There's something special in the moments before a woman introduces new life into the world. Eboné Bradley, a mother of four, says helping expectant parents is more than a job. It's her mission. I was just like other women, especially black women, they have no idea of their birth options. And so I felt like that was something I had to do.
I felt called to do it. A licensed doula. Based in Dallas for over a decade, Eponay has supported hundreds of birthing mothers.
When women do reach out to you, what are some of their top reasons for seeking out a doula? When women reach out to me, especially black women, the number, number, number one thing is like without fail, fear. They're afraid.
She says she's seen firsthand how pregnant moms feel disempowered in the decision-making around their own health care. And says she's seen doctors worry about statistical risks and sometimes dismiss women's concerns rather than listening to them. Doctors in general, most of them kind of tend to look at birth as something they want to manage. Birth is not by the book.
The United States has the highest maternal mortality rate among wealthy nations, and it's only getting worse, especially for black moms. who are three times more likely to die from a pregnancy-related cause than their white and Hispanic counterparts. Dr. Joya Crear-Perry is a leading specialist on maternal mortality among Black mothers.
We know the consequences of racism, sexism, gender oppression are causing us to die within childbirth. We have never invested in people who are the most marginalized. Our health care system was created to ensure that people who have resources are able to get things.
A retired OB-GYN... she says more support for birthing moms is needed. So when someone first comes to you and they are just starting to learn about their options and they're like, what is a doula?
How do you explain it? I always like to describe it as like a birth planner for your birth. We sit with you and we really help you to see what the vision is for your birth, help you find your power through education, through giving you emotional support.
and then helping you with resources, connecting you. A 2013 study found that, quote, socially disadvantaged mothers who use doulas were two times less likely to experience a birth complication. Eboné often partners with licensed midwives like Kenesha Jones and Therese Fruget, who are medically trained to deliver babies. Midwifery care is not just about caring for her body. We're caring for the whole woman.
So we want to know what your mental state is. We want to know what your emotions are like. In our practice, they actually have lots of choices.
We do their birth either here at the birth center or in their home. Some women come into our care and they're like, well, I really want a birth in the hospital, but I want midwifery care. And so we collaborate with an in-hospital provider and they get to have their hospital birth. A 2018 study found that U.S. states with more robust midwifery services reported better maternal care and better birthing outcomes, suggesting that states that have better resources dedicated to health care have better results.
Ebony, Teree and Kenesha are providing collaborative care for a new birth in this quiet neighborhood in Arlington, Texas. So are you starting to feel some signs? Notice any different signs in your body? A few days ago, you know, I had back contractions.
The bottom leg is going to go straight. Justina Arrington is a mother of two. Her third baby is due any moment.
So take me back to your first birth. Your son, he's eight years old, right? He just turned nine this year.
Yes, ma'am. It was just, it was real tiresome and it was like very traumatic, especially when I found out my doctor that I had been working with the entire time. He was not going to be there.
Justina's prenatal record. It was for babies. Show her baby started showing signs of fetal distress.
And she says the doctor told her for her safety and her babies that she would need an emergency C-section. When they first told you that you needed a C-section. What went through your mind?
Oh, I immediately started crying. Justina says though she was terrified of the surgery, she opted to undergo another C-section for her second pregnancy after her doctor warned she could be in labor for days. Once she told me like, hey, it's probably going to be like another 48 to 72 hours before this baby actually comes, it was like, okay, well, I don't want to do that.
Let's just do the C-section. The CDC reported that in 2020, about one out of every three deliveries in the U.S. were C-sections. Justina says the recovery from her two C-sections was painful. When she found out she was pregnant the third time, she and her husband were determined to have a vaginal birth at home, though that came with even greater risks for her baby. According to the American College of Obstetricians and Gynecologists, planned home births were not possible.
home birth is associated with more than two times increased risk of perinatal death and three times increased risk of seizures or serious neurological dysfunction in newborns. Only one percent of women in the U.S. opt to give birth at home. But advocates like the Midwives Alliance of North America say these statistics are too generalized and do not take into account the option for midwifery or a doula in the home or the outcomes for low-risk pregnancies.
Why did you, even with the risk of a home birth, why did you decide to give birth at home versus, say, a birthing center? It was a little bit cheaper to be at home. I knew that like my mom was coming from out of town and it was going to be other people here. You were just surrounded by love. Yes, for sure.
Medical organizations recommend a hospital setting for VBACs, vaginal births after C-sections, instead of at home, to allow for quick access to emergency medical care if it's needed. She came into our care because we knew we'd give her a chance. We knew it. We let her labor and at least try to have her baby at home.
We want her to know that she is at higher risk than most mothers would be. First thing we do is we have to get the previous records from her C-sections. We have to make sure that the surgery was done in a manner that is safe for her to try an out-of-hospital birth.
And once we do that, then we go about preparing her prenatal. Justina's birth team has worked with many women who desire VBACs. Success rates nationally range from about 60 to 80 percent.
But having a birth team can be costly. Licensed midwifery services can sometimes be covered through insurance plans, but that, along with the cost of hiring a doula, can be a big barrier for families. Only six states currently provide Medicaid reimbursement for doula services. Several more states have recently passed legislation or are considering adding doula coverage to Medicaid programs.
We're all deserving of justice and joy, so if we invested in health as a right, We would have nobody in this country who doesn't have access to whatever kind of birth that they want. Ebony says her doula practice has been compelled to offer alternative payment methods like scholarships to step in to fill the gap. So these are just regular index cards. To prepare the space for delivery, Justina and Ebony set up an affirmations board adorned with ultrasounds and words of encouragement. One thing that's always stood out to me was like you were created for this.
Like your body was created to do this. That's right there. Good morning.
So Justina just let me know her mucus blood came out the rest of the way last night with a lot more bleeding. So my contractions are about... two to four minutes apart for the last 25 minutes. She's feeling a lot of pressure in her pelvis.
So it's time for us to go. Ah! Justina, listen to my voice. Slow your breathing.
You got this, okay? Your baby's right here. I can see him.
If you want, you can reach down and touch. Here she comes, yay! After six and a half hours in labor, Justina successfully...
gave birth to her healthy baby girl, Taylynn. Look how big she is! Just to be able to find a team that was willing to take me on, that was willing to give me all the information. that I needed. It's a big relief, and it's just a big feel of like, like, wow, I did it.
What's Taylan like? Oh, my goodness. She's amazing. She is precious. Just knowing that I was able to have her naturally, it just feels different.
We're here on the ground doing the work, helping. What we see is healthy birth outcomes. We see healthy mamas, healthy babies, and all because they had doula support, and they were able to do it.