Black maternal health as well as other groups who face disparities in care.
Other doulas in the community fight towards awareness, access to care and more. One group, Oshun Family Center shows a strong commitment to annual Black Maternal Health events.
Doulas may not be able to solve the systemic issues quickly, nor are they responsible to do so. However, they can be a part of the change and help support each of their clients. As doulas, we can strive towards a future where everyone has access to safe, evidence-based, dignified care without disparities.
Author: Maria Silver Pyanov, CPD, CCE
Maria Silver Pyanov, CPD, CCE has been serving prenatal and postpartum families since 2007.