Nearly 18 years ago, Elysia Douglas’ friend was headed to Crawford Long Hospital (now Emory Midtown) for the birth of her son and asked if she would come along. The friend’s boyfriend wouldn’t be able to show up for the first part of the birth, and she initially just wanted Douglas to sit next to and be there for her. 

As the birth went on and her friend started feeling the pains, Douglas felt that she needed to do something. 

“Once her induction got started and she became more uncomfortable, there was nothing in me that could keep me sitting in that chair, just watching her be uncomfortable,” Douglas recalled. 

She made sure her friend had ice chips to chew, rubbed her back, and coached her breathing. Eventually, the child’s father made it to the hospital, but Douglas was asked to stay until the baby was born. 

The Baton Rouge, Louisiana, native and current Cumming resident said it was “the most miraculous thing I had ever witnessed in my life.” 

“It sounds corny, but it was literally the eureka moment that said, ‘I don’t know what this is, but this is where I’m supposed to be,’” Douglas recalled. 

Douglas now heads Atlanta Family Doulas, a service that offers prenatal and postpartum support in and outside the perimeter. She’s been at it for more than a decade.

Doula services for new mothers are on the rise as Black birthing people seek to take maternal health into their own hands. According to the U.S. Health and Human Services Department, certain aspects of doula care, like affirmation and advocacy, can be beneficial for populations that experience disparities in maternal care, such as Black women. 

Local doulas who spoke with Capital B Atlanta during Black Maternal Health Week, said that while grateful to be on the job, they want people to know that they can’t save Black women from every negative health outcome. 

Maternal death rates for Black women doubled in the United States during the coronavirus pandemic. Georgia is among the worst states for Black women to give birth. One Capital B analysis shows that majority Black counties in the state are more likely to be maternity care deserts, and the state has lost maternity wards left and right since 1994

Everybody knows how babies get in. We know how they get out. But that middle is when stuff goes down.

Naima Bond, founder of Oya Birth and Wellness

Doula care is just one way for Black women to advocate for themselves in the birthing process, and doulas specialize in educating expecting families on how.

“Everybody knows how babies get in. We know how they get out,” said Naima Bond, the founder of Oya Birth and Wellness. “But that middle is when stuff goes down. [That’s] when your water breaks or your mucus plug comes out. Things are going on with the baby’s heartbeat.” 

Bond says the more expecting families understand about the birthing process, the less she finds herself having to do so much advocacy. That is because her clients often will advocate on their own behalf with tools she provides. 

“Everybody needs childbirth education,” Bond said. “If you can’t get a doula, you have to get childbirth education. You just at least need to understand what’s going on with your body because there’s a lot of birth trauma. Some things could be avoided with just knowing what is supposed to happen.” 

Tanecia Lowery, the founder of Goddess Birth Sisters doula collective, emphasizes a need to seek alternatives to western medicine and treat birth as a spiritual experience. 

“A lot of these spaces really try to push synthetic supplements, synthetic medicine,” Lowery, who often goes by “Holly Hallelujah,” said in an interview. “We like to encourage moms to try a natural source first, like a holistic remedy, so we’re not putting so many synthetic things in our body.” 

Doulas who spoke with Capital B Atlanta also said that doctors and nurses ignoring the wishes and concerns of pregnant Black people often contributes to our higher death rates. Also, delayed prenatal care, lack of Medicaid access, and medical racism can contribute to negative health outcomes as well.

Though their service is becoming more visible, technically doulas are not medical professionals, so they often are disregarded in some hospitals. 

“I feel like people think if they get a doula, it’s kind of like a savior who’s going to save us from this death rate,” Lowery said. “But when we get in those spaces, we are made to comply as well, or we’ll get kicked out or reprimanded.”

Bond shared Lowery’s frustrations over the challenges doulas face. She said that  though they are a voice for expecting families, patients should also seek out more information to educate themselves on the process.

“You’ve got to vet your people. You’ve got to do your research,” Bond said. “Don’t make me have to be Jesus, too. That’s going to be a lot for everybody!” 

Douglas, the Atlanta Family Doulas founder, also emphasized that despite not being able to ensure a birth goes perfectly, Black doulas are still instrumental in maternal health. 

“There’s a message out there that doulas are gonna save you from bad experiences, but I think there’s some misinformation that if you have a doula, nothing bad will happen,” she said. “But the importance of having Black doulas with Black families is basically having somebody that looks like you, knowing that person is 100% for you and on your side — it’s an assurance like no other.” 

Kenya Hunter is Capital B Atlanta's health reporter. Twitter @KenyaTheHunter