Having a Doula Was Important to Me as a Black Pregnant Woman

For many years, when asked what my greatest fear was, childbirth always came to mind. Never mind the fact that I was single with absolutely zero baby plans on the horizon; the thought of giving birth gave me the heebie-jeebies. It was mostly the fear of the unknown, but also a little bit of something else.

I knew that as a Black woman, it would be riskier for me to give birth than any other race. Studies consistently show that Black women have a higher rate of maternal mortality in the United States. In 2019, the CDC reported that non-Hispanic Black women were three and a half times more likely to die from maternal causes than non-Hispanic White and Hispanic women. Even when controlling for class, wealth, and education, the numbers hold true.

One of the main reasons for the elevated Black maternal mortality rate is due to implicit biases present in healthcare (as well as the general population). Simply put, Black patients will face more negative experiences when it comes to doctor-patient relations, treatment plans, and health outcomes.

Studies have shown that even today, many white doctors and medical students still hold the false belief that Black people experience pain to a lesser degree than white people. Consequently, the concerns from Black women during and after labor may not be taken as seriously, leading to higher mortality rates. Having a doula in the delivery room can help mitigate this issue, by providing another voice in the room to advocate on the birthing parent's behalf.

Once I became pregnant, I felt a strong urge to be overprepared and extremely well informed on all medical aspects of the birthing process. I wanted to have as much knowledge as possible so I could properly advocate for myself in the delivery room. 

To help put my mind at ease, I also chose a Black female OB/GYN. Unfortunately, there was no guarantee that she would deliver my baby since it would depend on who was on call that day. That’s when having a doula became a top priority. I knew I wanted a trained professional who would be by my side from start to finish, to support me and keep me safe. Of course, many doctors are kind and caring professionals, but knowing I had a doula on my team made me feel more comfortable in case something happened.

The presence of a doula during childbirth has been shown to have numerous favorable outcomes for both mom and baby. Studies have shown having a doula can contribute to a lower risk of Cesareans and instrumental births, shorter and less stressful labor, and a more satisfying experience for moms overall during labor, delivery, and postpartum. These positive outcomes are especially noted when mothers are at risk for adverse birth outcomes due to poverty, racial biases, language barriers, domestic violence, or young age.

While a doula may seem like an unnecessary perk for some, having a doula was a non-negotiable for me. Besides wanting an advocate (besides myself), I wanted someone to help me through the pain and anxiety I would face. I needed an anchor to keep me calm and focused during the giant waves of labor, and I didn’t want to put that kind of pressure on my husband.

The journey with my doula began about halfway through my pregnancy. It’s important to look for a doula early on because they can book up fast! I would recommend starting the search as early as you feel comfortable doing so, as you'll have more time to get to know them and soak up all of the valuable knowledge they have.

We found our doula on DoulaMatch. The site covers all major U.S. cities, is easy to use, and is free. Each profile contains important information such as certifications, years in practice, cost, and client testimonials. The cost of a doula can vary greatly depending on where you are located and the level of services you require. On average, one can expect the fee to be between $800 and $2,500, though some doulas are open to payment plans, and others work on a sliding scale according to income.

It was important to me to have a Black woman doula who had attended over 50 births of varying types (hospitals, home births, breaches, C-sections, etc). In addition, I wanted to make sure the way she scheduled clients wasn't too packed for my comfort level, and that her backup doula wasn't often needed. Other than that, we just wanted someone we could connect with on a personal level, who shared the same views and values on pregnancy and labor, and felt like a natural fit. We interviewed about three or four different doula's until we found our perfect match.

My doula's name is Efe, and her presence in our home instantly put me at ease. From day one, Efe provided us with a sense of comfort as well as tons of information. Leading up to delivery day, she talked us through breathing techniques, birthing positions, and how to prepare for postpartum life. 

After the initial meeting, Efe came to our home once a month from month five until I reached 37 weeks. Each meeting lasted around two to three hours and included presentations on labor, delivery, and postpartum life. We would chat and get to know each other better during each session. She also printed out materials for us to make notes on and go over in our own time. In addition, Efe recommended books, videos, websites (including her own, just for clients!), and seminars that she trusted. Together we made a solid and thorough birth and postpartum plan.

She offered to help with any gadgets and gear, such as putting together my breast pump in order to help me practice. (Side note: definitely do this if you can!) Although it felt like a lot of information to take in, there was never any pressure to cram. It was simply there for us if and when we needed it.

When my due date approached and left with no signs of baby coming, my doctor started pushing for an induction. Efe was there for support right away when I was at a loss for what to do. She sat with me to discuss natural ways to stimulate labor and talk me through the pros and cons of medical induction.

In the end, an induction was the best decision. But Efe empowered me to ask the nurse to schedule me a week later than the office wanted to, giving me a little more time to see if the baby would come on his own. I most likely would have given in to the immediate induction, as I wouldn't have had any other point of view besides the doctors'.

Throughout the process of labor and delivery, Efe was by my side every step of the way. Before the induction, we spoke on the phone and she acted as a translator, explaining the procedure and medications in simpler terms. She helped me make choices about the induction process, such as delaying an epidural even though it was strongly suggested not to.

Once in active labor, she arrived to the hospital room, which made me feel calmed and less anxious. Late at night when my husband settled into the couch for some sleep, she slept upright in the chair next to me. When it was time to push, she coached me and held my hand.

The sweet and comforting nurse I had for most of the time so far was off shift and switched to someone who was decidedly less so. But that didn't matter much to me, because I had Efe to keep the nurturing energy flowing in the room. After my son was born, she was there not only to help with the first latch but also to take pictures and videos for us.

Having a doula throughout my pregnancy, labor, and delivery journey allowed me to feel calm and informed during it all. Most importantly, I felt more confident in expressing my wants and needs to the doctors and nurses, knowing I had someone experienced to back me up. And I felt safer knowing that she would be watching for any problems that could have been overlooked. 

I am so thankful that I learned about doulas early in my pregnancy, and that I was able to have one by my side when giving birth to my son, especially as a Black woman. As doulas become more and more popular, I hope that the gap in maternal mortality between races closes, and all women are able to have more positive birth outcomes.