How Black Doulas are Changing Maternal Health Care

By Published On: April 11th, 2022
Home > News & Advocacy > How Black Doulas are Changing Maternal Health Care

There's power in women of color serving one another through pregnancy and into parenthood. Our expert shares her heart for birth work and how it's positively impacting Black mothers.

Childbirth has the potential to be equally healing as it is transformative.

For a pregnant woman, it’s an opportunity to claim complete ownership over her body and believe that the deep-seated instincts she possesses are good. Trusting that she can accomplish the monumental task of laboring and delivering her baby—and then seeing it come to fruition—can mend parts of her past and pave the way for a renewed future.

This is the heartbeat of the work of Amber Churn, a certified childbirth doula and founder of Black Birth Nerds, who currently services women and their families in the cities of New York and Atlanta. She primarily takes on patients in the Black and Latina communities, but specifically seeks Black women, whom she says have a longstanding history of receiving inadequate medical care from physicians due to disparities in health coverage, patient-provider distrust, and a lack of proper prenatal education.

Dealing with these discrepancies and barriers during the vulnerable time of pregnancy makes it hard for Black mothers to know that medical professionals are for them, explains Churn.

Learning from the Past

Provider distrust is a shared experience amongst the Black community and is steeped in a dark history of horrific events and dismissive action from doctors.

J. Marion Sims, touted as the “Father of Gynecology,” perfected a technique to repair fistulas, which are holes between the vagina and the bladder or rectum that can lead to incontinence, by conducting routine, extremely painful experimental surgeries on enslaved Black women without the use of anesthesia. The 19th-century physician continued using Black bodies as medical test subjects for a host of other unethical experiments over the span of his practice, operating under the false and racist notion that Black people did not feel pain.

Amber Rose Isaac was a 26-year-old expectant mom from the Bronx when she tragically died during an emergency C-section before getting to meet her son. Her platelet levels had been falling, but she wasn’t able to see an in-person doctor even at seven months pregnant due to the coronavirus pandemic.

Her condition worsened, and she was finally admitted to a medical center months after her initial worries began; three days later, her family said doctors induced her labor when they learned Isaac developed HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelets) syndrome, a life-threatening pregnancy complication usually considered to be a variant of preeclampsia.

Her partner was barred from being in the room during her cesarean, and she died without loved ones around her. Before her surgery, Isaac tweeted that she couldn’t wait to tell everyone about her experience dealing with “incompetent doctors,” further solidifying her feelings of being brushed off during her pregnancy.

Churn says that the notion of Black patients not feeling heard or respected by a provider is nothing new, and unfortunately, neither is the outcome of Black maternal death.

“When Black women in the No. 1 country in the world for medical technology and accessibility are dying in childbirth, there is something systematically wrong … African American mothers have also been dying exponentially more in childbirth than white women,” she says—and she’s right. The Centers for Disease Control (CDC) reports that Black women in the U.S. are up to three times more likely to die from pregnancy or childbirth-related causes, an issue that’s echoed globally for thousands of women who struggle to give birth in poor countries, especially if they need to deliver in a medical facility versus at home.

This is why midwifery and doula services have been critical for centuries, especially for women of color. Churn explains that African nations have treated childbirth in the family home as a foundation of culture and take pride in caring for mothers and their babies. Historically, it was always women who were called on to assist with birth, and they were trusted by their communities and valued for their intuitive wisdom and compassion for the birthing mother.

She says that during the slave trade, these pivotal roles in maternity care were broken, and that she’s now working to restore things like education, accessibility and a sense of empowerment that have been taken away from Black mothers.

Serving in the Present

“What I do as a doula is bridge the gap between [inaccessible quality health care] and being an advocate for people of color,” says Churn. “I tell my clients, ‘I’m going to enlighten you with childbirth education. If there’s something your [provider] wants to do during labor, you should be knowledgeable about it. You should know you have the right to say no. You should be able to take a minute to talk to your partner.’”

Doula care is often referred to as the emotional support of childbirth. A doula is there to prepare partners for delivery day, as well as the possibility of having to navigate making decisions (due to complications or other detours) that can arise during labor. She’s also there to be a mouthpiece for mom and her birth plan; help birth partners feel confident in having an active role in the process; make the stages of labor as comfortable as possible, plus many other notable duties.

The education piece, specifically, is part of Churn’s passion for her patients, and she says it’s important for them to know they have options in birth; choosing for themselves, whether it be a hospital, birth center or home birth, a midwife or an OB, a med-free birth or an epidural, is the ultimate victory.

She reflects on a past birth where she assisted a mother seeking a VBAC (vaginal birth after cesarean). The woman had a traumatic cesarean first delivery and was hopeful to forgo another surgery. Despite push back and perceived undertones of judgment from her provider, the mother was able to have a successful—and healing—vaginal birth.

“I call her my VBAC warrior,” says Churn. “That’s my heart and my work: To protect. To advocate. To give back that sacred empowerment experience in birth by educating, by teaching communication, by giving a voice back to my clients.”

She also says that the things she teaches as a doula translate to everyday life, referring to them as identity-empowerment tools. She reminds mothers that they, as Black women, have a right and responsibility to say what they need to say. They have a long history of strength and resilience … and an innate knowing of community amongst each other. This communal mindset is what makes Black doulas and Black birth workers so pivotal for the healing experience of Black families. “We haven’t walked in each other’s exact shoes,” she says, “but there’s a comfort and trust in having another person of color beside you [in birth].”

The strength of the family unit as a whole is another important aspect for Churn’s service and is woven into her work model from day one. Part of her doula program involves focusing on dad and bringing him into the birth experience as much as she can. She says in her time as a doula, men have often been overlooked and not respected in the labor and delivery room, but that she wants fathers to feel empowered and not be on the sidelines. Churn believes that strong parents make a strong home, and she aims to ensure that baby is brought into a unified, cohesive and peaceful environment. Her hope is that a solid start to parenthood where mom and dad feel loved and cared for and honored will have a ripple effect in their child’s life, which in turn will bleed into the next generation, and so on.

Seeking a Better Future

It goes without saying that there’s an urgent need for action in the Black maternal health space and for maternal quality of life in general, not only during pregnancy, but the postpartum period as well.

Churn spends time talking with her clients about what happens after baby arrives—to their relationships and finances and schedules—and also puts an emphasis on mom’s self-care during recovery, all of which she says is missing from prenatal education.

“I want there to be a cultural and medical focus on postpartum care for mom with accessible information, so she can really prepare for that time,” says Churn. (We agree!) She also adds restored trust between Black patients and their providers to the list, and a true security that they will be cared for in all scenarios.

What else does she want for the future of health care? “More information on doulas! Women don’t know that a doula is an option and that we can handle a lot of things, like prenatal care, birth services, postpartum help, lactation support for breastfeeding … we’re a one stop shop!”

While doulas like Churn are doing amazing advocacy work standing in the gap for these mothers, they can’t get where they need to go alone.

“Everyone plays a part in mothers making it safely through childbirth,” explains Churn, and she shares a few ways to support Black birth workers:

  • Reach out to your state legislators to voice your concerns.
  • Donate to Black maternal health organizations or volunteer to serve. (You can gift Churn’s doula services to expectant moms from lower income communities through her site.)
  • Be willing to communicate what you know about this crisis to others; be honest about what you don’t know and seek knowledge.

And that’s exactly what Churn is doing every day, seeking more for her patients and humanity as a whole.

“I want to not only raise awareness of Black maternal health and doula services, but also bring curiosity and long-lasting transformative action.”

We have a feeling she’s accomplishing just that—and more.

Lauren Lisle