Birth Justice: Bringing Back Our Doulas

According to the CDC, as of 2021, Black women are three times more likely to die due to pregnancy-related problems than White women.

The mission of the birth justice movement is to remove the implicit bias, structural racism, and other causes of this imbalance. 

One way birth justice advocates want to do so is by bringing back doulas. 

Long before the obstetrics field developed, women assisted other women to bring children into the world.

They worked both as the primary medical provider and as birth and care attendants before, during, and after birth. 

The use of midwives and doulas paired with understanding the impact of medical interference from hospitals and the OBGYN practice is intrinsic to birth justice.

“The long history of trauma and reproductive oppression that Black communities and other undeserved groups have experienced is the constant force that drives and shapes the Birth Justice movement.” 

Doulas are the essential support system most women don’t have during childbirth. Their existence rose from the morbid history of birthing people in the 1980s.

Let’s explore the history of doulas a bit further.


Where Did Doulas Come From?

A doula is a woman who acts as a guide for pregnant women during labor. They are also employed to support mothers of newborn babies.

Doulas offer continuous physical, emotional, and educational support to women during pregnancy. 

The word itself, “doula,” comes from the Greek word for “slave.” Dana Raphael coined the term in 1976. 

The use of doulas grew during the 1980s amid the increase of cesarean sections. This new technique had provoked more distress among pregnant women. 

Around that time, black women were torturously used in experiments to help develop the cesarean section practice.

As a result, women began to invite a female friend, their childbirth instructor, or an obstetrical nurse to provide labor support. These doulas would advocate to avoid routine procedures that may lead to a cesarean.


What Do Doulas Today Do? 


Today, women still use doulas to help avert cesareans, but their scope of practice is much broader. It includes:

  • Community education
  • Breastfeeding support and education
  • Hospital advocacy
  • Pregnancy support
  • Birth and postpartum support
  • Abortion support 
  • Miscarriage and stillbirth grief support

As a result, doula-supported birthing women enjoy:

  • Better parenting skills 
  • Improved birth experiences
  • Less medical interventions
  • Advanced prenatal care


Doulas Still Face Challenges Today

Hospitals have historically antagonistic attitudes toward doulas. Medical officials often resent their presence in the birthing room. 

Institutionalized anger and racism against the holistic birth movement are evident. 

Despite the abolishment of slavery itself after 1865, racist mindsets about black people did not shift.

Birth justice looks at how this affected the profession. It drove the exclusion of women and black midwives/doulas, birthing women, black and BIPOC women, and black and BIPOC mothers.

The movement considers the choices women make and looks at the options presented around birth.


The Rise Of Community Doulas And Radical Doulas 

In the last decade, within the field of Birth Justice, there has been a push for the use of community doulas.

What are community doulas?

Community doulas are those hired from the community to work in the same community. And so they often make up the same racial demographic from the communities they work in. 

Research done on community doulas shows more positive birth outcomes for birthing women. 

Community doulas often become birth justice advocates. Why? Because they’re so intimately and directly involved with the everyday harrowing experiences of birth and labor.

What are radical doulas? 

They may then become radical doulas. Radical doulas take the flag and interact with the public about doula-related policies.


Through speaking engagements that highlight the birth and maternal crisis. Events like these also showcase research and push new models and practices.

The goal? Threefold:

  1. To end racial disparities
  2. To foster investment in community-based doulas programs
  3. To raise awareness about the advantages of doulas. 

Monica Basile wrote, “Doulas seek to provide an important intervention into the uneven distribution of power and authoritative knowledge in the birthing room by placing value and priority on the everyday nonmedical bodily knowledge and experiences of birthing people.”

Doulas help to give birthing women their power back. 

Doulas give us the power to make healthy informed decisions for ourselves and our families during pregnancy.

That power will have a transformational impact on countless families and communities… following years of injustice and oppression.


Where We’re Heading — Policies For Bringing Back Our Doulas

Racially marginalized communities are starting to see a shift toward healthier, less commercialized practices in women’s care. 

There’s a push for more breastfeeding, the use of midwives, and other holistic practices. 

Black women and other women of color lead the way. We want to empower people in their communities and safeguard the rights of birthing people.

We’ve also gained funding through organizations like Ford Foundation, Ms. Women’s Foundation, NY Women’s Foundation, Robert Wood Johnson Foundation, and Groundswell Birth Justice Fund. 

The Policies So Far

Many states are working to bring policy shifts around medical and Medicaid coverage of doulas and midwives onto insurance coverage.

A few states are even piloting community doula programs to train doulas to work with birthing mothers of color in their communities.

Some organizations and policies which support the use of doulas are: 

Policies not yet passed include: 

  • The MOMMIES Act
  • Health MOMMIES Act
  • The Maternal CARE Access and Reducing Emergencies Act
  • The Maternal CARE Act

All this helps to legally evolve and financially support the use of doulas in advancing birthing support for women.


Stay In The Know

As we work to bring back our doulas, you can stay up to date on policies and find out ways to help by signing up for our mailing list. 

If you want to make a bigger difference, contact us, and let’s start a conversation.