Disparities in maternal health and birthing processes and experiences mark some of Wisconsin’s most egregious statistics within the racial gaps experienced by many people of color in the state. Specifically, Black maternal health and Black infant mortality rates are points of contention and can give unease to potential Black parents looking to start a family in Wisconsin.
The work from organizations like Harambee Village Doulas (HVD), who started their work in 2014 picking up on the 2010 closure of South Madison Health and Family Center – Harambee, looks to counteract both the personal anxiety and intimidation or mistreatment that birthing people can experience without an advocate in a medical setting.
While the initial South Madison center’s impact throughout the ’90s into the 2000s may have aided in closing the gap between white and Black disparities in the processes, health, and experience around birthing, the same issues of adverse outcomes for Black birthing people and Black babies have been on the rise since.
World Doula Day is March 22, and World Doula Week is from that day until the 26. Harambee Village Doulas are eager to let those in need know they are here to help.
HVD is striving to bring back the opportunity in Madison for all birthing people, especially Black birthing people, to have holistic and less precarious care during the birthing process, as well as before and after childbirth. Doula Chandra Lewis shared statistics and information on the positive effects of enrolling the services of a doula.
Benefits can include, shorter labor, increased connection and oxytocin production along with fewer requests for epidurals, a 39% decrease in the risk of Cesarean, vacuum, or forceps-assisted births, approximately 15% increase in the likelihood of spontaneous vaginal birth, increased satisfaction with the overall birth experience, and a 38% decrease in low 5-minute APGAR score.
Madison365 talked with members of the Harambee Village Doulas team — including Tia Murray, founder and CEO; Uchenna “Uno” Jones, nurse consultant and doula mentor, and doula Chandra Lewis — to have a conversation about the importance of doula work, and the upcoming recognition of that work with World Doula Day and World Doula Week coming up.
Madison365: What speaks to you about doula work, and why is it important?
Tia Murray: We are trying to be more intentional about celebrating the work, particularly the work that our doulas have been doing for almost 10 years and are continuing to do. We don’t just coordinate the work, we also do the work, so you’ll catch us in the birth room and supporting families prenatal and postpartum.
Uchenna “Uno” Jones: I’m one of the few doulas who happen to also be a nurse with extensive labor and delivery experience as well. What’s beautiful about being a doula is you can have any kind of career and combo it up with doula and create this nuanced profession for yourself offering very unique types of care to the clients that you serve. I like the fact that doula week is an opportunity to celebrate doulas and the work that we do because, as Tia said, most often we’re doing the work and our clients celebrate us, along with maybe other fellow doulas, but not necessarily the community at large. So this is kind of like a great opportunity to say, ‘Hey, we’re out here providing these amazing services day and night, Monday through Friday.’
TM: There is a large doula community here in Madison, but nobody was particularly thinking about Black birthing folks in the nuanced way that is necessary considering our outcomes. The type of work that we’re doing as Black doulas, particularly around reproductive justice and dismantling inequities in maternal child health, felt very alone…We really built Harambee Village to be a hub for doulas that look like us, doulas that are doing this type of work, and all doulas really.
Chandra Lewis: Doula week is an opportunity to highlight that birth work is activism, and we’re here on the frontlines doing this work. Every birthing person deserves dignity, care, choice, and justice. We’re out here being able to provide those things. It is our fight that everyone who wants access to doula care is able to have access to doula care, and for money to not be a barrier.
UJ: Being doulas is an act of reproductive justice on our part. Standing up against the health-care system saying, ‘Enough is enough.’ You have to take better care of us, after all, you built it off of us.
CL: “Doula has become this buzzword that if you’re rich enough, you can have one. Harambee Village does this work so people that look like me and you, people that come from different socio-economic backgrounds, people that may not have even heard of a doula, and people that have other social things going on, have a person to walk with them through their birthing experience.”
Madison365: How has working through Harambee Village Doulas shaped your perspective on maternal health and birthing, especially within the Black community in Madison?
TM: From 2000 to 2005, we saw an increasing decline in Black infant mortality and Black preterm birth in Dane County, and then it actually made parity with white infant mortality. It was the same and then it began to continue to decline. I think a lot of people don’t realize what actually happened right here in Dane County. Historically, if you look at Black infant mortality on a national level since we began measuring it, that has never happened…What’s interesting is, after that center closed, in the public health data that we have locally, you see a spike in Black infant mortality. It’s continued to rise ever since then.
CL: UW is a huge teaching hospital. Meriter has a huge partnership with UW, so you get teachers or students from all over and they’re bringing in that knowledge from all over. We’re combating what people are told, we’re combating medical racism, we’re combating not being heard, and our clients being stereotyped as the angry Black woman when they’re just trying to get their concerns met.
UJ: “A lot of moral injury happens at the bedside. This impacts the birthing person’s decision to have more children in the future sometimes. We’re talking about generational lineages getting cut short because of some of the trauma that takes place. As doulas, we’re trying to navigate all of that in real time, while trying to take care of ourselves, take care and advocate for the mom, as well as making sure that the environment is conducive to birth.
CL: Some of our doulas, if they have the capacity, offer to be present at doctor’s appointments to help make sure that clients understand what they’re hearing. We’re asking doctors to give the client some time to think about all of the medical information that you just gave them to make the best decision. Our job is to empower our clients so that they can advocate for themselves. Providing them the tools so that they can advocate for themselves and make the best medical decision for them and their birthing experience.
UJ: The way in which our health care professionals are being taught, they are taught a culture of ‘don’t trust the patient.’ The patient doesn’t know their body, we know their body. Unfortunately, there’s a cultural disconnect. Different cultures birth differently, but they don’t know that. As doulas, we take the time to really spend that quality time with our patients to know who they are, what matters to them, and what cultural considerations we need to make.
TM: We are changing the narrative in our outcomes. We’re not seeing a lot of pre-term birth, and we’re not seeing low birth weight babies which are leading to Black babies dying…I would actually go as far as to say that we’re impacting maternal mortality as well because of our doula work. Maybe clients are advocating more and speaking up, or we’re there to help facilitate that. That’s how we’re also engaging in that positive narrative too. We are seeing some beautiful experiences and some better outcomes. It doesn’t mean that it’s always pretty, or always ugly, but we’re seeing that as well.
Madison365: What sticks out about World Doula Day and World Doula Week?
UJ: Since this is Women’s Month, March, I think it coincides that this is a work that’s been done by women for women since the beginning of time. The word ‘doula’ came about when somebody wanted to show a little more distinction, but historically, women have been doing this for other women. Midwifery is what the word was before we had to create a space where we could provide advocacy when midwifery wasn’t enough, and hospitalization and medicalization of birth took over.
CL: Along with celebrating doulas who do the work, maybe garnering some interest. Getting people excited about, ‘Oh, I might want to be a doula.’ Growing our Black doula workforce and letting them know that we have an upcoming doula training class. We have an interest meeting on April 5 at 6 p.m. for people that are interested in that upcoming doula training class.
TM: I’m excited about the opportunities we’ve had to train more doulas to do the work, and I’m excited about the potential that highlighting doulas during this time may bring. I’m also excited about really celebrating our doulas who are on the ground doing the work. Because oftentimes we just get stuck doing the work. It feels good to have a big team of folks doing the work and to be able to highlight and celebrate them and to doula them a little bit for seven days out of the year.
UJ: There’s a lot of things to celebrate within that time, but also remembering our history and where it all started. I think it’s an opportunity to look back and then look forward, and plan out the work that still needs to be done. The amount of policy change that we have to do … there’s a lot of things that are coming to the forefront as a result of all the wonderful work doulas from all over have been doing.
Madison365: How can people get engaged with doula work and/or with HVD specifically?
CL: We are always available here at the Harambee Birth and Family Center. You can book a tour, come see the facility, and learn a little bit more about what we do. Our phone number is area code (608)-298-7720, and you can always send an email to email@example.com
The content schedule for HVD socials will be as follows for March 22 to March 28.
- March 22nd – HVD story & what is a birth doula
- March 23rd – Prenatal doula support
- March 24th – Labor & Birth doula support
- March 25th – How doulas help Partners
- March 26th – Lactation Doula Support & 20 years of the African American Breastfeeding Alliance of Dane County, Inc. (AABA)
- March 27th – Postpartum / Postnatal doula support
- March 28th – How can readers support doulas? Other types of doulas & training, contacting organizations for donation needs, and other doula organizations in the Madison/Dane County Area, etc.
UJ: If individuals feel so inclined to support the work, they can donate, because that helps. We offer a lot of scholarships so that we can make it as affordable as possible for families who really need the care but may not have the funds. That’s really important. We accept donations of various gently used or even brand-new baby items that can support families. We partner with other organizations and do community baby showers, and those are really beautiful to watch and see transpire. There’s so many different ways.
For those interested in seeking doula services or simply looking to learn more about their upcoming birthing experience, Jones assured that HVD services were available for everyone, but that the focus is never lost on the history, experience, and disparities felt through anti-Blackness.
“We serve all birthing bodies, not just Black, but our focus and education is rooted in the Black body,” said Jones. “All of our doulas know about the Black body before they learn about anybody else’s body because that’s what was experimented on, and that was what was mistreated the most. Our philosophy is if we can get it right, by caring for the Black body, we have cared for all bodies.”
To learn more about the Harambee Village Doulas and the Harambee Birth and Family Center located at 2423 American Lane, Madison, visit the Harambee Village website here.