BHM Profile | Local doula highlights racial inequities in maternal care

Nikiya Ellis, a birth doula, poses for a portrait in front of the Stockton Community Garden in the Manchester district in Richmond, where she helps provide healthy food for new mothers. Photo by Enza Marcy

Ebonique Little, Spectrum Editor

For some, their first brush with racism occurs before they are born.

After talking with new moms about their birthing experiences, Nikiya Ellis learned that Black women face greater disparities in maternal care than white women due to racial biases, ultimately impacting the well-being of both mother and baby.

In 2017, Ellis became trained as a birth doula — or a companion who provides emotional support to a woman during pregnancy and childbirth — to provide better outcomes for pregnant women of color.

“We’re not being heard,” Ellis said. “We’re not being valued.” 

Ellis founded her company, The Diverse Doula, a year later. It seeks to “honor the birthing person’s cultural beliefs, preferences, rituals and practices during pregnancy and childbirth,” according to its website.

By celebrating the diversity of her clients, Ellis said she is able to provide a more comfortable and equitable experience than normal health care providers create for Black women and other women of color.

“In a hospital situation, where the anxiety is high and the birthing person’s body is saying, ‘This is not a safe place,’ the baby isn’t going to come out, which causes labor to be longer, which causes an emergency C-section,” Ellis said.

A cesarean section, or C-section, is a surgical procedure where an incision is made in the mother’s abdomen in situations where vaginal delivery would pose significant risk to the mother or baby. With this operation, women have a higher chance of infection, blood loss and death, according to the American Pregnancy Association

Ellis said it is important for Black women to have a midwife or doula who looks like them on their journey to motherhood, as it can alleviate stress.

“It’s going to be easier to talk to her. It’s going to be easier for her to understand the stresses that we have and the environment around us because of racism,” Ellis said. “Representation matters.”

Toccara Wilson, a former client of Ellis, echoed those sentiments and said sharing a similar background with Ellis was important.

“I really did want another person of color that also experiences life the way I’ve experienced life and seen a lot of things that I’ve seen,” Wilson said.

Wilson said she would’ve had an anxious birthing experience if not for Ellis.

“Me being a minority Black woman — it’s just the statistics and the rates and the deaths and the different stories I was hearing was horrifying,” Wilson said. 

Black women are three to four times more likely to die from pregnancy or childbirth than their white counterparts, according to the National Partnership for Women & Families. This demographic is more likely to experience a host of other complications during pregnancy, such as high blood pressure and fibroids, which are benign uterine tumors that cause heavy bleeding postdelivery. 

“As a Black woman, I’m looked at as a ‘strong Black woman,’ and that’s not true. Like, my pain is justifiable, and I want you to listen to me, not overtalk me.” — Kenda Sutton-EL, co-founder of Birth in Color RVA

Discrimination in the health care industry affects the quality of medical care and slows the practitioner’s responsiveness to the patient’s needs, the partnership stated.

“With all the microaggressions and things in the world, it really helps to have someone who understands and doesn’t question whatever it is that you’re showing emotion or just facts of things happening,” Wilson said.

Ellis said being able to provide this sort of compassion during life-altering moments is why she continues her work in the field.

“I want to support the moms,” Ellis said. “And that’s what took me on the line to being a doula is just because I’ve always had really good relationships with other women, supporting them through tough times.”

Ellis said there is no official entity in charge of doula training. Most programs consist of some form of childbirth education, though the learning process can range from a few days to a few weeks. 

Despite this variance, Ellis said she has a natural ability to connect with her clients.

“I’m in tune with the mother,” Ellis said. “I really feel like I have a gift of intuition. I kind of know what they need before they need it.”

Ellis builds a relationship with her clients over the course of their pregnancies through countless phone calls and meetings. During the client’s labor, dancing, holding hands or being quiet fosters a strong connection, she said.

After the birth, Ellis said she participates in the mother and family’s cultural traditions, such as the burial of the placenta. In Jamaica, this practice involves burying the mother’s placenta and umbilical cord. Family and friends then plant a tree sapling at the burial spot.

Ellis’ support for Black women continues through educational summits, panel discussions and Birth in Color RVA, a collective of doulas she co-founded with Kenda Sutton-EL in 2019. At the end of the year, the group will be composed of about 100 doulas of color and include a chapter in Lynchburg.

By expanding their group and training new doulas, Sutton-EL said they hope pregnant women will feel empowered to communicate their needs.

“As a Black woman, I’m looked at as a ‘strong Black woman,’” Sutton-EL said. “And that’s not true. Like, my pain is justifiable, and I want you to listen to me, not overtalk me.”

Ellis and Sutton-EL also lead efforts to provide mothers with healthy food options and breastfeeding educational resources. 

“Breastfeeding in the Black community is sometimes unheard of, or looked down upon,” Sutton-EL said. “If you look at the data, Black women don’t breastfeed as much simply because ancestrally and culturally, Black women were forced to breastfeed their slave master’s children.”

Sutton-EL said Birth in Color RVA has provided racial bias training to over 20 health care organizations. Through this initiative, they work to debunk stereotypes and medical malpractices to ensure Black women feel safe when they seek medical help. 

“We go throughout Virginia making sure that Black women are educated on their rights, that providers are educated on their biases and trying to overcome them,” Sutton-EL said.

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