13 Talking Black Maternal Health With Sistas Caring 4 Sistas

This is one of the most important episodes of Birth Story Podcast you can listen to. In this segment Heidi travels to Asheville, NC during Black Maternal Health Awareness Week to sit down and talk with Maggie and Cindy, two representatives of MAHEC (Mountain Area Health Education Center), Mothering Asheville, and the SistasCaring4Sistas Doula program, about the disparity of maternal and infant mortality rates between black and white women.

Looking for a Virtual Doula to create a custom birthing experience and guide you through your journey to parenthood in the United States? Contact Heidi at www.mydoulaheidi.com

For additional free birth education resources and to purchase Heidi’s book, Birth Story: Pregnancy Guidebook + Journal, visit www.birthstory.com.

Want to share your thoughts on the episode? Leave a review and send a message directly to Heidi on Instagram.

TRANSCRIPTION

What does a contraction feel like? How do I know if I'm in labor and what does the day of labor look like? Wait, is this normal? Hey, I'm Heidi Campbell, a certified birth doula host of this podcast, birth story and owner of my doula, Heidi. I have supported hundreds of women through their labor and deliveries.

And I believe that every one of them and you deserves a microphone and a stage. So here we are listen each week to get answers to these tough questions and more birth story, where we talk about pregnancy labor deliveries, where we tell our stories, share our feelings, and of course chat about our favorite baby products and motherhood.

And because I'm passionate about birth outcomes. You will hear from some of the top experts in labor and delivery, whether you are pregnant and trying desperately to get pregnant. I hope you will stick around and be part of this tribe. Hey, it's Heidi, before you start listening, I just want to jump on here and acknowledge something.

The sound recording of today's episode is a less than what you are used to hearing on the bursary podcast, but there's a reason why this interview is so important that I traveled all the way to Asheville, North Carolina. With one microphone for three people sitting around a table, having a really important discussion about black maternal health.

So I hope that you can listen past all the imperfections for the beauty of the content in this episode. Hi, it's Heidi. Welcome to the birth story podcast. Episode 13. I'm so glad that you're listening because this week is black maternal health awareness week, and I've traveled to Asheville, North Carolina to record with Maggie and Sandy from MAHEC mountain area health education center and mothering Asheville and sisters caring for sisters.

You will hear from these two incredibly inspiring women who are leaders in this community, fighting innovatively to change the disparity of maternal and infant mortality rates between black and white women. I'm recording today to learn, to open my eyes, to reach out across this Canyon and to share it that the change must occur.

If you are a black woman in the United States with an advanced degree, you are three to four times more likely to die in childbirth than a white woman with less than an eighth grade education. And I did not say that pregnant black moms are more likely to get an epidural. Sadly, you heard me correctly.

Beautiful black pregnant women. Bursting with life are more likely to die. We are here to talk about why and what can and must be done to erase the statistic and to save lives. So Cindy and Maggie, thank you for joining me today. Yeah, we're excited to be here quickly. Introduce yourselves, and then I'm going to get into a little bit of the numbers.

Okay. Um, my name is Cindy McMillan. I am a Dona certified birth doula. I'm also the last chain childbirth educator. A breastfeeding peer counselor, and the director of marketing and education for sisters cancer sisters, the community based doula program. Yeah. And I'm Maggie Adams and I'm a project manager for mothering Asheville, which is a movement here to address the black, white disparity, um, particularly in infant mortality, but, but also even sternal mortality, which just as canning.

So it's just, it's just a part of. Cindy, we didn't talk about this, but I certified with donut also back in 2008. So we have the same certifying. Awesome. So before we dig in with Cindy and Maggie, I just want to go over some of the statistics that many of the listeners may not be aware of. Um, I'll be honest.

When I did the research for this interview, some of this was very new and startling to me, and that's why we're doing this. So in the United States, um, we are one of only 13 countries in the world where the maternal death rate is worse than it was 25 years ago. Only 4% of physicians are black. 900 women are dying each year in childbirth in the United States, and yet 60% of those deaths have been deemed preventable overall in the U S the maternal mortality rate is 28.7 deaths per 100,000.

Now that drives me crazy when I read that, because if you break it down, black women comprise 40 per 100,000 compared to 12.4 per 100,000 deaths in white women. So it's really unfair that we lumped those numbers together because it doesn't tell the true story. And we're doing this interview today to try to shed light on the true story.

And then also the next worst country in the world from maternal mortality is New Zealand and their death rate is a three times lower than the United States at 11.9 per 100,000. Sad. So here we are. We're going to shed light. We're going to raise awareness. We're going to pave a way for action for maybe other municipalities in the country that are looking to do what it is that you guys are doing here.

And, um, we have so much to learn from you guys. So, yeah, let's do it.

Yes. Let's start with the old. Okay. Are you interested in sharing your birth story? Um, well, I had some very unique. Bird stories. I would say for myself, because I was, I was, um, I had my first story when I was 20 and, um, almost died while pregnant with her. Um, that was when they didn't quite know 97. Yeah, I grandma's.

His was, and they was just, it was horrible. That was my only natural birth. And then my second son, five years later, I got pregnant with twins. And, um, I remember I kept telling the doctors that I was in. I think I was like maybe four months and I kept stressing to them that, no, I think I'm having more than one baby in here.

That's more than one. And it got to know, we saw only one baby, but only saw one baby. So I'm like my seventh and a half month they realized I was actually having twins. And one of my twins had a heart defect. So it was trying to work diligently then to try to see what they can do, um, in each role. But there was nothing I can do is set up, but let me go ahead and have the twins.

Um, I stayed at the hospital for about a month before I got a, I would actually do the delivery. I went under general anesthesia. And my delivery. And, um, when I came to, I remember my bed just being wet, soaking wet, and it was so much blood everywhere. And I remember trying to talk and I was telling the nurses and, you know, screaming for my husband at the time.

And, um, I just kept leading the doctor came in and I know, yeah, she was like, you need to stop bleeding or you're not going to make it. So in my mind, I was like, what am I doing to make myself bleed? So I kind of just relax myself while they did what they had to do. I was preparing myself to die on that bed.

That's all I kept thinking was like, I hope my, my sons are okay. I hadn't had not had a chance to see them yet or anything. And, um, Luckily, I made it through that, but the hard part was the hospital taking my ass, my son that had the heart defect and, um, force the blood transfusion on him when he didn't need it.

And my other sister, and who's actually here as that's alive, um, he needed a blood test  but they didn't give it to him. And no matter what I did, I said, and what I did, it took me to court. To take us to the, and my son and gave him the blood transfusion and within. Say three or four days he was dead. So that was my trust of the house, the care system at that point.

Cause I was like, they wouldn't listen to me. They wouldn't listen to me and almost, um, I almost died and then my son had the Pedro sacrifice because the doctor was not listening to me because I knew my bloodline, my blood history. I knew my mother had, um, like cottage clotting. Deficiencies. I know that there was, my sister had passed away from bleeding disorders instead of them doing the research and the homework, like I was asking them to, they didn't.

So, so that was, that was the drive to the work. I'm doing right now, you know, I found out about a profession, supports women and are there to be the extra ear and really be there to be by their side. I was so. Because that wasn't what I had experienced. Even with my husband being there, or he didn't know what was going on.

He didn't know how to support time. And he wasn't trying to, I respect my wishes, which were, if something happens, this is what I want you to do. That was respected on his end because he was in his feelings. But a doula is totally different. She has no judgment. She's, she's letting you experience this your way.

Um, things may go wrong and I understand that. Um, but it's always better to have somebody there that understanding and empathizing with you along the way, when you were pregnant and you were preparing for your birth. First of all, I have a million things to say about I'm sorry that they, he didn't listen to you.

And I'm sorry that they didn't hear you when you know your body. You knew there were two babies in there and they didn't discover that until. I sudden, I mean, that's just unbelievable to me that seven months, a seven and a half months. So I'm sorry to hear a story. And we, as doulas are fighting to advocate for our moms the back then, did you, did you, had you ever heard of a doula, did you think to have like a.

Like someone besides them, you know, your partner to be there. Um, No, no. I never knew what a doula was. You know, we hear stories about my grandmother, she delivered at home, you know? So you've never heard about somebody support me. You heard about your grandmother's mother being there to deliver the baby or, you know, all those, the real little stuff.

Yeah. So it was always a thing. Um, well this is what a woman has to go through what she starts bearing and chosen. You, you kind of just. Deal with it. Nobody at that time was preparing you for the emotional things that she was wanting to go through. All the changes, all the physical changes, the emotional changes, the, I mean, when you compile that labor and pregnancy on top of a pass, Whether it's good or bad, you're compounding a lot.

Yeah. It's a lot of stress there. Um, and most black women, including myself, didn't have a very rosy PACS. So not only was I. Pregnant now, but I was also traumatized as a kid and different areas of life. So like sexual abuse, I've been there in rate in there. So when it came down to them, literally, I was worried about my body image.

Ellsbury about how I going to react to touch. I was worried about, um, lights or male doctor, female doctor. I was just, is someone going to take advantage is I was just so. Concerned about the things that past history I wasn't in protecting my kids. I will never let anybody hurt my kid in it. Like I got was hurt or I would, I would never let anybody, you know, my whole framework in my mind was different.

If I had somebody there to talk to, I could have relieved some of that and been more, yeah. You know, I'm going to interject right there because. We're going to get to this, I guess, with you. But I want to say that with the clients that I've worked with over the 15 years, that I've been a doula, that the trauma piece is like the biggest piece in mind, world two birth outcome.

Yeah. I have plenty of moms that call me and say, I really want to have a natural childbirth and then we start digging into it. And I find out that they have been

getting raped, sexually abused, have big traumas. And one of the things as a doula that we have to teach and train is that childbirth is very difficult and it will get you to your core of course. And all of your things come out. Yes. So all the things that we talk about, and we're going to talk, talk about today with labor and delivery.

One of the pieces, I think that's hidden. Is what we bring to birth, to birth. When those contractions start and you are forced inside yourself, you're going to face some things that you maybe didn't want to face. And those are what that's probably another whole topic for another day, birth outcomes related to past trauma.

And then where that leads you. So. You had so many things, you had trauma, you had a baby at home already. Now you're pregnant again with a medical community. That's not listening to you. And then I'm sorry that your baby died. Yeah. And it was above, it was, it was rough. And I don't, I don't want another mom to ever have to experience it.

Health care profession. No, not listening to them. You know, I always look at them as they're practicing medicine. There's always a bedside manner. Sometimes you got to listen to who you're taking care of. They know their body way better than anybody. You know what I'm saying? I think in the, in the black community, I had never had, I had high blood pressure before, but I'm CA I blood pressure when I was pregnant and all that stress.

Oh, that's just, and that was my third pregnancy when my son and I did, I got high blood pressure really bad. And then I started thinking I'm okay. Just type the one that's right. Everybody has had this lovely pregnancy. And luckily, you know, they can be big and pregnant and eat what they want to eat. And here I am just so full of stress, my blood pressure shooting up the roof, I'm getting headaches and that's yeah, it's fluid.

And then Nicole calls. Sarah and you know, and you don't be one that either, but then you understand the one hand this has to happen, right? Because your blood pressure doulas, we help alleviate some of that stress. Wait on us. We hold that space. I love that. I love that, you know, you don't have Pequod at it that do that.

So I'm like, where was doulas in 97? It wasn't in my neighborhood. The first bird hag did was 2000 and then five. And I didn't, I'd never heard of a doula either, but I had a friend and she said, just come be with me. I need someone with me for this birth and can support me. And, and I walked out of that delivery.

I thought my whole world just changed. And my sister said you were her doula. And I said, what is a doula? So, and it helped me transition to bring Maggie. And because you told me when you were pregnant, you didn't know what to do with, it was, I didn't know what to do with it, but now here we are two doulas.

So how does that inter Maggie? Yeah, so, so, um, I didn't know what a doula was five years ago either. Um, so this work that embarked where this is canned for sisters was born, um, started about four and a half years ago with a grant to the blue cross blue shield foundation and, um, of North Carolina blue cross blue shield of North Carolina foundation.

And it was, um, a grant that came out called the community centered health home. And it was based off a model that the prevention Institute had come out with. Um, that really said there's factors outside of the healthcare system that are contributing, um, to health inequities and health disparities. Um, and so at that time, um, I was working at MAHEC, um, and MAHEC OB GYN, um, had applied for that grant.

We had no, no idea what we were gonna do with it. It was one of the first times that we started thinking about like, Hey, let's do this a little bit differently. Yeah. And so when we first started doing this work, we had no idea that we were going to be focusing on black, white disparity, or I've learned recently where we really want to be calling it.

And then not equity because disparity is, is just a difference where an inadequate in equity is preventable and unjust the things in language that we're trying to, to shift a little bit. But when we, um, started this grant, well, we wanted to do was start building trust, um, and relationship in committee.

How much money did you get from blue cross blue shield? $125,000 and free. Autonomy to do whatever you want with the money, or wouldn't say like free autonomy, but for them, yeah, it was, um, it was like, we don't know what to do. We want you guys to teach us how to do it and tell us, you know, what you're figuring out and, um, and how you do that.

And the model really says that like, uh, the idea is that. There's three things that you really have to be doing simultaneously to improve outcomes. And I say you have to build community capacity. You have to make a clinical shift and you have to address the policy and the environment where people live, work and play.

And so, uh, what happened was that he had started two groups I'm wondering, which was in his studio apartments, which is a public housing neighborhood here in Nashville. North Carolina in Asheville public housing is, is primarily occupied by black people here in this city, which is due to historical trauma and institutional racism.

A lot of that started in the, in the seventies with urban renewal. And just kind of continued to transfer on and on and on, um, in this city and in Asheville today stands as you know, the second most gentrified city in the United States. Our black community has continued to lessen and lessen every year.

We are same as, as public health people and not really understanding, you know, all of the context. We're also the white women that are like, okay, we're going to go try to build a trust and a community with black women don't really know what that's going to be like. So let me start over. Yeah. Does that mean that everyone that was working on the grant was white?

At that point. Yeah. Yeah. Which is pretty typical. Most of the times as white folks love to write grants, to go into black communities and fix them. That's that is literally the pattern that we have seen for so long.

So it's, you know, I laugh about it. It's really messed up. That is, uh, what is it done over and over and over again to black communities and like, no wonder why there's no trust. You know what no wonder why the black community doesn't trust the white community doesn't trust the healthcare community. Like we, we just come in and we're like, Oh, where, why?

Like, we're going to fix this. We know how to do it, but we didn't know anything about you. We don't know what it's like to be a black person living in America. We don't understand what it's like to be. Disenfranchised and have everything taken away, but we know how to fix you. So I'm going to interrupt right there.

So let's, let's answer that question. That's answered that question. So, Cindy, you were a doula, you were black, you were in this community, you know what it's like? So let's answer, Maggie's question that she's putting out there. What. What is it like for, we just heard your story, but also the stories of the women that you're serving right now through this program, which I guess we don't get to in a minute how you're doing that, but tell me who they are, how they feel about healthcare, how they feel about hospitals, how they feel about.

Pregnancies. Now we're going to take a short break to just share a few things with you and we'll be right back with our guests. I am so excited to tell you about my first book that I wrote that is launching this summer. It's a 42 week guide to your pregnancy. It's a collection of birth stories. It has a ton of doula advice from all of the questions that my clients have asked me over the last 14 years.

It has hysterical partner tips that you will want to read to your partner. And it has journaling prompts because nobody has time to write a 20 pages in their journal about their pregnancy. So I've taken the Liberty to give you some prompts of things that I think you might want to remember member back on after the baby's born.

So again, you can go to birth story.com and preorder a copy today. It would mean the world to me. Hey guys, if you're enjoying this podcast than I need you help to spread the word, if you know anyone who is pregnant is trying to become pregnant or just loves a good birth story. If you could send them to iTunes or Stitcher.

Or Spotify or SoundCloud wherever they listen to their podcasts and ask them to subscribe to the birth story podcast.

Well, it's sad, but Maggie is it's hitting the nail on the head. She's absolutely correct. And even now it's. There's no trust. There's no trust. I mean, if it wasn't, as far as the fact that Maggie and the other ladies that did come to Becka view and actually genuinely. Wanting to build a relationship without knowing, knowing the background noise without, um, I mean, they would take that time rain, sunshine, who would sit at a picnic table and they would generally hear us out instead of coming in and saying, well, we're bringing this to the committee.

It was none of that. We came up with, they gave us the freedom to come up with ideas and freedom to empower deal. They. They gave us the tools to actually empower ourselves because, um, certain things that they knew about that was going on within the community didn't reach our community. So once they started saying, well, we have an invitation here and it would you guys like to show up and we're like, okay.

You know, getting something. Some more information. And once we heard on top of each one of our schools, all of us, we have, um, adverse grade stories, some just unsupported, um, went to a conference and heard about the infant mortality rate here in Baldwin County. And it sends us into like, A rage. We were so upset.

We was so hurt because in our minds, for years after we had our kids, I always thought that the government was trying to kill us. The healthcare system was trying to kill us. Um, why, why is there so much unfair treatment with black women versus white women? If this was a, I would say it was in black, my son was still be here.

If I wasn't black, I wouldn't have bled. Like I did on that table. They would have been there to take care of me. Things would have been explained differently. You know, I couldn't approve that for a fact. I couldn't say that for a fact. I just know how I felt, but now as a doula, I actually can see it. So I wasn't wrong.

Now it's like you're watching it in action or why, why would it help care provider get into a field where he not ever equity believer treat every woman, child person the same. Why would you take on the role of being in charge of someone's life when you can't do it equitable? Then I started thinking in another way of money talks.

So we're pawns. Our bodies are cons. Our kids are pawns in a money exchange. Can't do that, but this would've solved to Nick is coming down to we're black. We hold them with value and world, and it shouldn't be like that. But I feel that so injustice. So in just, you know, I, our moms love our children. Just the same as any other mom, I'm mom sacrifice for their children.

Just like any other mom, once you get pregnant, you can't go back. You know, I see them fighting for abortion rights and abortion. Isn't a question that, what do you think. About a mom who was pregnant and was just her child. What about a mom who was pregnant and loses her life? That should be held on a higher pedestal than someone who's saying.

I can't do this right now. Right. What about the ones? Right. Right. You can't fight for a pro to be pro-life and to save lives. If you're not going to support those lives, which I think is also like, I mean, why you see a lot when there was likely a contingent over the women's March and it was like that this is a white women's March, right?

Because a lot of that idea is like, especially as white liberals, oftentimes we have these ideas about, you know, how progressive we are and how we're doing all this work for women's rights without looking at the intersectionality, how much privilege we actually have is white women. Versus the privilege that a black woman does not have the same boss.

Right. And so that's like, what we're seeing so much of right. Is is that like we are getting to this point, they were like, not understanding that like, literally just as much as like we're seeing like, you know, black people shot and killed black babies are dying and black moms are dying because of the health care system.

It's the same thing. Same thing. That's so interesting that you say that, and I'm going to say something I'm probably comments way everyone, but how much privilege a white woman has? Who's straight. Who's married to a white, yeah, man. Whether we want to believe it or not. We get more power and more privilege when we marry a white man.

Yeah. So let's go back to how Maggie and Cindy's are connected to have helped, you know, what a dual is and to become a doula. Um, so looking at our women, because I starts with us, you know what I'm saying? We, we birth children, we populate, you know, so, you know, they always say, which came first, the chicken or the egg, you know?

So we, we had an intricate part of society, whether you black, white, green, purple. It doesn't matter why the inequitable treatment. I mean, we're in 2019, This is a whole nother generation. This is a whole nother, I mean, we're actually at a place where we should be having each other's back. We supposed to be supporting each other, looking out for each other, um, and to have a, uh, racism plays such a big role in healthcare.

That's scary. That's scary and sad. It's hugely scary. So Maddie, as part of MAHEC and the screen and this initiative, what do you see? You put doulas in place? You have been so creative and so novel and creating a system for change. But what were you seeing? What are you seeing? Yeah, you mentioned three pillars earlier.

So I want to first start by saying like that doulas are actually food shows the ladies that are the doulas now without any influence from that's why people chose and said, this is a solution that we have decided that week. We chose that when you go into their community and you said, I have no agenda.

Let's talk for a year and a half for a year and a year and a half before we did anything with no, this is the way we're going to do it. It's how do you want to do it? What solution does this community need? Cindy and your peers said. We need women supporting women during their pregnancy, during their labor, during their delivery and their postpartum care.

We need a, what a black woman supporting a black woman through their healthcare in your community. How many black OB GYN are there? I haven't seen any. Okay. I haven't seen any. And you know what? We have women asking from one all the time. And we can't produce, but they look, they love our support. I mean, I mean, I love our support and we asked for, we hadn't seen black nurses either up till recently, you know what I'm saying?

So it's a little change at a time, but it's gone. So where did the term doula kind of surface. And when you're having these community conversations, I must have known what to do a little was we had. Melissa Baker, one of our dear friends, amazing woman, and she invited came award deck and she got all of our, you know, she told us she was in Titan game of war that to the table.

This is our first time I'm actually sitting down with cane mine. So who was King? Tell everybody

we met. Well, we met her at a spotty event. We had four, um, the picnic table we'll know, he's decided to do a mother's day event for the women and, and that's good for you. And they get a destressor, you know, and came, came and she tabled. One of the events we have massages and I keep puncture and food and it was just so relaxing candles.

And, um, she ended up coming to the picnic table and we didn't know at the time that came up, wasn't doula. She had her own doula company and what's the name of her company? Homegrown. Oh, grand babies. And she's here out of hash house here. Okay. And she came to the table and we mentioned all the things we really wanted to do after she was angry.

She was like, I have a skill. I would like to teach you ladies, if you would, if you were willing to learn. And it was like, okay, you know, I lost the scale and it was where I'm like screaming and jumping for joy. And she was like, doula. It was the first time we actually heard the word now who was speaking support and this and that for women and black women, you know, health disparities, infants dying, you know, and when she said doula and explain what a doula was, he was like, Oh yes.

Oh yeah. I mean, you have that fancy word for it.

So it was all excited. It was like, You didn't learn what this job entailed. So he gets a job. He has a job with a certification, you know, I have to be certified in something that can actually benefit our community. Um, And we started the training in November, 2016, and we were so excited. It was after we started learning it.

We didn't want to stop learning and we haven't stopped learning each, each year has been. So training came from Kmart and homegrown babies. And our brand as the brand,

right? Is, is that so, so we decided we want to do stuff and do things differently. And a lot of that came from understanding the historical context of how black people in Asheville had been historically. This disenfranchise over and over again. And so, so that's why we were like, okay, we're going to take a step back.

We're not going to come with a solution. We want to first build a relationship. We want to understand what's going on perspective of people that actually are living the experience that, that we think we understand. And our healthcare providers that have been involved with us from the beginning can talk to that and much better than I can and feel like this preconceived notion of like all the reasons that black women and black babies are dying.

Without even thinking about the historical context of racism. And so when we taught Winston, he was talking about like racism today. That's only like a product of hundreds of years of racism and slavery and Jim Crow or sterilization of black women up until recently, black bodies have been used and abused over and over again by white people.

And if we didn't have that historical context, I think we wouldn't have any able. So you kind of take that step back. And so that's been an important part of our work is having that historical knowledge. And so when the ladies had this thought, which they were like, this is what we want to do stresses.

What's one of the biggest factors that we see. We want to give people a chance to just relax. We said, okay. And when they say, you know, we want these doula training, that's the whole idea, right? It was alright. You have a solution. We have the money we have, the resources let's make that happen. The doulas assistance cam for sisters was born and birth through these ladies.

And so, so that's where, kind of the story. So creative, innovative blessing, empowering. Thank you may hack like with you guys for just not being another group of weight, people pushing your agenda on committee. You don't know anything about like, this is so revolutionary, there are mirrors and people that have blue cross blue shield and United healthcares of the world that could hear this and say like, This is something that's a word.

It can be replicated. It can be modeled. It can be shared. Across the whole across the world, but across the country. So where are we now? So Cindy, tell me about sisters caring for sisters. Um, since this campus sisters, um, we have really evolved in the past several years. Um, when you were saying what you was just saying, it made me think that one of the other beautiful parts and pieces to this right.

That, um, I am so thankful and I know the other, the ladies are really thankful for it is we're able to help bridge things. Yeah. And the trust within the community. Um, of women and healthcare providers here at Mac, um, a lot of the women, we, we, um, support our patients of MAHEC or, you know, and so, because we are working so closely with the healthcare providers and we're working so close with the community, we are able to.

Kind of show the community, every health care provider isn't that bad and every healthcare provider, um, we can explain their roles and vice versa. What happens if you come across a healthcare provider that needs some cultural or sensitivity training? Like if you I've been at birds where I didn't like what I saw, what went down.

Um, neither. I want to let it happen. They don't want all of us ladies. So, so this is give you a platform. We're not silent. We're not silent when we're in the hospital settings, we're not silent. And I'm here with, on campus at MAHEC. And one of the reasons why is because in order for this to be successful, you're going to have to have those hard conversations you're going to have to, you're not going to agree all the time, but it's constant.

That's respect that this is a whole different culture than you're dealing with. And the culture itself gotta respect. This is who has been, um, kind of put in the place to be your healthcare provider. And if you don't like them, you can always request another one. You know, you don't have to be right. I heard something that does give you more voice and more power.

So Frank Casta Blango executive director of MAHEC. Shared with me that because of the training from came on home grown babies through the training, through donut international, which is a certifying body that, that the doulas here that are part of this program have been given a MAHEC Oh yeah. To wear to the hospital.

Yes. And I'm thinking that has, that comes with power. I know they're also one of the little programs, um, sisters, campus, sisters, and then a lot of them who was here are open to going to the opera in room with our class. It just so happened to be assistant. And you know, that is amazing because our support doesn't stop.

It doesn't stop reconsidered considered staff.

This is unbelievable because that support should never end just because the birth went from a vaginal delivery to a Syrian delivery. Your support system should be able to be trained. To be by your side? Yeah. For the whole entire process. Oh, process. Okay. I'm just so excited. I have so many days. Tell me about how you engage the community to know about now a couple of years later that we have six doulas on staff, we're here to serve you.

How does a woman who becomes pregnant today? Find you get your services and then walk me through your process. You're do lab. You're doing what you're doing. What do you do for these women? For the, the a to Z? Well, right now we have a lot of systems in place to get our name out. Since this campus sisters is.

Um, well, none of that then your apartment one reason is because we also host a mother to mother, um, program for women in the community with kids. And we meet once a month and we just talk about everyday life and get things off our chest system. It's a group of women. I mean, they're amazing. I mean, they just open up about concerns.

Stressors is going on in their life. Um, a lot of them have newborns or older kids, so we didn't start our picnic table. It just evolved. And we get more women just rolling to know that we're supporting our women in all avenues. Um, we. We are known here in Manhattan. Could we have a doula that, so with the centering program, so she's with pregnant women all the time.

We do a lot of speaking events. Um, we have our Facebook, um, And a little platform. Um, we have partners, partners. Yes. How many women, like what's your capacity like per month? Like how many women can you do? I mean, because you have to, I mean, to be a doula, you have to be on call. I mean, you have to not asleep in the night, you know, when go into labor at night, you have to do prenatals.

You have to build a relationship. I mean, so what's your capacity. Um, right now we are, we are really busy. Um, This year has turned over to a really, really it's good for us. We're having a wonderful, she's actually doing three to four birds a month, which is that's a lot and she's alive. We have another one that's doing about the same.

Um, mine I'm more spaced out because I also do the marketing education. So I'm also in the process of getting my certification for it. Teaching for my LCCE. It takes a lot of studying, but my books are still full. I'm doing like one to two words a month. Okay. Okay. So if I hired you today or I was calling you and saying, you know, um, I, I want you to be my doula.

Like I tell me where to sign. I want to join your program. I may have, I want to be part of this then what happens? Whereas you want to be a doula. You want to be a client client first. We will, we have a referral. The system set up. Now our women go through a, um, who wants to do it from, for us. They have to meet certain criteria.

Okay. Now, and one of the main criteria is, is being African American and being a woman of color. Um, doesn't mean that we only serve women of color, but that's one of the criteria staff actually. You, you take precedence over anything else? Um, we also work with teen moms, you know, too, so, but once we do that and then we assign, we'll have a doula call you once we go through the criteria is your risk factors, things that's going on.

They usually have a referring doctor for you or for a health care physician. And then, um, our director of operations would give. You'll call and tell you who you do a late is. And then within a week, a couple of days that the little car you got to set up a meeting, so you guys can sit down and talk for each other.

You might not be a fit for each other. We haven't had one that hasn't. I don't think, you know, um, let's see, okay. For each other and if it clicks and she's your doula and we doesn't, we don't set it at like 31 week 32 weeks. We take you from the moment you ready for a doula, it could be 19 weeks. It can be 11, 12 weeks.

When you feel like you need that support, you need that support. Exactly monthly net a week on that. Yeah. I have had moms that have hired me, like the second that they found out they were pregnant. A lot of moms that did IVF and had moms, fertility journeys, and just knew that they needed that support. Um, you know, the moment they started, it's beautiful.

I believe that the longer. Gestation, you have your, with your doula, the better outcome. Now I really do, because you get to spend so much more time with them walking with them, you know, spending that time questions. I'm sure you get so many questions like, Oh, I don't feel so happy today. What's going on?

And you're able to say, Oh, what can we do to make you happy? What would you like to do today? I'm free for a couple hours. Where are you going to go? I'll go for a walk. And then it just that little bit shows that somebody really does. And his listening. Do you go to the doctor's visit it's with your clients?

Yes. Okay. And do you call them clients? I'm a common clients. I call them moms. I'll call them by their name. I just didn't know. I was like, I call my clients, my clients, you know? Um, I'll call you sweetie.  to make sure he didn't say Asian.

yeah. If more hospitals would treat all women as customers or clients and not patients, you know, I'm like usually when you're pregnant, it's. It's not a national emergency, you know, a little more customer service. I try not to even think of them as clients either, because that sounds so business. Like this is even though this is a business you want to add a car, some personal gain you in that personal case.

So I think these moms in my sister's house says cancer sisters means. So it's the  system. Well, get the direct referrals from. A healthcare provider or from a partner within acute, any organization around us that are then saying that, but then there's also word of mouth. And so that's where that big clinical shift is, is that they're community based the laws that are also within the health care clinic, um, that are able to build that connection like, and he was talking about earlier.

And so in this hearing, you talk just brings me back to all those terms. Again, novel. Innovative. I want to stay. If you're listening, this should not just be covered. With Medicaid as well. I think all over the board, every woman deserves a doula. Every woman should have a doula within childbearing age. It must somehow, right?

I say that I promote the midwifery eggs. I promote the doulas. I think those two combined were, were, were really good onto something. Yeah. So yeah, big. Yeah. I actually just had United healthcare cover my services in full for all at and T employees. So I will give a big shout out on this podcast that I at least have one employer that is paying.

Or doula services info through commercial insurance. That's a major change that is it's brewing. It's coming, you know, that's why, that's why we're here. Um, so I want to go back to, are you a hundred percent? Hospital-based if one of you were, um, Mamas said, I feel the most comfortable birthing my child in my home or do, is there a birthing center here punching center.

So tell me about that. What are their options for delivering in this program? They have the option of the hospital. Well, the birthing center. Okay. Yeah. And, um, and this is say this how traumatic some women are because of our healthcare system. We had a mom who actually delivered at home because she was a.

She was afraid to transfer the transfer to the hospital. So, you know, and that, that goes to show how traumatic them hospitals can be for our community. She knew the baby was coming. Yeah. It was like, I'm not going anywhere.

When she did go to the hospital, they was ready to take her baby away. For no other reason other than delivering at home soon, anyone listening outside of North Carolina, home birth in North Carolina, for some reason, did I have a whole podcast on this is illegal stuff. I'm assuming that. This happens quite often when you haven't let's call it an accidental.

Oh, I have, I had clients that had an accidental Homer, um, in precipitous labor, you know, I've had, uh, but, and had a load of paperwork. So even they call nine one, one, the ambulance comes, the baby's already here and they get to the hospital and they are immediately like, Trying to enjoy and embrace the beauty of late, that just occurred and all that's happening is judgment.

Anger. You could have. I couldn't, I can't help that my water broke and I had the urge to push I'm 45 minutes away from the hospital on traffic. Thank you, healthcare community for your judgment, you know, but I'm here now. So anyway, lots of tangent, I can just, you know, Um, go on. So let's talk about actual, like labor and delivery.

So you've done the prenatal care. You built a relationship and then your momma calls and says, I think it's time to go. Do you labor with them at home? If, but they weren't really that totally up to them. We asked them to call us, um, don't text and you can text any other time, except when you think. You were in labor.

Um, if they are uncertain, we say, well, why don't you call your healthcare provider? See what they say, call me back on. Yeah. You know, let me know what's going on. I can come over labor with you, um, walk with you, whatever. Um, usually if it's time to go, then I'll be like meet you at the hospital. Know, and we get there.

I used to get there while they're still in the OB, ER, pause for a minute. You, we have spoken that this community many times is low income is transportation to the hospital on issue. Um, as soon as, as we're not allowed to provide transportation, um, which it would be amazing if we did, but we don't. So usually, um, And we'll have somebody bring it down over.

Okay. Is, may have allowed to provide money for Uber or Lyft or something. If transportation were an issue we're not there yet. We're working on it. See where I'm getting at though. It's illegal to birth your baby at home, but yet we don't help moms get to the hospital with transportation. Okay. That's just one nugget.

Okay. So to the hospital one way or the other, but you have to meet them there since you can't provide transportation. Right. And then you've got your badge, boom, doula, Dona certified, homegrown babies trained. And my purpose, you wear your verbal scraps that has this, this campuses does on one side mag. OB specialists on the other side.

Um, and my daughter bag while my little necessities, I have my massage oils. My. Essential oils, spray bottle moms get to wear whatever they want to labor. And so they don't do, you know, they don't get told that unless we tell them you have to have someone advocating for you. I don't know that, you know, our hospital has a certain amount of wireless monitors.

There's some ask for wireless monitors so they can move in and out. You want to offer them to you or intermittent monitoring, you know, rather than continuous monitoring. So would come in handy. We know. So you're massaging your laboring. Do many of your moms prefer a natural childbirth or an unmedicated epidural birth?

Do they have a strong opinion? Either way? Um, a lot of the moms don't stay to realize that they doula passing traits. In the bag and you kind of coach them through with certain things that you're going to do. You got, you were willing to do to help alleviate some of the pain, the pressure actually showing them, telling them and showing them what their body's doing.

They'd be more active. Try it. Without any interventions. Um, but we always let it be known. We don't judge you. We don't have, it's this your part with however you want to label, we can work with you. If you get that epidural, we could still labor in that bag and right there, what you just said, they're getting a voice in their ear that they're not getting anywhere else that says, this is your birth.

This is you. Your body is you have choices. You have control. What do you want? Yes. So going for the labor and the delivery and getting to know this, and we've already mentioned in your community, we just don't have any black OB GYN. What do you want to share with the medical community across the country?

Like if you are white, OB GYN right now. And you're thinking, I don't want any of anyone to feel. I'm not doing this on purpose. I don't, I don't want to make the black women that I serve feel like they are not heard, which is the biggest issue here with institutional or structural racism is black women voicing and then being shut down and not heard.

So what advice can you give? From this community, from your experiences to white OB GYN across the country, across the board, I would definitely say they need just, we would really appreciate if they stop judging a book by its cover. Because it's deeper than that. Um, I will like for our healthcare community to find that place of empathy, you know, if you can't, for some reason, see past color and try that, imagine that being your mother or your sister or your aunt in that bed, or even your grandmother, because everyone, one point in time, you wouldn't be here without.

Going through this same process and you know, things about the body and you know, how the body works, because it's just, you go to school for transfer some of your studied your, your education and to humanity, the humane thing to do. You know what I'm saying? I see more people take care of their animals, better care of their animals and blood black women.

That's hurtful. And that's coming from a black woman. That's that's just real. We're no different. We're no different. We love our kids, children. I don't care what Latin life we've had, how much finances we have, how, how dark our skin color is. It does not matter. So I think they need to just take a step back.

Let's take a step back and look, look, it's no difference. I don't think you were seeing the skin color spiraling looking at us as people, as women, as women and equitable women. We deserve it. Yep. Thank you for sharing. Thank you guys for saying yes to this conversation and for teaching me. And for sharing your story.

And as we kick off the week, this week for black maternal health awareness, you know, I just really appreciate you being here.

Thank you for listening to burst story. My goal is you'll walk away from each episode with a clear picture of how labor and delivery might go, and that you will feel empowered by the end of your pregnancy to speak up plan and prepare for the birth you want. No matter what that looks like.