Legacy by Uché Blackstock MD

Author:Uché Blackstock, MD [Blackstock, Uché]
Language: eng
Format: epub
Publisher: Penguin Publishing Group
Published: 2024-01-23T00:00:00+00:00

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Today, doulas are seen as one of the primary solutions that policymakers recommend in addressing the Black maternal mortality crisis, and there is good data to show that they can improve outcomes in birthing people and babies, especially when combined with other kinds of support and care. Back in 2014, when I first gave birth, however, doulas just weren’t on my own radar. The term is of ancient Greek origin, meaning “a woman who serves,” and was popularized in the 1970s by Dana Louise Raphael, a US medical anthropologist who believed in the vital importance of breastfeeding and of nonmedical caregivers before, during, and after childbirth. The idea of a doula is that this person “mothers the mother,” taking some of the stress out of what can be an intimidating experience for most birthing people. When you have a doula, you have someone to advocate for you, to ask the right questions, and to be there for you in all phases of your pregnancy, labor, and postpartum. In Black communities, doulas are especially critical in providing culturally responsive care and support that can be invaluable to Black birthing people, especially when there are so few Black ob-gyns. There is evidence to suggest that continuous support during childbirth, such as the type of support that doulas provide, can increase the chance of a vaginal delivery and decrease the likelihood of C-section and instrumental birth, like I had during my first delivery. It can also reduce the need for epidural anesthesia and increase the rate of breastfeeding, which substantially improves the health of new mothers and babies.

While the term doula is relatively new, the role is as old as time, especially in Black communities. Black women have always supported one another around pregnancy, childbirth, and parenting, whether as grandmothers, aunties, sisters, friends, or birth workers. In fact, there is a long rich history of Black birth workers that is rarely acknowledged in the medical literature. During the seventeenth century, when enslaved Africans were first brought to these shores by European colonists, there would have been women among them who knew how to care for pregnant and laboring people, and who brought their traditional birth practices with them. These women passed down their knowledge from generation to generation, their descendants going on to do the work of midwives, doulas, and lactation experts long before there were terms to describe these roles. During the Jim Crow era in the South, when many hospitals denied access to Black women, Black “Granny midwives,” as they were known, traveled from house to house making sure that Black mothers received the care they needed, no matter where they lived or how much they could afford to pay. These midwives were pillars of their communities, well known and respected.

That all changed after the turn of the twentieth century, when the 1910 Flexner Report—which made recommendations for the standardization of medical institutions and practices that led to the closures of historically Black medical schools—radically changed the landscape of birth workers too.

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