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Doulas & Black Moms: Bridging the Gap Between Mental Treatment and Maternal Care

There is a growing body of evidence that disparities in medical treatment in the United States — compounded over centuries by the legacy of slavery, Jim Crow segregation and prevalence of anti-Black biases — have adversely affected the health of Black women in numerous ways, including the birthing process.

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Chelsea Rae Crowder-Luke speaks with her doula in her home in Los Angeles, and she was 34 weeks at the time of the interview. Photo courtesy California Black Media.
Chelsea Rae Crowder-Luke speaks with her doula in her home in Los Angeles, and she was 34 weeks at the time of the interview. Photo courtesy California Black Media.

By Aldon Thomas Stiles
California Black Media

There is a growing body of evidence that disparities in medical treatment in the United States — compounded over centuries by the legacy of slavery, Jim Crow segregation and prevalence of anti-Black biases — have adversely affected the health of Black women in numerous ways, including the birthing process.

In June, the tragic and high-profile death of Olympic Gold Medalist and sprinter Tori Bowie during childbirth brought more national attention to the crisis of Black maternal mortality in the United States.

Aware of the discrepancies in treatment as compared to women of other races and terrified by the potential mental health ramifications of those disparities — which can lead to greater fear and anxiety about pregnancy and childbirth — some Black women are seeking alternatives to hospital births.

Black women die at nearly twice the rate of white women during labor, according to data from the National Institutes of Health (NIH).

In July, the U.S. Department of Health and Human Services (HHS) announced that the federal government has launched a civil rights investigation into the treatment of Black expectant mothers at Cedars Sinai Medical Center in Los Angeles.

“Maternal health is a priority for the Biden-Harris Administration and one in which the HHS Office for Civil Rights is working on around the country to ensure equity and equality,” read an emailed statement from HHS to several news outlets.

The federal investigation comes seven years after the 2016 death of a Black woman, Kira Dixon Johnson, who died from internal bleeding following a cesarean section at Cedars Sinai.

Dr. Melissa Frank, director of the Division of Maternal, Child, and Adolescent Health with the Los Angeles County Department of Public Health, stated that she has “lived the disparity” associated with maternal healthcare.

During the delivery of her second daughter, Franklin says she could tell something was wrong and expressed that to hospital staff, “I feel like I’m dying,” but her concerns were largely dismissed.

When the hospital staff finally checked on her, they discovered that her blood pressure was dangerously low to which she responded, “I told y’all!”

According to data from the Centers for Disease Control and Prevention (CDC), in 2021, Black women in the U. S. were more than twice as likely as white women to die due to complications related to maternity and the birthing process.

In California, the risk of death due to pregnancy complications is four to six times higher for Black mothers than any other ethnic group, according to data from the California Health Care Foundation.

Research has indicated that maternal mental health conditions, including prenatal and postpartum anxiety and depression, are the most common complications of pregnancy and childbirth.

According to the American Hospital Association Institute for Diversity and Health Equity, 12.5% of birthing people will suffer from postpartum depression. However, Black women are about 1.6 times more likely to deal with its effects than white women.

Hiring a doula is one solution Black women are using to help address some of the mental health issues associated with the birthing process. A 2013 study by the National Center for Biotechnology Information found that mothers who received support from a doula during childbirth were two times less likely to experience complications.

A doula is a trained professional who provides emotional and physical support to pregnant individuals during pregnancy, childbirth and the postpartum period.

Doulas are not medical professionals and do not deliver babies or provide medical care. Instead, they offer support in the form of physical comfort, emotional well-being, information, and advocacy.

According to another study by the National Center for Biotechnology Information, doula-assisted mothers were 57.5% less likely to suffer from postpartum depression or anxiety. This confirms that having the support of a doula during the birthing process can have a significant positive impact on the mental health of mothers.

The long history of discriminatory care towards Black women in the healthcare system has resulted in another mental health issue: generational trauma.

“When we speak about Black maternal health, we cannot ignore the fact that the foundation of medicine in this country and many of its early principles were deeply rooted in racism,” said Assemblymember Akilah Weber (D-La Mesa), a board-certified obstetrician/gynecologist, and founder and past director of the Pediatric & Adolescent Gynecology Division at Rady Children’s Hospital-San Diego.

“Some of the earliest examples of experimental research relied on these racist concepts. The pain of Black individuals was not only ignored but assumed to not be experienced to the same degree as white individuals.”

Franklin emphasized the importance of culturally competent care for the mental health of Black mothers.

“The support of doulas as alternative birthing spaces gives Black women the opportunity, the choice of giving birth in a way that’s culturally affirming,” said Franklin. This highlights the significance of providing care that is sensitive to the cultural needs and experiences of Black women during the birthing process.

Franklin also pointed out that doulas alone cannot bear the burden of an unfair healthcare system. She emphasized the importance of hospitals employing well trained providers who operate in anti-bias and anti-racism spaces. This can help Black women give birth with “the support of a village.”

California has been taking steps to address healthcare disparities and improve outcomes for Black mothers and birthing individuals. The state introduced various policies and initiatives aimed at making culturally competent care a reality.

For example, the Department of Health Care Services (DHCS) has taken steps to improve access to doula services for expectant mothers. One such initiative is the inclusion of doula services as a preventative care option covered under Medi-Cal. This can help make doula support more accessible and affordable for those who need it.

Los Angeles County Supervisor Holly J. Mitchell has emphasized the importance of doula care in improving pregnancy experiences and birthing outcomes.

In a press release, she stated that “Doula care is shown to improve pregnancy experiences and birthing outcomes. We must increase awareness of doula services for mothers and families across the County and expand our workforce to be more representative of our communities most in need.” This highlights the need for greater awareness and accessibility of doula services, particularly for those in underserved communities.

In the meantime, Dr. Franklin’s advice is to listen to Black women when they express concerns about their health. This means taking their concerns seriously and providing them with the care and support they need.

Activism

Oakland Post: Week of May 21 – 27, 2025

The printed Weekly Edition of the Oakland Post: Week of May 21 – 27, 2025

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OPINION: Your Voice and Vote Impact the Quality of Your Health Care

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare. 

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Rhonda M. Smith.
Rhonda M. Smith.

By Rhonda M. Smith, Special to California Black Media Partners

Shortly after last year’s election, I hopped into a Lyft and struck up a conversation with the driver. As we talked, the topic inevitably turned to politics. He confidently told me that he didn’t vote — not because he supported Donald Trump, but because he didn’t like Kamala Harris’ résumé. When I asked what exactly he didn’t like, he couldn’t specifically articulate his dislike or point to anything specific. In his words, he “just didn’t like her résumé.”

That moment really hit hard for me. As a Black woman, I’ve lived through enough election cycles to recognize how often uncertainty, misinformation, or political apathy keep people from voting, especially Black voters whose voices are historically left out of the conversation and whose health, economic security, and opportunities are directly impacted by the individual elected to office, and the legislative branches and political parties that push forth their agenda.

That conversation with the Lyft driver reflects a troubling surge in fear-driven politics across our country. We’ve seen White House executive orders gut federal programs meant to help our most vulnerable populations and policies that systematically exclude or harm Black and underserved communities.

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare.

Medicaid, called Medi-Cal in California, doesn’t just cover care. It protects individuals and families from medical debt, keeps rural hospitals open, creates jobs, and helps our communities thrive. Simply put; Medicaid is a lifeline for 1 in 5 Black Americans. For many, it’s the only thing standing between them and a medical emergency they can’t afford, especially with the skyrocketing costs of health care. The proposed cuts mean up to 7.2 million Black Americans could lose their healthcare coverage, making it harder for them to receive timely, life-saving care. Cuts to Medicaid would also result in fewer prenatal visits, delayed cancer screenings, unfilled prescriptions, and closures of community clinics. When healthcare is inaccessible or unaffordable, it doesn’t just harm individuals, it weakens entire communities and widens inequities.

The reality is Black Americans already face disproportionately higher rates of poorer health outcomes. Our life expectancy is nearly five years shorter in comparison to White Americans. Black pregnant people are 3.6 times more likely to die during pregnancy or postpartum than their white counterparts.

These policies don’t happen in a vacuum. They are determined by who holds power and who shows up to vote. Showing up amplifies our voices. Taking action and exercising our right to vote is how we express our power.

I urge you to start today. Call your representatives, on both sides of the aisle, and demand they protect Medicaid (Medi-Cal), the Affordable Care Act (Covered CA), and access to food assistance programs, maternal health resources, mental health services, and protect our basic freedoms and human rights. Stay informed, talk to your neighbors and register to vote.

About the Author

Rhonda M. Smith is the Executive Director of the California Black Health Network, a statewide nonprofit dedicated to advancing health equity for all Black Californians.

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OPINION: Supreme Court Case Highlights Clash Between Parental Rights and Progressive Indoctrination

At the center of this controversy are some parents from Montgomery County in Maryland, who assert a fundamental principle: the right to shield their children from exposure to sexual content that is inappropriate for their age, while also steering their moral and ethical upbringing in alignment with their faith. The local school board decided to introduce a curriculum that includes LGBTQ+ themes — often embracing controversial discussions of human sexuality and gender identity.

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Craig J. DeLuz. Courtesy of Craig J. DeLuz.
Craig J. DeLuz. Courtesy of Craig J. DeLuz.

By Craig J. DeLuz, Special to California Black Media Partners

In America’s schools, the tension between parental rights and learning curricula has created a contentious battlefield.

In this debate, it is essential to recognize that parents are, first and foremost, their children’s primary educators. When they send their children to school — public or private — they do not surrender their rights or responsibilities. Yet, the education establishment has been increasingly encroaching on this vital paradigm.

A case recently argued before the Supreme Court regarding Maryland parents’ rights to opt out of lessons that infringe upon their religious beliefs epitomizes this growing conflict. This case, Mahmoud v. Taylor, is not simply about retreating from progressive educational mandates. It is fundamentally a defense of First Amendment rights, a defense of parents’ rights to be parents.

At the center of this controversy are some parents from Montgomery County in Maryland, who assert a fundamental principle: the right to shield their children from exposure to sexual content that is inappropriate for their age, while also steering their moral and ethical upbringing in alignment with their faith. The local school board decided to introduce a curriculum that includes LGBTQ+ themes, often embracing controversial discussions of human sexuality and gender identity. The parents argue that the subject matter is age-inappropriate, and the school board does not give parents the option to withdraw their children when those lessons are taught.

This case raises profound questions about the role of public education in a democratic society. In their fervent quest for inclusivity, some educators seem to have overlooked an essential truth: that the promotion of inclusivity should never infringe upon parental rights and the deeply held convictions that guide families of different faith backgrounds.

This matter goes well beyond mere exposure. It veers into indoctrination when children are repeatedly confronted with concepts that clash with their family values. 

“I don’t think anybody can read that and say: well, this is just telling children that there are occasions when men marry other men,” noted Justice Samuel Alito. “It has a clear moral message, and it may be a good message. It’s just a message that a lot of religious people disagree with.”

Justice Amy Coney Barrett raised a crucial point, noting that it is one thing to merely expose students to diverse ideas; it is quite another to present certain viewpoints as indisputable truths. By framing an ideology with the certainty of “this is the right view of the world,” educators risk indoctrination rather than enlightenment. This distinction is not merely academic; it speaks to the very essence of cultivating a truly informed citizenry.

Even Justice Elena Kagan expressed concern regarding the exposure of young children to certain materials in Montgomery County.

“I, too, was struck by these young kids’ picture books and, on matters concerning sexuality, I suspect there are a lot of non-religious parents who weren’t all that thrilled about this,” she said.

Justice John Roberts aptly questioned the practicality of expecting young children to compartmentalize their beliefs in the classroom.

“It is unreasonable to expect five-year-olds, still forming their worldviews, to reconcile lessons that conflict fundamentally with the teachings they receive at home,” he said.

As was noted in my previous commentary, “The Hidden Truth In The Battle Over Books In American Schools”, what lies at the heart of these debates is a moral disconnect between the values held by the majority of Americans and those promoted by the educational establishment. While the majority rightly argue that material containing controversial content of a sexual nature should have no place in our children’s classrooms, the education establishment continues to tout the necessity of exposing children to such content under the guise of inclusivity. This disregards the legitimate values held by the wider community.

Highlighted in this case that is before the Supreme Court is a crucial truth: parents must resolutely maintain their right to direct their children’s education, according to their values. This struggle is not simply a skirmish; it reflects a broader movement aimed at reshaping education by privileging a state-sanctioned narrative while marginalizing dissenting voices.

It is imperative that we assert, without hesitation, that parents are — and must remain — the primary educators of their children.

When parents enroll a child in a school, it should in no way be interpreted as a relinquishment of parental authority or the moral guidance essential to their upbringing. We must stand firm in defending parental rights against the encroaching ideologies of the education establishment.

About the Author

Craig J. DeLuz has almost 30 years of experience in public policy and advocacy. He has served as a member of The Robla School District Board of Trustees for over 20 years. He also currently hosts a daily news and commentary show called “The RUNDOWN.” You can follow him on X at @CraigDeLuz.

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