Birth and Postpartum Inequities Among Minorities

Did you know that black women die 3 to 4 times more than white people for a pregnancy related cause?  Black women with a college degree or higher increases the mortality rate to 5 times more than white women of similar education. What can we do about all these inequities?

The month of April is National Minority Health Month. Included in this was the 3rd consecutive year of Black Maternal Health week  sponsored by Black Mamas Matters Alliance (BMMA)  The goal being to end worldwide maternal mortality rates and bring awareness and change regarding maternal inequities, birth justice and care for black women and all minorities.

The care of these women needed after the birth is sometimes overlooked. Some of us postpartum doulas don’t see all the inequities that happen while these women give birth.  However, as a postpartum doula we may witness the aftermath of these inequities while working with black, brown, indigenous people or other minorities.

These facts remain……..

Women of color are more likely to experience postpartum mental illness but are less likely to receive treatment.  (Keefe, Brownstein-Evans, & Rouland Polmateer, 2016))

Breastfeeding initiation rates among black infants (74%) are lower when compared with white infants (87%). (Source CDC)

21% of Black mothers and 19% of Hispanic moms experience poor treatment around birth and postpartum compared to only 8% of white mothers to get to the best possible outcome.

Change needs to start somewhere. Doulas can help be a part of making this change in the birth and postpartum world through perspective transformation.

Perpective Transformation  is the process of becoming critically aware of how and why  assumptions have come to constrain the way we perceive, understand and feel about our world; changing these structures of habitual expectation to make possible a more inclusive and integrating perspective; and, finally making choices or otherwise acting upon these new understandings.    Mesirow (1978)

Equity is about fairness and whatever is necessary to provide people with opportunities to achieve their best possible outcomes especially around birth and postpartum. We have a chance to develop our own equity lens when perspective transformation takes place and we take responsibility.

As doulas we have a chance to show up. To understand the historical context and current context of being equitable so we can better serve through our decisions, behavior and actions.

It is time for us as doulas to be a part of this movement and become more than advocates and make an impact.  Here are some things we can do now to foster transformation in our communities and beyond.

  • Know your communities and have resources for them.
  • Help birthing and postpartum women navigate the system.
  • Pair doulas with the right client.  A doula and client of the same culture, color or social communities when possible. This will involve collaboration with other doulas.
  • Connect with other doulas for cross networking, support, praise and encouragement.
  • Continue to read and learn all you can about the issues and take action.
  • Join an advocacy group.  DONA International has several advocacy committees go to for more information.  Also, the Intercultural coalition has a committee.  with good articles and other resources.

Other resources that may be of interest to you on books and articles

Killing the Black Body by Dorothy Roberts

How to Be an Antiracist by Ibram X. Kendi

About Marcia Thuermer

Hi, I am Marcia Thuermer, PCD/PDT(DONA), a certified postpartum doula and DONA-approved postpartum doula trainer, lactation consultant and pediatric sleep coach at I have over 18 years of experience in all areas in maternal and infant care. As a postpartum doula trainer, I am dedicated to helping my students be successful professionally in a full or part time career doing what they love.