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Doulas, midwives are helping Black women in their birthing experiences

The centuries-old tradition of using a doula or midwife is now making a resurgence following years of negative maternal outcomes for Black women.
Posted at 8:17 PM, Feb 28, 2023

Samantha Griffin says her job is to be the best friend an expectant parent never knew they needed.

"When they have questions, we can answer them, and when they need something during birth — whether it's ice chips or some sort of massage — we can help with that," Griffin said.

Griffin is a doula and the owner of DC Metro Maternity.

Doulas are women who typically don't have formal medical training but are employed to provide guidance during and after a pregnancy.

Many of Griffin's clients are fellow Black women, seeking support — especially during delivery.

"When Black women are in those rooms, a lot of times if everyone around them doesn't know them well or doesn't look like them, it can be a little intimidating because birth is more vulnerable than, say, going to your job every day," Griffin said.

Non-Hispanic Black women are almost three times more likely to die during or after childbirth, regardless of education or income levels. 

According to a report from the Government Accountability Office, the numbers have only worsened since the pandemic, with about 68 deaths per 100,000 live births.

"That's the terrifying thing: You can do everything 'right' and still be at risk," Griffin said.

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Jacquelin Knighton co-founded her company, Doulas of PG County, after her own negative birthing experience.

"It ended up being an unnecessary cesarean section, and I ended up being very disappointed with my birth," she said. "I didn't feel like I had a lot of autonomy. I didn't feel like I had a lot of say so in that."

Now she works to make sure women are comfortable and aware of their options in the moment.

"A lot of people get what we call white coat syndrome where they're like, 'Okay, sure. Whatever you're saying must be right, so let's do that,' which isn't always true," Knighton said. "There's always usually some time to talk about it, so you do look and say, 'Do you need a minute to talk about this?'"

That second voice is crucial in speaking up after childbirth, too. Tennis superstar Serena Williams says her cries for help after delivery were initially downplayed.

"I told the nurse, 'I can't breathe. I need a mask,'" Williams said on her HBO series "Being Serena." "I put the oxygen mask on, and I started coughing cause I couldn't breathe."

More and more women are employing the help of doulas and midwives. Midwives often take part in the actual medical side of a delivery. 

Historians say the need for such partnerships isn't new.

"We can possibly trace this to the beginning of humankind with the presence of women giving birth," said Linda Holmes, author of "Safe in a Midwife's Hands." "There were women supporting women."

For African-American women, midwives were a necessity during slavery and later during segregation, relying on traditions and experience. 

"The doctors were like, 'They're not going to pay us much for this. We are not interested in caring for Black people and solving, for the most part, resolving this public health gap in care,'" Holmes said.

Jade Godbolt nurses her newborn child at their Dallas-area home after giving birth

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Increases in at-home births were seen across races and ethnicities, although home births were much less common among Hispanic women than others.


Over time, that acceptance soured when the medical community blamed Black midwives for infant mortality rates.

"Once Black women were moved into hospital settings and medical care, then the infant mortality and the lack of equity and the problems, it was being marketed as if we just got rid of the midwives, everything would be solved," Holmes said. "It was not true. That was a lie."

Now both professions are seeing a resurgence, as more studies indicate positive birth outcomes when that partnership is present.

According to a study published in The Lancet medical journal, women who received doula care had about 52% lower odds of cesarean delivery and 57% lower odds of postpartum depression and anxiety. Doulas providing care alongside a midwife most consistently showed a reduction in odds of c-section.

Several states — including Oregon, Florida and Virginia — are reimbursing doula services through Medicaid. That means more doulas in delivery rooms.

The doulas Scripps News spoke to say they try to create a great environment for parents. That includes working peacefully alongside hospital staff. 

"I see it as a moment to collaborate with nurses, doctors, midwives, whoever is in the room," Griffin said.

"Typically when we walk into hospital rooms, nurses are excited to see us because that means they get a chart, they get to maybe take a lunch break and eat a little bit and they know that their clients are still in great hands," Knighton said.

Both say the goal is to turn the birthing experience into just that: an experience to be cherished.