mother holding her baby

Meet Black Doulas Who Are Helping Make Births Safer

By Cheryl S. Grant
Reviewed by Terri Major-Kincade, M.D.
April 13, 2022

Black Maternal Health Week is April 11–17. This week is intended to build activism, community, and awareness to help end racial disparities, reduce maternal mortality rates, and give all families the respect, rights, and resources to have healthy pregnancies and births.

As you prepare for what could be an exciting (yet also possibly stressful) event in your life, having a support system can help to get you through those moments when you feel overwhelmed. So, you might consider hiring a doula to support you in delivering your baby and/or to help you prepare and recover from the birth.

A doula is a professional trained to provide emotional and educational support before, during, and after childbirth, empowering the birth parent to have the most comfortable and satisfying experience possible. Some doulas specialize in either birth or postpartum services, while others offer support before, during, and after childbirth.

How Doulas Can Help Black Families in Particular

It’s been well documented that Black women are more likely to die from childbirth than white women. As we work to address this disparity on a systemic level, doulas may be able to offer a helping hand.

In fact, in a 2013 study that examined the birth outcomes of socially disadvantaged women, researchers found that mothers who opted to use a doula were “four times less likely to have a low birth weight (LBW) baby [and] two times less likely to experience a birth complication involving themselves or their baby.”

Although the study was small, researchers suggested that the support and encouragement the doulas offered to the expecting parents during pregnancy, labor, and the postpartum period resulted in a positive, informed experience that helped to keep both parents and babies safe.

A 2017 review of several studies suggests that women who received continuous labor support may be more likely to give birth vaginally without interventions like vacuum suction, forceps, or cesarean section. They may be more likely to be satisfied and have shorter labors and even lower rates of postpartum depression—and having a doula was identified as a way to have continuous labor support.

"Doulas support folks as they are making decisions around having babies or not having babies, and making sure that they know their rights within reproductive justice or reproductive healthcare settings so that they have an equitable experience,” says Leah Hairston, M.S.S.W., a traveling doula based in Baltimore.

Doulas Share Their Passion for Helping Others

Hairston says that when she was a kid, her mom would find her skimming her biology textbooks. "Being a doula is a calling. Other kids would say they wanted to be a teacher, but I would stuff pillows under my shirt [and think], ‘I want to teach people how to give birth,’" she says.

Marise Angibeau-Gray, a birth doula in Union County, New Jersey, agrees that being a doula is all about guiding and empowering families. She offers her services on Boober, a platform that helps parents find maternal care providers and specialized services, such as matching Black pregnant people to Black doulas.

"I decided to become a doula amid my grief after pregnancy loss," Angibeau-Gray says. "I realized how many misconceptions there are about birth, and I didn't get the care or guidance I expected to receive from medical providers."

What Doulas Add to a Support System

Although your doctor or midwife will see you for prenatal appointments, provide medical care, help you deliver your baby, and help make sure your body heals after delivery, a doula plays a different role in your care—exactly how they do that depends on your needs and wants.

"We are educators who can help people understand what the birth process looks like,” Hairston says. For example, if you start having contractions, your doula might be the first person you call. They can keep in touch with you while you’re in early labor and advise you on when you need to go to the hospital or birthing center.

A doula’s relationship with a birthing person can begin before their child is born and continue well past the postpartum period. "I've talked to my babies who are 4 and 5 years old now,” Hairston says. “We are lifetime friends and partners who want you to feel safe and heard.”

Many doulas offer services above and beyond pregnancy and birth support, such as massage therapy, reiki, or birth photography, and many also have experience in other fields. "I'm also a social worker, and I worked for many years in trauma-informed care," Hairston says.

How to Choose a Doula

Several criteria should be involved when choosing a doula. "Finding one aligned with the energy and experience that the client desires is most important," says Angibeau-Gray.

You might start your search by asking for word-of-mouth recommendations or using a database such as the ones provided by the National Black Doulas Association or DONA International. Have a conversation with a prospective doula to discuss what you’re looking for and to find out more about them.

"It needs to be someone who is well trained,” Hairston says, “and I say ‘trained’ versus ‘certified’ because many people can get certifications, but not everybody puts in the work to do birth work well.”

Although there is no federal training requirement that doulas need to complete, the Maternal Health Task Force at the Harvard Chan School in Boston reports that more than 80 organizations and programs set criteria for doula certification.

"There are doulas who choose to train and certify with different organizations, while others prefer to organically work with birthing people and don't believe in the construct of aligning with an organization,” Angibeau-Gray says.

That’s why a conversation is so important. “You want to make sure you’re asking the right questions,” Hairston says. She recommends asking some key questions:

  • Where were you trained?
  • Do you have a mentor?
  • Who are your colleagues?

The answers your prospective doula provides should make you feel assured that you’d be in good hands if you hired them.

There’s a Range of Costs for a Doula

Want to know how much a doula costs? "There is a huge range,” Angibeau-Gray says. “Some doulas offer pro bono community-based services while others have private clients and charge thousands.”

It all depends on what the client is looking for, the doula's level of experience, and how long you plan to work with them. Many doulas offer packages covering a certain period of the pregnancy and birth process.

"For a birth experience, it could range from $1,000 to $7,000," Hairston says. "For postpartum, depending on if it's a part of a package with the birth experience or separate, it could run you anywhere from $400 to $10,000.”

Some health insurance policies cover the cost of a doula, and several states have passed bills or budget items to have doula care covered by Medicaid (Arizona, California, Illinois, Indiana, Louisiana, Minnesota, Oregon, Nevada, New Jersey, Rhode Island, and Washington). More are expected to follow. There are also some organizations that work to provide lower-cost doula services to families, including the Doula Foundation.

Who Should Hire a Doula?

Hairston and Angibeau-Gray both agree that just about everyone should consider hiring a doula. "But especially people who are unsure about the pregnancy-to-postpartum process and anyone needing more individualized support," Angibeau-Gray says.

Angibeau-Gray sums it up: "Black families can truly benefit from having a doula because of the need for more advocacy to prevent negative and trauma-filled experiences.”

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