California Black Media

Doulas & Black Moms: Bridging the Gap Between Mental Treatment and Maternal Care

There is a growing body of evidence that disparities in medical treatment in the United States — compounded over centuries by the legacy of slavery, Jim Crow segregation and prevalence of anti-Black biases — have adversely affected the health of Black women in numerous ways, including the birthing process.

Published

10 months ago

August 31, 2023

Oakland Post

Chelsea Rae Crowder-Luke speaks with her doula in her home in Los Angeles, and she was 34 weeks at the time of the interview. Photo courtesy California Black Media.

By Aldon Thomas Stiles
California Black Media

In June, the tragic and high-profile death of Olympic Gold Medalist and sprinter Tori Bowie during childbirth brought more national attention to the crisis of Black maternal mortality in the United States.

Aware of the discrepancies in treatment as compared to women of other races and terrified by the potential mental health ramifications of those disparities — which can lead to greater fear and anxiety about pregnancy and childbirth — some Black women are seeking alternatives to hospital births.

Black women die at nearly twice the rate of white women during labor, according to data from the National Institutes of Health (NIH).

In July, the U.S. Department of Health and Human Services (HHS) announced that the federal government has launched a civil rights investigation into the treatment of Black expectant mothers at Cedars Sinai Medical Center in Los Angeles.

“Maternal health is a priority for the Biden-Harris Administration and one in which the HHS Office for Civil Rights is working on around the country to ensure equity and equality,” read an emailed statement from HHS to several news outlets.

The federal investigation comes seven years after the 2016 death of a Black woman, Kira Dixon Johnson, who died from internal bleeding following a cesarean section at Cedars Sinai.

Dr. Melissa Frank, director of the Division of Maternal, Child, and Adolescent Health with the Los Angeles County Department of Public Health, stated that she has “lived the disparity” associated with maternal healthcare.

During the delivery of her second daughter, Franklin says she could tell something was wrong and expressed that to hospital staff, “I feel like I’m dying,” but her concerns were largely dismissed.

When the hospital staff finally checked on her, they discovered that her blood pressure was dangerously low to which she responded, “I told y’all!”

According to data from the Centers for Disease Control and Prevention (CDC), in 2021, Black women in the U. S. were more than twice as likely as white women to die due to complications related to maternity and the birthing process.

In California, the risk of death due to pregnancy complications is four to six times higher for Black mothers than any other ethnic group, according to data from the California Health Care Foundation.

Research has indicated that maternal mental health conditions, including prenatal and postpartum anxiety and depression, are the most common complications of pregnancy and childbirth.

According to the American Hospital Association Institute for Diversity and Health Equity, 12.5% of birthing people will suffer from postpartum depression. However, Black women are about 1.6 times more likely to deal with its effects than white women.

Hiring a doula is one solution Black women are using to help address some of the mental health issues associated with the birthing process. A 2013 study by the National Center for Biotechnology Information found that mothers who received support from a doula during childbirth were two times less likely to experience complications.

A doula is a trained professional who provides emotional and physical support to pregnant individuals during pregnancy, childbirth and the postpartum period.

Doulas are not medical professionals and do not deliver babies or provide medical care. Instead, they offer support in the form of physical comfort, emotional well-being, information, and advocacy.

According to another study by the National Center for Biotechnology Information, doula-assisted mothers were 57.5% less likely to suffer from postpartum depression or anxiety. This confirms that having the support of a doula during the birthing process can have a significant positive impact on the mental health of mothers.

The long history of discriminatory care towards Black women in the healthcare system has resulted in another mental health issue: generational trauma.

“When we speak about Black maternal health, we cannot ignore the fact that the foundation of medicine in this country and many of its early principles were deeply rooted in racism,” said Assemblymember Akilah Weber (D-La Mesa), a board-certified obstetrician/gynecologist, and founder and past director of the Pediatric & Adolescent Gynecology Division at Rady Children’s Hospital-San Diego.

“Some of the earliest examples of experimental research relied on these racist concepts. The pain of Black individuals was not only ignored but assumed to not be experienced to the same degree as white individuals.”

Franklin emphasized the importance of culturally competent care for the mental health of Black mothers.

“The support of doulas as alternative birthing spaces gives Black women the opportunity, the choice of giving birth in a way that’s culturally affirming,” said Franklin. This highlights the significance of providing care that is sensitive to the cultural needs and experiences of Black women during the birthing process.

Franklin also pointed out that doulas alone cannot bear the burden of an unfair healthcare system. She emphasized the importance of hospitals employing well trained providers who operate in anti-bias and anti-racism spaces. This can help Black women give birth with “the support of a village.”

California has been taking steps to address healthcare disparities and improve outcomes for Black mothers and birthing individuals. The state introduced various policies and initiatives aimed at making culturally competent care a reality.

For example, the Department of Health Care Services (DHCS) has taken steps to improve access to doula services for expectant mothers. One such initiative is the inclusion of doula services as a preventative care option covered under Medi-Cal. This can help make doula support more accessible and affordable for those who need it.

Los Angeles County Supervisor Holly J. Mitchell has emphasized the importance of doula care in improving pregnancy experiences and birthing outcomes.

In a press release, she stated that “Doula care is shown to improve pregnancy experiences and birthing outcomes. We must increase awareness of doula services for mothers and families across the County and expand our workforce to be more representative of our communities most in need.” This highlights the need for greater awareness and accessibility of doula services, particularly for those in underserved communities.

In the meantime, Dr. Franklin’s advice is to listen to Black women when they express concerns about their health. This means taking their concerns seriously and providing them with the care and support they need.

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Oakland Post: Week of June 12-18, 2024

The printed Weekly Edition of the Oakland Post: Week of June 12-18, 2024

Published

3 days ago

June 14, 2024

Oakland Post

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Antonio‌ ‌Ray‌ ‌Harvey‌

More Segregated Than Deep South: ACLU Releases Report on Calif. Public Schools

The 2024 State of Black Education: Report Card was recently published by the American Civil Liberties Union California Action (ACLU California Action). It states that California is the third most segregated state for Black students.  Co-author of the report, policy counsel Amir Whitaker from ACLU Southern California explained the criteria the ACLU use to rank California during the commemoration of the 70th anniversary of the landmark 1954 U.S. Supreme Court decision Brown vs. Board of Education held at the State Capitol the day after the Memorial Day holiday.

Published

3 days ago

June 13, 2024

Oakland Post

Asm. Mia Bonta (D-Alameda) was a guest speaker at the State of Black Education report card briefing at the State Capitol on May 29. CBM Photo by Antonio Ray Harvey.

By Antonio‌ ‌Ray‌ ‌Harvey‌, California‌ ‌Black‌ ‌Media‌

The 2024 State of Black Education: Report Card was recently published by the American Civil Liberties Union California Action (ACLU California Action).

It states that California is the third most segregated state for Black students.

Co-author of the report, policy counsel Amir Whitaker from ACLU Southern California explained the criteria the ACLU use to rank California during the commemoration of the 70th anniversary of the landmark 1954 U.S. Supreme Court decision Brown vs. Board of Education held at the State Capitol the day after the Memorial Day holiday.

“For every state in the Deep South, California (schools) are more segregated,” Whittaker said. “People often think that California is not segregated or unequal as Deep South states and others. The inequalities here (in California) are actually wider.”

New York and Illinois are ahead of California regarding the racial diversity of their student bodies. According to a report May 2022 report by Stanford Graduate School of Education, the Los Angeles, Philadelphia, and New York City school districts are in the top 10 most racially segregated districts for White-Black, White-Hispanic, and White-Asian segregation based on the average levels from 1991-2020.

In bigger school districts, segregation between low-income (students who are eligible for free lunch) and non-low-income students increased by 47% since 1991, according to the Stanford Graduate School’s report.

“That’s why it’s important to look at this data,” Whitaker said. “When you have millions of people living in places like Los Angeles, Chicago, and New York, the urban areas are a lot more segregated than the south. That’s a big part of it.

A number of factors contribute to the segregation of schools in California such as parents sending their children to private schools, others optioning for homeschooling, and other reasons, Whitaker said.

The Brown v. Board of Education case declared that separating children in public schools based on race was unconstitutional. However, Whitaker pointed to cases after the landmark decision that circumvented that federal law.

According to a 2014 report by the Civil Rights Project, in the 1990s, decisions by the U.S. Supreme Court decision ended federal desegregation orders in San Francisco and San Jose. In addition, court decisions in the state that ordered desegregation in the 1970s were overturned by the 1990s. Legally, California has no school integration policy to adhere to.

“This is why we did this report. There needs to be a report just on this issue (of school segregation),” Whitaker told California Black Media. “Right now, there’s no task force or anything addressing it. I have never seen the California Department of Education talk about it. This is a pandemic (and) a crisis.”

ACLU Northern California hosted an overview of the report and panel discussion at the State Capitol on May 29. California Black Legislative Caucus member Assemblymember Mia Bonta (D-Alameda) and Sen. Steven Bradford were the guest speakers. Parents, students, educators, and Black education advocates from all over the state attended the 90-minute presentation at the State Capitol.

School segregation is the No. 1 issue listed in among the report’s “24 areas of documented inequality,” along with problematic trends of racial harassment, a continuous decline of Black student enrollment, school closures, connection with school staff, chronic absenteeism, low Black teacher representation, and parent participation.

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California Black Media

L.A. Pilot Program Addressing Asian American Hate Could Be California Model

Californians who are Asian American or Pacific Islanders (AAPI) were the targets of an escalated number of hate crimes and hate incidents during the COVID-19 pandemic. Many AAPI people, particularly the elderly, reported being too scared to leave their homes. Others experienced firsthand hateful incidents stemming from deep-rooted prejudices and stereotypes — such as verbal or physical assaults in public.

Published

3 days ago

June 13, 2024

Oakland Post

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By McKenzie Jackson, California Black Media

Californians who are Asian American or Pacific Islanders (AAPI) were the targets of an escalated number of hate crimes and hate incidents during the COVID-19 pandemic.

Many AAPI people, particularly the elderly, reported being too scared to leave their homes. Others experienced firsthand hateful incidents stemming from deep-rooted prejudices and stereotypes — such as verbal or physical assaults in public. Yet, too many of them were hesitant to voice their emotions, according to Yu Wang, an associate marriage and family therapist at the Asian Pacific Counseling and Treatment Center in Los Angeles.

“A space for healing is critically needed,” Wang said, also noting that some Asian cultures don’t put a heavy emphasis on sharing feelings and vulnerabilities. “It makes it difficult to talk about experiences related to racism. Also, many of us lack to the language to express emotions, which exacerbates feelings of isolation and fear.”

The Asian/Pacific Islanders (AAPI) Equity Alliance in collaboration with other Asian American community groups recently launched the Healing Our People through Engagement (HOPE) pilot program in Los Angeles County geared at healing racial trauma experienced by Asian American community members by providing healing spaces and reducing isolation. Based on the successes of the initiative, supporters and organizers believe the “culturally centered” program could become a model for other cities around the state.

Ethnic Media Services hosted an hourlong Zoom press conference on the last day of May, which was AAPI Heritage Month, to allow HOPE program facilitators and allies the opportunity to provide details of the initiative to the media.

HOPE is a healing space for five distinct Asian American communities — Cambodian, Chinese, Filipino, Japanese, and Korean — created to make sense of their experiences with racism and recent surges in hate crimes. The psychology of the program is radical healing, a framework that has aided Black people in dealing with years of prejudice-caused trauma. HOPE is funded by a grant from the California Department of Social Services.

More than 11,000 stories of hate have been reported to the California-based online resource, Stop AAPI Hate, since 2020.

AAPI Managing Director of Programs Michelle Sewrathan Wong called HOPE vital and said Asian Americans endured episodes of brutality on a scale not seen in generations.

“They were scapegoated by politicians for transmission of COVID-19, targeted for violent physical attacks, made to feel unsafe and unwelcome in their own communities and bullied and ridiculed by neighbors and strangers,” she stated.

HOPE opened healing spaces in Los Angeles County that offer six two-hour sessions conducted in groups by facilitators, who are staff from partner community organizations.

DePaul University Associate Professor of Psychology Dr. Anne Saw said the radical healing framework promotes healing over coping.

“Healing may be lifelong because racism is ongoing, yet a program like ours reminds people of the cultural, community, family, and individual strengths they have to resist racism,” Saw said. We believe that healing in a group can be more powerful than an individual engaging in healing on their own because of the support they receive.”

This resource is supported in whole or in part by funding provided by the State of California, administered by the California State Library in partnership with the California Department of Social Services and the California Commission on Asian and Pacific Islander American Affairs as part of the Stop the Hate program. To report a hate incident or hate crime and get support, go to CA vs Hate.