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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.

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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.
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

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.

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.

Activism

Up to the Job: How San Francisco’s PRC Is Providing Work Opportunities That Turn Into Lasting Stability

Each year, PRC serves more than 5,000 clients through a wide range of programs. These include housing navigation, legal advocacy to ensure access to health and public benefits, supportive housing, job and life-skills training, and residential treatment programs. 

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Black Leadership Council (BLC) Advocacy Day in Sacramento. BLC works to advance meaningful change through policy engagement to unlock the full potential of Black and low-income communities. Photo courtesy of PRC.
Black Leadership Council (BLC) Advocacy Day in Sacramento. BLC works to advance meaningful change through policy engagement to unlock the full potential of Black and low-income communities. Photo courtesy of PRC.

By Joe Kocurek, California Black Media

Seville Christian arrived in San Francisco in the 1990s from Kansas City, Mo., a transgender woman coming from a time and place still hostile to who she was.

San Francisco offered a deeper LGBTQ+ history and a more visible community of people like her, but even in a city known for acceptance, building a stable life from scratch was no small task.

After arriving in the city, she turned to Positive Resource Center (PRC) looking for work — and for a foothold — in a new place.

“PRC gave me my first job,” Christian said. “A simple gig — passing out magazines at the San Francisco Pride Parade.”

That first opportunity marked the beginning of a decades-long relationship with PRC, one that has seen Christian grow from client to valued employee, and eventually to policy fellow.

“Today, I’ve been with PRC for 27 years, going on 28,” she said.

Seville Christian’s decades-long relationship with PRC includes as a client, fellow and beloved employee. Photo courtesy of PRC.

Seville Christian’s decades-long relationship with PRC includes as a client, fellow and beloved employee. Photo courtesy of PRC.

Helping people access employment and build sustainable careers has been a cornerstone of PRC’s mission since its inception nearly four decades ago. In its most recent annual impact report, PRC served 443 clients through workforce development services, including career counseling, educational programs, hands-on training, and job search assistance. The average wage earned by PRC clients is $26.48 per hour — approximately 38% above San Francisco’s minimum wage.

To advance this work, organizations like PRC have benefited from funding through California’s Stop the Hate Program, which provides direct support to community-based organizations leading anti-hate initiatives.

Christian’s path was not without challenges. During some rocky years, she experienced periods of housing instability and struggled with addiction. Through PRC, she enrolled in a life-skills program that emphasized using her own lived experience as a means of helping others. The program helped set her on a path toward completing an associate’s degree and ultimately launching a career in case management.

“Today, whether someone is new to the city or has lived here their whole life, I know how to help them navigate to where they need to be,” Christian said.

Each year, PRC serves more than 5,000 clients through a wide range of programs. These include housing navigation, legal advocacy to ensure access to health and public benefits, supportive housing, job and life-skills training, and residential treatment programs.

Members of PRC’s Black Leadership Council meet with a lawmaker in Sacramento. Photo courtesy of PRC.

Members of PRC’s Black Leadership Council meet with a lawmaker in Sacramento. Photo courtesy of PRC.

While PRC was founded to serve people living with HIV, its mission has expanded over the decades to meet the needs of people with disabilities, individuals experiencing homelessness, and those facing mental health and substance use challenges.

According to PRC’s Chief of Public Policy and Public Affairs, Tasha Henneman, some of the organization’s earliest programs remain as vital today as they were at the start.

“Our emergency financial assistance program helped more than 1,200 people this year pay rent, cover medical bills, and keep the lights on,” Henneman said. “And over 1,400 people reached out for legal advocacy, resulting in more than $2.5 million in retroactive benefits unlocked.”

Beyond direct services, PRC is deeply committed to community empowerment and policy change. Programs such as the Black Leadership Council support community leaders in advocating for systemic reform, while the Black Trans Initiative focuses on addressing the unique challenges faced by Black transgender individuals.

A recent study from the Williams Institute highlighted findings that 71% of transgender homicide victims in the U.S. between 2010 and 2021 were Black and that nearly a third of the transgender homicides during that period were confirmed or suspected hate crimes.

PRC’s direct and indirect services can be a lifeline for people experiencing hate and are an example of the resources people can get connected with through the state’s CA vs Hate hotline.

PRC is now also producing a film project that centers the lived experiences of Black trans clients, including individuals like Christian.

PRC welcomed guests to their annual Open House in April, an evening dedicated to connection, reflection, and learning more about the programs and people working every day to support San Franciscans experiencing housing instability, unemployment, and behavioral health challenges. Photo courtesy of PRC.

PRC welcomed guests to their annual Open House in April, an evening dedicated to connection, reflection, and learning more about the programs and people working every day to support San Franciscans experiencing housing instability, unemployment, and behavioral health challenges. Photo courtesy of PRC.

“Our film highlights the health journeys and lived experiences of some of PRC’s Black trans clients,” Henneman said. “Our goal is to give voice, visibility, and agency to the participants — and to bring their stories, both harrowing and inspirational, to policymakers and the broader public.”

The film, expected to be released later this year, is directed by Yule Caise, with assistant director Zarina Codes, a Black transgender San Francisco resident.

Today, Christian continues her relationship with PRC as an ambassador, reflecting on a journey that began with a single job opportunity and grew into a lifelong commitment to service.

“Sometimes I’ll be riding the bus or standing in a grocery store, and someone will come up to me from a women’s shelter,” she said. “They’ll say, ‘Oh, Miss Seville, I just want to thank you. You really helped me with what I was dealing with.’”

She paused, smiling.

“And in those moments,” Christian said, “I think to myself, “Well!.”

A single word that sums up pride in a journey to find the best in herself.

Get Support After Hate:

California vs Hate is a non-emergency, multilingual hotline and online portal offering confidential support for hate crimes and incidents. Victims and witnesses can get help anonymously by calling 833-8-NO-HATE (833-866-4283), Monday to Friday, 9 a.m.–6 p.m. PT, or online at any time. Anonymous. Confidential. No Police. No ICE.

This story was produced in partnership with CA vs Hate. Join them for the first-ever CA Civil Rights Summit on May 11, 2026. More information at www.cavshate.org/summit.

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Activism

Oakland Post: Week of April 22 – 28, 2026

The printed Weekly Edition of the Oakland Post: Week of April 22 – 28, 2026

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To enlarge your view of this issue, use the slider, magnifying glass icon or full page icon in the lower right corner of the browser window.

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Activism

Up to the Job: How San Francisco’s PRC Is Providing Work Opportunities That Turn Into Lasting Stability

Each year, PRC serves more than 5,000 clients through a wide range of programs. These include housing navigation, legal advocacy to ensure access to health and public benefits, supportive housing, job and life-skills training, and residential treatment programs. 

Published

on

Black Leadership Council (BLC) Advocacy Day in Sacramento. BLC works to advance meaningful change through policy engagement to unlock the full potential of Black and low-income communities. Photo courtesy PRC.
Black Leadership Council (BLC) Advocacy Day in Sacramento. BLC works to advance meaningful change through policy engagement to unlock the full potential of Black and low-income communities. Photo courtesy PRC.

Joe Kocurek | California Black Media  

 Seville Christian arrived in San Francisco in the 1990s from Kansas City, Mo., a transgender woman coming from a time and place still hostile to who she was. 

 San Francisco offered a deeper LGBTQ+ history and a more visible community of people like her, but even in a city known for acceptance, building a stable life from scratch was no small task. 

 After arriving in the city, she turned to Positive Resource Center (PRC) looking for work — and for a foothold — in a new place. 

 “PRC gave me my first job,” Christian said. “A simple gig — passing out magazines at the San Francisco Pride Parade.” 

 That first opportunity marked the beginning of a decades-long relationship with PRC, one that has seen Christian grow from client to valued employee, and eventually to policy fellow. 

 “Today, I’ve been with PRC for 27 years, going on 28,” she said. 

Helping people access employment and build sustainable careers has been a cornerstone of PRC’s mission since its inception nearly four decades ago. In its most recent annual impact report, PRC served 443 clients through workforce development services, including career counseling, educational programs, hands-on training, and job search assistance. The average wage earned by PRC clients is $26.48 per hour — approximately 38% above San Francisco’s minimum wage. 

To advance this work, organizations like PRC have benefited from funding through California’s Stop the Hate Program, which provides direct support to community-based organizations leading anti-hate initiatives. 

Christian’s path was not without challenges. During some rocky years, she experienced periods of housing instability and struggled with addiction. Through PRC, she enrolled in a life-skills program that emphasized using her own lived experience as a means of helping others. The program helped set her on a path toward completing an associate’s degree and ultimately launching a career in case management. 

“Today, whether someone is new to the city or has lived here their whole life, I know how to help them navigate to where they need to be,” Christian said. 

PRC welcomed guests to their annual Open House in April, an evening dedicated to connection, reflection, and learning more about the programs and people working every day to support San Franciscans experiencing housing instability, unemployment, and behavioral health challenges.

PRC welcomed guests to their annual Open House in April, an evening dedicated to connection, reflection, and learning more about the programs and people working every day to support San Franciscans experiencing housing instability, unemployment, and behavioral health challenges.

Each year, PRC serves more than 5,000 clients through a wide range of programs. These include housing navigation, legal advocacy to ensure access to health and public benefits, supportive housing, job and life-skills training, and residential treatment programs. 

While PRC was founded to serve people living with HIV, its mission has expanded over the decades to meet the needs of people with disabilities, individuals experiencing homelessness, and those facing mental health and substance use challenges.  

According to PRC’s Chief of Public Policy and Public Affairs, Tasha Henneman, some of the organization’s earliest programs remain as vital today as they were at the start. 

“Our emergency financial assistance program helped more than 1,200 people this year pay rent, cover medical bills, and keep the lights on,” Henneman said. “And over 1,400 people reached out for legal advocacy, resulting in more than $2.5 million in retroactive benefits unlocked.” 

Beyond direct services, PRC is deeply committed to community empowerment and policy change. Programs such as the Black Leadership Council support community leaders in advocating for systemic reform, while the Black Trans Initiative focuses on addressing the unique challenges faced by Black transgender individuals. 

 A recent study from the Williams Institute highlighted findings that 71% of transgender homicide victims in the U.S. between 2010 and 2021 were Black and that nearly a third of the transgender homicides during that period were confirmed or suspected hate crimes.  

PRC’s direct and indirect services can be a lifeline for people experiencing hate and are an example of the resources people can get connected with through the state’s CA vs Hate hotline.  

PRC is now also producing a film project that centers the lived experiences of Black trans clients, including individuals like Christian.

 “Our film highlights the health journeys and lived experiences of some of PRC’s Black trans clients,” Henneman said. “Our goal is to give voice, visibility, and agency to the participants — and to bring their stories, both harrowing and inspirational, to policymakers and the broader public.” 

The film, expected to be released later this year, is directed by Yule Caise, with assistant director Zarina Codes, a Black transgender San Francisco resident. 

 Today, Christian continues her relationship with PRC as an ambassador, reflecting on a journey that began with a single job opportunity and grew into a lifelong commitment to service. 

“Sometimes I’ll be riding the bus or standing in a grocery store, and someone will come up to me from a women’s shelter,” she said. “They’ll say, ‘Oh, Miss Seville, I just want to thank you. You really helped me with what I was dealing with.’” 

She paused, smiling. 

“And in those moments,” Christian said, “I think to myself, “Well!.” 

A single word that sums up pride in a journey to find the best in herself.  

 Get Support After Hate:

California vs Hate is a non-emergency, multilingual hotline and online portal offering confidential support for hate crimes and incidents. Victims and witnesses can get help anonymously by calling 833-8-NO-HATE (833-866-4283), Monday to Friday, 9 a.m.–6 p.m. PT, or online at any time. Anonymous. Confidential. No Police. No ICE.This story was produced in partnership with CA vs Hate. Join them for the first-ever CA Civil Rights Summit on May 11, 2026. More information at www.cavshate.org/summit.

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