Even in the best of circumstances pregnancy and childbirth can seem like daunting milestones for many women. For Latinas and women of color, it’s oftentimes even more complicated. Some believe that by reclaiming some of our ancestral birth practices — often in decidedly modern ways — Latinas and women of color in general, may be able to vastly alter the average childbirth experience, making it once again, something that feels more organic and empowering. Doulas and midwives are essentially trained to do just that and their popularity is rising in the U.S. even though it’s been an ancestral practice.
Black women in America are three times more likely to die during pregnancy or postpartum compared to white women, and while Latinas tend to fare more similarly to our white counterparts, there are believed to be significant differences between women belonging to do different sects within the Latinx community.
According to the Kaiser Family Foundation, Black and Latina women specifically are at risk for “severe maternal morbidity,” which refers to complications of labor and delivery that may affect a woman’s long- or short-term health. As a whole individuals in the Latinx community tend to face more difficult barriers when it comes to accessing quality healthcare, as well as social and economic challenges that white people don’t.
The bottom line is women of color often have a different birthing experience than white women, and the implications of that can often be quite dangerous. Hospital births may present unique challenges for women of color who often don’t realize there are other options. Women who want to have more control of their birthing experience can enlist the help of a doula, which is basically a birthing partner present for emotional and physical support, and/or a midwife who is an actual healthcare professional who assists with labor, delivery and postpartum care.
“One thing that kept coming up in conversations with my clients was the word ‘Doula,'” Selena Maldonado, a Puerto Rican doula based in New York City who previously worked as a childcare specialist, tells HipLatina. “I began to realize that most clients who had a doula, tended to have better birth experiences. Whether it was the birth they planned for or not, all of my clients felt empowered and this really piqued my interest.”
Selena predominantly works with Latina moms and has seen firsthand the challenges women in our community face when it comes to birth. “Latina women face many barriers when it comes to childbirth, and the root cause of this is systemic racism in the medical industrial complex system.” Many childbirth, healthcare, and even law experts agree.
Simply being Latina or a woman of color in America can lead to serious emotional and physical barriers when it comes bringing a child into this world. Selena explains that these barriers can include language and education or simply being ignored by medical professionals with implicit or explicit biases against our communities.
“Rhetoric like ‘go back to your country’ is disgusting and a complete insult to anyone who has immigrated or comes from a family of recent immigrants. These words don’t need to be said for a provider’s intention and feelings toward Latinx people to be understood. We can always feel it even when it’s not explicitly said,” Lydia Harris, a Black and Mexican American doula tells us.
“We can look at the events that took place in Los Angeles during the 60s and 70s, where Latinx birthing people were being tricked into being sterilized. We can also look back at the first large scale human trial of birth control that occurred in Puerto Rico in the mid 1950s,” says Selena. ” This type of trauma is passed down through generations on a cellular level, creating this distrust [for the healthcare system] way before the child rearing age.”
One thing in particular that comes to mind is the recent threat of the U.S. government overturning Roe V. Wade, essentially leaving women with no federal protection for abortions. According to an essay published on the American Civil Liberties Union website, the idea of abortion bans goes all the way back to the time of slavery, and is deeply rooted in racism and connected to midwifery bans that surfaced at the time.
“Just like slavery, anti-abortion efforts are rooted in white supremacy, the exploitation of Black women, and placing women’s bodies in service to men. Just like slavery, maximizing wealth and consolidating power motivated the anti-abortion enterprise.,” writes Michele Goodwin,
She also notes that before the Civil War abortions were performed by midwives among Indigenous, European, and Black women, and that they were legal. When slavery ended though, those Black midwives suddenly became competition for white male doctors. Male gynecologists decided to change the narrative surrounding midwifery — and essentially women helping other women birth babies — in order to keep lining their own pockets. They went as far as to describe the ancestral practice of midwifery as barbaric and unhygienic, and with its demise as a common practice, so went the availability of safe and legal abortions across the country.
As moms and women, we have put up with it for too long. Women have helped other women through labor and delivery in non-hospital settings for all of time, and like a number of practices that have gone the wayside — at least for a time — in America thanks to racism, it’s at a detriment to women and their babies.
Latina midwives and doulas like Selena and Lydia are helping women reclaim their bodies and their births. Midwives and doulas can practice in home or hospital settings, they use modern tools and medicine when necessary and at the request of birthing mothers. The biggest difference is that they are there to serve you and to help you have a safe birthing experience in the best way for you.
“Birth became medicalized within the Latinx community because unfortunately Latinx people, like many minorities, don’t have a strong voice in this country,” says Lydia. “When white supremacy and misogyny took over the birth experience in America it took with it the Black birth experience and the Latinx birth experience…My goal as a doula and as a future provider is to bring the best of both birth cultures to create an incredible experience for my clients and eventually, my patients.”
Not only that, but midwives and doulas are accessible to nearly all women in America. Their services are not something that only well-off white women with a penchant for all things natural can enlist, as has become the perception in recent years. Selena tells us that one of her goals is for women to know that these services are available regardless of a woman’s financial situation. She deems them a necessity that all families deserve.
What’s the biggest hurdle keeping more BIPOC and Latina moms from using midwives and doulas? Knowledge. Both Lydia and Selena tell us that many women in the Latinx community don’t even know their services are available, despite how ubiquitous they are in many Latin American countries. Many expectant moms don’t feel comfortable asking questions of their healthcare providers or may find themselves frustrated by a language barrier.
“Many people don’t even know that they have a choice about where they can birth, who their provider is, and all the other options that are never presented to them,” says Selena. “Many people have this mindset that childbirth is a natural occurrence, and therefore they do not have to prepare for it; however, that cannot be further from the truth. In order to have an empowering birth, birthing people must be educated and aware of the many options that they have. “
And the greatest benefit? Postpartum care. Midwives generally spend more time and give more personalized attention to expectant moms throughout pregnancy and labor and delivery, and doulas continue to care for their charges throughout the postpartum phase, which is not at all the norm in America. Most women don’t talk to their obstetrician again after their six-week or even the two-week postpartum checkup until they’re pregnant again.
“In Mexican culture, it is taboo to leave the house before you have healed, and being forced to bring your baby to a 3-5 day newborn check, then baby and yourself to a 2-week postpartum check go against traditional culture,” say Lydia. “I think an incredible way for midwives and doulas to help in the postpartum period is to meet the mothers/birthing people where they are,” she explains, noting that she thinks in-home postpartum visits make a huge difference for women.
The ritual of cuarentena, a common practice throughout LATAM where the mom recovers and bonds with her baby at home for the first 40 days, is one made that much easier with the help of a doula. In the U.S., which federally only provides 12 weeks of unpaid maternity leave, having a doula will at least make that time you have with your baby time you can truly spend bonding.
Depending on the state you live in and your health insurance plan, the services of midwives and doulas may be covered or reimbursed by your insurance. Typically, it is easier to get your insurance to cover a doula who is certified, so if you cannot pay out of pocket, be sure to ask any doula you interview about their certification prior to hiring them.
“As a doula my continuity of care does not stop at birth, it goes well into the first weeks a client is postpartum,” says Selena. “This is particularly important for me because once a baby is born, we often forget about the person who has just birthed this human! Doing things such as laundry, mental health check-ins, tidying up the home, and making a warm and nourishing meal are just some of the things that I do to ensure my families are healing properly.”