For much of my life I felt there was a Big Mystery about race, something I didn’t understand. It seemed out of my grasp. So I went forward in my life, “helping to change the world one birth at a time” [1] like many other “First Wave” [2] birth doulas. I finished my second master’s degree and got a doctorate. I taught classes in Human Sexuality to mixed race groups and got a few hours of race training from my community college. In 2015, Dane County, Wisconsin (my home), focused on the perinatal findings in their first Race To Equity report. It showed that we had the largest disparity between birth outcomes for Black and White women in the United States. Whoa! Black women here were doing worse than in Alabama or Mississippi, who traditionally had worse health outcomes for women. White women in our county had better birth outcomes than in many other places in the country – which made the difference between the two so startling. While its true that Black women face more perinatal health care challenges that was not enough to explain the difference.

My first reaction was shame. This had happened on my watch – I’d been a doula here for 30 years, trained hundreds of doulas, started organizations, went to volunteer births, did workshops for nurses, and I was still fairly clueless. I’d had an influence on creating those positive outcomes- but only for White women! I went through an emotional journey about it all, then got over myself. I began to ask the question, “Who did I need to become to contribute to the solution?”

But let’s back up a minute. Why did I even care about these inequities? Why did I consider it was my responsibility to change my life?

First, when I began as a birth doula trainer in 1997 I made a commitment to my state “to contribute to the highest quality birth doulas possible who know how to communicate effectively with medical people”. The fact that we had an entire community without effective birth doula care advocating and supporting them meant I had slipped. I knew that birth doula support could remedy many of these disparities over time. THAT was something I could do something about. But it meant that I would need to become a doula trainer that Black people would want to learn from.

Second, racism, which is at the heart of racial inequities, is based on the belief that some people are inherently more valuable than others. Not through their actions but simply because of the circumstances of their birth. If like me, you don’t agree, the next step is to realize that America has legal, immigration, medical, and economic systems that are set up to treat people unequally. If you want to fix those inequities, that’s called social justice and sometimes reproductive justice.

In my personal ethics, either “Everyone matters or no one matters” [3] . I’ve been marginalized, which makes me especially sensitive to the concept that all human life has inherent value simply because it exists. Once we say that it is acceptable for white people and their babies’ health to be better than black babies’, our future is over as a culture. That only leads to violence and violation and the perpetuation of trauma. We’re already living that out today. For the last several hundred years, we’ve valued White people more than others in the U.S. That’s very clear by our federal, state, and local laws and how they are enforced. It also shows up in how people are treated in medical care today. So part of my call to activism is to change how the results of these policies have shown up in pregnant people’s bodies.

Continued...