By Sheden Tesfaldet and Niyah Harris
Birth in Color RVA offers non-medical support to expectant and new parents in the Richmond area, focusing on women of color. Services range from prenatal and postpartum yoga, coaching on healthy diets, providing expertise for breastfeeding and offering workshops for fathers. Overall, the doulas of Birth in Color want to keep everyone healthy and thriving as new life commences.
“My favorite part is the ability to empower people to have a birth experience that they ideally want,” said Sequoi Phipps-Hawkins, who's been a community-based doula for Birth in Color RVA since the beginning of the year.
Phipps-Hawkins is part of a growing movement in healthcare. Doulas, who aren’t required to receive medical training, provide guidance and assistance to expectant parents in hopes of creating a more successful pregnancy and delivery experience. Birth in Color RVA is among several Birth in Color locations across Virginia, which also include Roanoke, Hampton Roads, Danville, Lynchburg, the Northern Neck and Southwest Virginia.
Currently, Black women have a significantly higher risk of mortality due to pregnancy. “We are seen as expendable,” Phipps-Hawkins said. “People of color are overlooked in the field of medicine.”
Birth in Color RVA exists to advocate for women and educate the public. Phipps-Hawkins and her organization aim to be part of a needed change.
Kenda Sutton-EL, who comes from a long line of healthcare workers, said she felt destined to continue her family’s legacy, and in 2007, acted on her calling by becoming a doula. Sutton-EL started by helping her pregnant friends, and for years coached people and their partners through their journeys toward parenthood. In 2018, she founded Birth in Color RVA.
Sutton-EL said doulas provide parents assistance from conception to delivery, and are central in voicing preferences and concerns to medical personnel.
“If there was a provider who wasn't familiar, the doula could actually step in and say, ‘Hey, I do know that she has been this and this is what's going on,’” Sutton-El said.
Sutton-EL said she’s motivated by statistics she finds unacceptable. In the United States each year, about 50,000 women are severely injured during pregnancy or childbirth and 700 women die from complications. Two-thirds of pregnancy-related deaths are considered preventable, according to the Centers for Disease Control and Prevention.
“It’s so that everyone knows that they have their own right to their own bodily autonomy,” Sutton-EL said about founding Birth in Color RVA. “They know exactly what's going on within their bodies, they're not afraid to ask questions, and make informed decisions based upon the research and knowledge that they have gained.
In 2000, The CDC’s Healthy People goals included reducing the maternal mortality death rate to 5 per 100,000 births. In 2010, the goal was 3.3 per 100,000 births. Neither goal was reached.
Black women, in particular, experience negative birthing outcomes at higher rates than white women. The disparity remains consistent, regardless of most socioeconomic factors.
For instance, the pregnancy-related mortality rate among college-educated Black women is 5.2 times higher than their white counterparts, according to the Kaiser Family Foundation. When compared to white women with less than a high school diploma, Black women with a college diploma had a PRMR that was 1.6 times higher.
In Virginia, the maternal mortality rate is 15.6 per 100,000 pregnancies. While all women of color had poorer birthing outcomes than white women on average, the disparities facing Black women were the most drastic.
Black women in Virginia die at a rate more than two times higher than white women — 47.2 per 100,000 compared to 18.1. To combat this, the Virginia Department of Health launched the Maternal Mortality Review Team to examine all pregnancy-associated deaths in the state.
“Preliminary data more recently has shown that those trends tend to continue,” said Melanie J. Rouse, coordinator of the MMRT. “And so, it is still very much an important issue in maternal care and healthcare in the state of Virginia.”
Rouse said that while the MMRT doesn’t necessarily work directly with doula clinics, it can recommend the promotion of doula services based on case reviews.
Sutton-EL is convinced that racial bias in healthcare systems plays a role in endangering Black women during pregnancy. “Most of it stems from racism, where they just don't listen to Black women,” she said.
Sutton-EL pointed to the myth of the strong Black woman. This is the misconception that Black women are somehow impervious to pain that others might feel. An example in mainstream American culture is tennis star Serena Williams’ description in a 2018 Vogue interview of her birth experience. She said she was ignored after telling medical providers about a pain that turned out to be a potentially fatal blood clot in her lungs.
Another example is a 2016 survey of student physicians that indicated 40% of respondents believed the myth that Black people’s skin is thicker than that of white people.
In a 2019 report, the MMRT found that 44% of pregnancy-related deaths stemmed from provider-related causes. Sutton-EL said that racial biases negatively impact the care given to Black mothers and can adversely affect birth experiences.
“[If] they already think, ‘Oh, this person must be lying, because they are Black or a dark hue,' then that's problematic,” Sutton-EL said. “That means they're not going to get the care that they need. That means they're not going to pay attention to the symptoms that they're telling them that they're having.”
This summer, VDH announced it received a grant from the CDC to address and reduce maternal mortality in the state. The grant provides $450,000 per year for two years.
“Our goals are to continue our case review of pregnancy-associated deaths within the state and to make any recommendations that are able to really address the needs of women of childbearing age within the state,” MMRT's Rouse said.
It is unclear how that funding might impact the work of Birth in Color RVA.
Since its founding, Birth in Color has grown to more than 50 doulas. Applications and training information for those interested in becoming birth workers are online. Training begins with 15-20 hours of self-guided study. There is also a mentorship program, as well as weekly meetings and a monthly 8-hour session.
“Our total training is 60 hours with a three-day, in-person training,” Phipps-Hawkins said.
Phipps-Hawkins encouraged people who might be interested in pursuing life as a doula to read books, watch YouTube videos and listen to podcasts to get a better idea of what it’s like.
She said her relationship with her clients is an honor.
“It truly is such a privilege to be in this space that they’re in as they welcome their child earthside,” Phipps-Hawkins said.
She considers each successful birth a victory, adding that she is helping create a birth experience where new parents feel empowered, prepared and in control.