by Miajenell Peake
*editor note: We use Black birthers/Black clients instead of Black women because not everyone who gives birth is a woman. When we specify Black women, we are referencing particular instances.*
I live in Memphis, TN a city that most folks know to be the barbecue capital of the world. Birthplace of music legends Aretha Franklin, B.B. King, Isaac Hayes and Elvis Presley. And assassination site of Dr. Martin Luther King Jr.
As a Black birth doula, I interact with the city in a different way. Memphis is well regarded for its extensive medical and educational facilities, and yet it also once held the highest infant mortality rate in the nation. It currently holds cesarean rates almost double the national rate.
I’m not surprised by these statistics. I work with majority Black clients, and the negligent treatment they receive in hospitals is both common and criminal. Their concerns are taken lightly, disregarded or completely ignored and the staff are often preoccupied with numbers instead of care.
Deeply affordable and accessible healthcare are not realities in our communities. Black women in particular are three times more likely to die from pregnancy related issues than white women. Black babies have the highest infant mortality risk. Stress induced by racism increases the incidence of preterm labor and low birthweight. And in the US, most hospitals that are accessible are lower quality, less sanitary, understaffed and overcrowded.
Doulas are addressing many of these concerns by listening to our clients and ensuring that their voices are heard. And since we are not employed by the hospitals, we aren’t bound by its expectations and practices.
When I first moved to Memphis, there was only one Black doula in the city. At that time, several friends were having babies and shared their anxiety around giving birth. They didn’t know much about the birthing process other than what they’d heard from family members and close friends. I noticed that the advice they received centered pain and shared birth trauma experiences, with little regard for hope, excitement and joy.
I was working at a doula agency in Memphis the first time I witnessed the racialized disparity between grounded, patient centered care and willful neglect. At this agency, I was the only Black doula there. I noticed how white women who were encouraged to breastfeed by their nurses immediately saw a lactation specialist and formula was rarely mentioned, whereas in hospitals Black clients are less likely encouraged to breastfeed, often suggesting formula instead. The white women were also able to move outside of their labor rooms and use intermittent fetal monitoring. Their labors were not rushed.
After a few births with this agency, I resigned. I created my own doula agency, Peake Wellness a few months after because I wanted to offer specialized and grounded care to more folks who look like me, in communities that are overlooked often.
My main focus has been ensuring clients are able to navigate the healthcare system, leave birth without trauma, gain valuable information and be treated with dignity. It’s important that I candidly discuss which hospitals and providers Black folks should avoid if they can, because I know the realities and consequences of doctors and midwives having negligent bedside manners.
Because doulas as a whole, are not part of the healthcare system, we are the most unbiased birth experts in the labor room.
During an early labor hospital visit, one of my clients was given an antibiotic she was deathly allergic to. I noticed that her lips and fingers were swelling and that she was itching uncontrollably. When I told the nurse, she immediately dismissed her symptoms as a reaction to a previous medical intervention. After vocalizing my client’s concerns and asking for another nurse, the second nurse came in and fixed the grave error.
Sometimes I think about what would have happened to her and her child had I not been in the room that day, requesting that she be taken off the medication immediately.
Checking in with clients and educating them on how past trauma can impact the birthing process is a necessary step in being a birth doula. Folks who have experienced sexual and emotional trauma may feel triggered during check ups and may not be able to advocate for themselves. After working closely with clients and learning their body language, doulas are able to move in to support when this happens and communicate with physicians when breaks are needed.
Doctors and nurses have a history of doing procedures on bodies without informed consent and often recommend cesarean sections to young Black mothers, even when these surgeries aren’t necessary. Having a doula around, decreases cesarean risk, increasing breastfeeding rates and leaves clients with a more positive birthing experience.
Throughout my prenatal sessions with clients, I normalize therapy and strongly encourage each client to seek counseling before and after birth. I often tell clients that although I am their hired doula, I am also their sister. With growing gentrification and displacement, some of my clients are pushed further out. I offer provider payment plans and assist clients with navigating insurance reimbursement for doula services.
When they are feeling alone, overwhelmed, or overworked, my clients know they can call me. Sometimes I function as babysitter because their parents often have to go to work shortly after giving birth. This practice is becoming more common and I’m excited about it. We are creating a community where people feel safe and vulnerable while knowing that their children are protected and cared for.
While the majority of folks in the U.S. give birth in hospitals, the practice is fairly new. Until the 1900s, home births were the default way to deliver and in different countries across the African continent, home births are still the norm.
Birth support is a necessary component in building a more equitable world because it means the experiences of those who give birth are believed and centered. We don’t rely on machines to tell us how a birther is doing, we trust that when we build safe containers for them to share, they will. I enjoy being a birth doula because I get to revisit practices that folks in my lineage shared centuries ago and I get to contribute to building freer, Blacker futures just by engaging my calling.
Black doulas are crucial to the birthing process and all people, regardless of gender and socioeconomic status, should have access to one.
Reading Suggestions:
“Killing the Black Body,” Dorothy Roberts (1997)
“Medical Apartheid,” Harriet A. Washington (2006)
“Birthing Justice,” Julia Chinyere Oparah (2015)
“Battling over Birth: Black Women and Maternal Health Crisis,” Julia Chinyere Oparah (2017)
Affectionately known by her clients as “Mia,” this native Memphian has always been passionate about health care, specifically reproductive health. Mia earned degrees in Psychology, Biology and Women’s Studies from Georgia State University and a masters in Public Health and Health Policy from Meharry Medical College. Mia is certified by the doula training and certification organization, DONA International. Her specializations are hospital and home births.
