There is an epidemic of postpartum deaths among Black women. The maternal death rates for Black women skyrocket way above any other developed country in the world.
Black women are two to three times more likely to die from medical complications postpartum than our white counterparts–and half of these deaths occur 3 to 7 days after birth. With these alarming statistics coming to the forefront of the nation’s consciousness, Black women are turning to alternate birthing methods to ensure a safe, comfortable delivery. Naima Beckles, co-owner of For Your Birth in New York City, is seeking to provide her clients with pre and post natal care as a Lamaze Certified Childbirth Educator, DONA certified birth doula, lactation counselor, and mother to two boys herself. We asked Beckles about her work as a doula, and why some women should consider hiring a doula when considering their birthing options.
HB: What’s a doula, and how are you different from midwives and doctors?
NB: Doulas provide hands-on physical, emotional and educational support to women and their partners throughout their pregnancy journeys. Doulas are not health care providers. We’re more like coaches for your pregnancy, labor and birth. Where doctors and midwives concern themselves with keeping you and your baby healthy, doulas focus specifically on a woman’s preference and comfort. We might remind our clients of pain management techniques, show partners places to massage, or bring things the client might find comfort in like ice, music, a birthing ball.
It’s also a misconception that doulas only attend homebirths or are hired by woman who want to give birth without medical intervention. While on the rise, homebirths are still incredibly rare. Less than 2% of births nationally are planned homebirths. Doulas, by far, attend births in hospitals – often with women planning to receive medical interventions including an epidural – more frequently than they are attending homebirths.
NB: I was naïve when I was pregnant with my first child. I thought that birth happened the way it does in the movies – her water breaks, she runs screaming to the hospital, and three pushes later there’s a chubby baby. Luckily, I took a childbirth education class, switched my care to midwives, and learned about doulas. Those three moves that I made in my pregnancy changed my life. I learned so much about my body and self-advocacy. And most importantly, I discovered that lots of women like me don’t know what options we have for birth. I became a doula and a childbirth educator so that I could inform and support others like me.
HB: What kind of training goes into being a doula?
NB: I was trained by Debra Pascali-Bonaro through DONA International. The beginning of a doulas training takes place in an intensive workshop. We’re taught the history of birth, evidence-based information on the benefits of doula support, and practical hands-on techniques to support laboring people. After the workshop, doulas typically start attending births under the mentorship of experienced doulas or within supportive doula groups. They read and reflect a lot and complete the steps for certification.
HB: What would you say to those who are skeptical of at home births versus modern hospital intervention?
NB: Births that are attended by licensed home-birth midwives are modern. Home-birth midwives have the training, expertise and equipment to handle normal birth. In addition, home-birth midwives primarily work with clients who are low-risk and are having healthy pregnancies. Higher risk pregnant people should be in the care of doctors or midwives who deliver in hospitals. I would encourage people who are skeptical to do their research and to make decisions that make them feel secure, safe and well cared for.
I chose to birth my children at home with licensed home-birth midwives because I had low-risk, normal pregnancies and I felt confident in the care that those midwives provided. When I was shopping for care providers, I interviewed doctors, midwives who delivered in hospitals only, and home-birth midwives. It just so happened that I felt most trusting and secure with these particular midwives who delivered at home. The care that I got from them was the most personalized and comprehensive clinical care I’ve ever received.
HB: Can you talk about at what point in a home delivery process a doula would recommend a hospital visit?
NB: The attending homebirth midwife is the clinician in charge of medical care and would determine when a hospital transfer is necessary. Midwives who deliver at home routinely prepare their clients for the possibility of a hospital transfer well before labor gets started.
HB: If you’re a woman interested in hiring a doula, what should you know? What qualifications should she be looking for?
NB: If you’re interested in hiring a doula, I’d recommend interviewing 2-3 people. Ask them questions about their experience as a doula and beyond. Often times doulas who attend births have unique skill sets that are from other industries that might appeal to you. I know doulas who have also been lawyers, fitness instructors, massage therapists, teachers. My business and doula partner, Michele Arrieta has a background in improv comedy! She has an amazing sense of humor and is quick on her toes. I’d also recommend reading client testimonials or asking for references. Knowing what others have experienced with the doula you’re considering hiring can be a good measure of professionalism and dependability. I would not rule out hiring a new doula. It’s been my experience that doulas new to the field are very passionate and committed to their clients. They’re eager to learn and support. I worked with new doulas in each of my pregnancies.
HB: The maternity death rates for black mothers are astronomically higher than those of our white counterparts. Why do you think that is?
NB: Black mothers are three to four times more likely to die or have post-delivery complications than white mothers. Black women with a high level of education and socio-economic status are still much more likely to die in or after childbirth than poorer white women without high school diplomas. Reporting by Propublica suggests that it’s unconscious biases or racism within the medical bureaucracy that affects quality of care and accounts for this appalling statistic.
HB: How can we get health officials to start taking the pain and specific health needs of Black women seriously?
NB: The state of care around childbirth for black women is in crisis and what’s most important in crisis prevention is being prepared. I want all women, but black women in particular to know they can do these three things to protect their health: 1) Put your team in place – In addition to having a doctor and/or midwife, add a doula and two trusted family members to your support team. The non-medical people will help care for your heart and your head. They’ll remember that giving birth is a profoundly human experience and will provide emotional and spiritual support. And they can help amplify your voice and advocate for you when you’re not able to. 2) Share information – Know your medical history and share it with your team. Birth is not the time to hide prior conditions or illnesses. Make sure that the people taking care of you know your history. 3) Educate yourself – Arm yourself with information before birth. Take a childbirth class or read a couple books. Know what normal birth looks like and become familiar with what isn’t normal.
HB: Can you discuss the gaps in health care during pregnancy for those in impoverished communities? Can doula’s help fill that gap?
NB: One huge gap is that after giving birth in a hospital women typically don’t see their doctor again until 6 weeks later. This is true for all women, however women in impoverished communities are most vulnerable. While doulas are not clinician nor medically trained, we are another set of eyes and ears. We can often urge our clients to seek additional care.
HB: What’s the top 3 most interesting things you have learned about women/women’s bodies through being a doula.
1.) We aren’t always taught to know and trust our bodies, so when it’s time to give birth our capacity to advocate for them is diminished. This has got to change.
2.) When a baby is born, so is the mother each time that she gives birth. I’m so privileged to be in the room to see both of those births happen, time and again.
3.) Women are strong. But we already know that : )
Visit ForYourBirth.com for more information about Naima and her team.