Filling health gaps to prepare Black mothers for safe births

Health
A woman in a pink shirt holds a baby as another woman looks on

Tyesha Alexander, left, holds her months-old daughter Leilani as her doula, Charity Bean, looks on. Credit: Mary Hall/NewsNation.

BELLEVILLE, Ill. (NewsNation) — Charity Bean knows what it’s like to feel out of control while giving birth. After 12 hours of labor, a doctor made the decision to speed things up without explaining what would happen next.

A nurse “hooked me up to the monitors and then she was out the door,” said Bean, who was 18 years old at the time.

Today, Bean is one of a growing network of doulas across the country filling the gaps in health care for Black pregnant women, to help turn the tide on an increasing number of Black women dying during childbirth, according to recent data released by the Centers for Disease Control and Prevention. 

“I had no clue what induction meant at the time,” Brown said. “Nobody told me, ‘Just wait a minute. …Get up and move to help your body move along.’ I had family support and love, but they didn’t know.”

Her mission is to help women have more autonomy over their obstetrics care — acting as a health coach to her clients during both pregnancy and labor.

“My vision is to provide the education that all people need so they would have the option of informed consent,” Bean said. “What happens is (Black women) don’t even know how to have conversations with our doctors … A lot of traumas come from the unknown.”

Source: Center for Disease Control and Prevention. Visualization: Mary Hall/NewsNation.
‘These are the words you need to use

The intimate, community-focused approach doulas offer empowers Black women to create the kind of birth experience they want, sharing knowledge that can potentially save their lives.

Pregnancy and labor have always been risky for both mothers and babies. But Black women are not benefiting from improvements to medical care that have led to healthier birth outcomes for other women. And the rate of Black infants who die is more than twice any other race.

Charity Bean is a doula based in Belleville, Illinois. Credit: Mary Hall/NewsNation.

Doulas’ dual identity as both medical experts and Black women is part of what makes them so effective. The disparity is particularly stark considering the majority of pregnancy-related deaths are preventable.

Studies link doulas that share your race and culture to lower rates of pre-term birth and the need for C-sections, which are higher among Black women.

A March of Dimes report found doulas improve communication between lower-income people of color and their doctors.

Working with a doula looks different depending on need, but often they attend doctors appointments, offer pregnancy classes and develop exercise and nutrition plans.

Doulas can also help a patient know when a doctor is blowing off their concerns — and when they need to push for testing.

“These are the words you need to use: ‘Are you refusing to acknowledge my concerns? And if so, can I get that in writing?’ And you hate to be that way,” Bean said. “Because if…something happened, she has to live with the loss of her babies, not you.”

The topics gained additional attention after Serena Williams’ health scare in 2018 due to birth complications. Williams knew she had a history of blood clots, yet she still had to fight with medical staff to get a CT scan.

The wisdom of the body

Knowing what is normal during pregnancy — and what isn’t — made a huge difference for Tyesha Alexander, one of Bean’s recent clients. 

The new mom to 2-month-old Leilani had hyperemesis gravidarum during her first trimester, a severe form of morning sickness that caused her to be hospitalized twice for dehydration. 

“I couldn’t even drink water,” said Alexander, who lost 60 pounds during that time. “I was throwing up every 5-10 minutes.”

Alexander lives in University City, Missouri, a suburb of St. Louis. But if she lived in a rural area — like many of Bean’s other clients — her story could’ve been different. 

Doulas often serve in health care deserts. Whether in a city or on farmland, Black Americans are more likely to have to travel more than 30 minutes to access health care, which can be extremely dangerous for a pregnant woman experiencing complications.

During Tyesha Alexander’s first trimester, she had a severe form of morning sickness that caused her to be hospitalized twice for dehydration. Credit: Mary Hall/NewsNation.

Meanwhile, there are too few doulas to make up the difference. It’s not known exactly how many Black people are practicing doulas in the U.S., but the National Black Doulas Association’s directory shows wide swaths of the country without coverage.

For those who do have someone nearby, the cost can range from $500 to more than $2,000. And that’s on top of other hospital and health care bills.

“You have people who literally have to choose between the baby they’re carrying, and the children they have at home to afford it,” Bean said. “And I’m completely mortified at the lack of (health care access).”

Alexander said working with Bean gave her confidence in her labor plan — and the knowledge of how to listen to her body. 

“My vision is to provide the education that all people need so they would have the option of informed consent. … A lot of traumas come from the unknown.”

Charity Bean

“I probably would have ended up, unfortunately, just sticking to the status quo, because I didn’t know any better,” Alexander said. “That’s exactly the problem. … We are always unheard or our concerns or issues are diminished.”

Despite challenges during her pregnancy, Alexander attributes the smooth, two-hour labor to her doula and midwives.

“I personally didn’t have to reach out to (Bean) and say, ‘I’m feeling this. What is it?’ Because she already drilled in my head, ‘This is what it’s going to feel like,’” Alexander said, resting her hand on her stomach, where little Leilani was perched. “‘This is what you do when it happens.’”

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