What does maternal health look like to you?

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I have two children who made two very different entrances into this world. I often wonder how my labor would have been different with a doula present at my eldest child’s birth. The first part of my laboring included my sisters, mom, mother-in-law, and husband in the room with me. There was music and dancing (not by me) and some silly games. A few dance routines and many laughs later, there was no sign that my daughter was making any moves to grace us with her presence. Hours later, we finally asked the party to leave the room and there was still no progress. With my family waiting outside, things started to change, but not quick enough and after loads of Pitocin and the vacuum pump, Harper made her grand appearance. At one point, the vacuum popped off her head and I may have screamed because I though her head went flying across the room – thankfully, it did not. It was very clear at the end of all of this that I had no idea what I was doing. I apparently tried to birth Harper by pushing with my face. I heard Harper’s first cries, then I heard my husband say to the doctor, “Is her face going to stay like that forever?” I looked like Jay Leno after wisdom teeth surgery or as someone in the room mentioned, the large Scottish antagonist in Austin Powers.

Labor is a wild adventure, and no two births are ever the same. I had no idea what I was doing, and no clear understanding of what I needed or wanted in those hours. A doula is a professional trained in childbirth who provides emotional, physical, and educational support to a mother who is expecting, experiencing labor, or has recently given birth. In my situation, a doula could potentially have helped me stay focused on my goal of having a baby and worry less about entertaining my family in an effort to avoid the vacuum use and the head-popping noise that accompanied it.

Many of the Children & Family Resource Center (CFRC) staff are trained doulas themselves as our work with parents of all ages positions us to be advocates for families and support their goals for healthy births and beyond. We also work with local doulas who provide our families with physical support, emotional support, partner support, and connections to evidence-based information before, during, and after labor – many times at no cost to the family. Doulas offer a wide range of support and facilitate communication between women and their caregivers and encourage women to advocate for themselves and to participate in informed decision making about their care, supporting positive birth outcomes.

CFRC believes that nurturing the development of children by building a strong foundation of family and community starts prenatally and that a healthy birth is the first step in creating that foundation. Disparities in poor birth outcomes have lifelong implications for the health and well-being of the child, the family, and our community.

Across the state of North Carolina, there has been an increase in the percent of low birthweight births. There are also significant amounts of data that highlight the racial disparities in maternal health. According to Blue Cross Blue Shield, nationally, Black mothers have 3 times higher maternal mortality and 2 times higher morbidity than White mothers. Black women are also more likely than White women to experience poor communication during perinatal health care encounters. At a local level, there are several areas of maternal health disparities for Black and Hispanic residents of Henderson County. Of the 1,092 births in Henderson County in 2018, 9% were considered low birthweight or extremely low birthweight. Of those low birthweight births, 6% were to Black mothers and 18% to Hispanic mothers. Compared to the populations of these groups in Henderson County, the ratios for Black and Hispanic mothers are high.

Children & Family Resource Center (CFRC) often connects our families with SistasCaring4Sistas, a community-based doula program founded by women of color for women of color who could benefit from their evidence-based form of birth support. Their doulas are part of a larger social justice movement, working in partnership with MAHEC and Mothering Asheville, and are committed to eliminating health disparities for mothers and infants. SistasCaring4Sistas knows the maternal health landscape here in Western North Carolina and across the country and is prepared to support the communities of color who have historically experienced and continue to experience pregnancy and birth-related complications.

My son Leo literally tried running into this world ahead of schedule and it became an elevated situation quickly. Without a proactive OB-GYN, I would have still been at my desk at work when he tried jumping out one foot at a time. Thankfully, we were at the hospital when he stopped breathing and was intubated, and I feel certain my husband wished he was looking at my extremely swollen face instead of the closed door of the operating room. A doula would have been a helpful support for him in that moment as well.

My birth stories are my personal experience as a white woman. MY stories were not impacted by institutional racism, and I cannot begin to understand how that would feel. I can, however, imagine that having a doula by your side to advocate for you and empower your decision making as a mother, in what is already a high stress environment before you factor in implicit bias and racism, would be powerful.

Just as all births are unique, so are the families bringing them into this world. There is ample data as well as other collections of stories that bring attention to firsthand narratives of the health inequities that exist in the way people of color are treated in maternal health. If we can eliminate these health disparities now and build a strong foundation for all babies, we will change the trajectory for local families and in the long term, our own community. Doulas can help us get there.

CFRC currently utilizes evidence-based education programs, community collaborations, one-on-one comprehensive support, and community advocacy to help meet our mission of building that strong foundation. Having a doula at a birth is expensive and many times a barrier to families and we are working to connect our clients to the resources in our community who generously offer up their time to help eliminate health disparities and ensure mom and baby get a healthy start.

Parenting is the hardest job there is and it can be even more challenging depending on your skin color and socio-economic status. How we react today to what is going on in our country will have long term effects on our children, our future workforce, and our nation.

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