by Crystal Azul
I grew up hearing stories about births and deaths from my mom, who was raised in a poor, evangelical home in Mexico. My mom would tell me the story of her nephew Esteban’s birth. It happened during the middle of a hurricane, the water had risen a foot into the tiny house, and my mom’s cousin was in active labor. Baby Esteban, nearly having a water birth, came out of his squatting mother like a slippery fish, caught by my mom’s capable hands.
When my friends started having babies, I became actively interested in birth justice work, especially after hearing their stories of unnecessary interventions, lack of communication from hospital staff about procedures, and the feelings of being too overwhelmed to make an informed decision during labor. As a feminist, womanist, and queer POC, I understood all too well the importance of advocacy during times of medical vulnerability. In 2011, I finally trained as a doula in Arcata (Humboldt County) and had my first client – a 17 year old woman who found me on a volunteer doula list through the Family Practice Nurses who worked with mothers on WIC. After this first experience of working for my client and representing her wishes, I knew that would never want to work for a hospital or similar institution and began searching for ways to be a doula in community.
Last August, I attended SQUATfest, a conference for people working in birth/reproductive justice and held at the Women’s Building in SF. As can be expected, the conference was predominantly white and cis, though some effort had been made to offer scholarships for low-income/POC birth workers. For many (qt)poc folks, accessibility with regards to affordability is one of the biggest obstacles to becoming a doula or hiring a doula. (There is a movement to include doula services through Medi-Cal, and there are volunteer doula programs in select hospitals that provide doulas for those who qualify as low-income.) During SQUATfest, I spent time in the Doulas & Midwives of color circle. There were many conversations about working in mostly white and privileged spaces, bringing services and support to communities of color, and burn-out being a major issue for (qt) POC birth workers. Some of the newer birthworkers discussed finding it challenging to “connect with birthworkers of color for mentorship because they are too done, tired and are moving on, have too much risk/responsibility already on their plate, or are homophobic/transphobic.” I had the privilege of hearing the wisdom of such birth justice workers as Midwives Makeda Kamara, Claudia Booker, and our local Certified Professional Midwife Laura Perez from Sacred Birth Place in Oakland.
In general, hospitals are not our advocates or allies. It is absolutely necessary that we invest in QTPOC Doulas receiving the support, training, space, and resources needed to work with and for (qt)POC communities.
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According to the Centers for Disease Control, nationwide, African American women are nearly four times more likely than non-Hispanic Whites to die due to pregnancy-related causes. Black women are dying because of racial disparities, babies are being born too early or with low-birth weights, and the studies show that this is happening regardless of education or social status. I continue to hear stories of Latinas not having procedures explained to them, so that decisions about care are made without being adequately informed. Dealing with nurses and doctors can be a very stressful experience for (qt)POCs because we often feel unheard, misread, and so we often do not seek medical advice or treatment because we do not see ourselves reflected in those spaces. (qt)POC Doulas can help alleviate some of that stress by acting as advocates – we are trained to navigate the medical world, bring the humanity back into the often sterile and cold environment of hospital, and, in essence, build a safety bubble around a client/friend/family member because we are there to represent you and not an institution.
A full-spectrum doula not only provides continuous comfort measures during birth, but may also support a person going through abortion (though they have only more recently been called doulas, the care-work has been going on for as long as it’s been necessary), adoption, surrogacy, miscarriage, and stillbirth. Within the queer and trans communities, people are beginning to see what doulas do as an incredibly important component of qtpoc activism. Rafael/a Luna-Pizano, whom I connected with at SQUATfest and who is working on a workshop in Seattle specifically for QTPOC interested in birth work, had this to say about their path to doulaing: “Many folks recovering from surgeries/trauma to the body & spirit within trans community can really benefit from pelvic work. I became more and more interested in supporting abdominal, pelvic and cranio-sacral work, which led me to learn more about the organs housed in these areas. The methods of bodywork used to support pregnant folks and folks in labor, overlapped with the techniques I was learning for supporting post-op recovery in the pelvic areas.”
We doulas and birth justice workers continue to ask how we may become more embedded in our communities – how do we let people know that doulas are here to support (qt)poc, how do we illustrate just how necessary our skills are to the overall health of our communities even before people begin considering birth? Laura Perez, CPM, stated that it would be “amazing to have community support to sustain birth center(s)… we do want space/services to be available to the local community at large.” While visiting with my friend and hermana doula Ana from Houston, we talked about how in the Latina communities, doulas and midwives have often been seen as for the lower classes, for those who can’t afford a hospital birth. And now, for white folks, having a doula and a midwife is a status symbol because it indicates that you have access to financial resources or you have really great insurance, which amounts to the same thing. This can be difficult for birth workers of color, who want to serve their communities but must take on clients (most of them white) who can afford to compensate them for their services. Some birth workers report feeling drained by being at the “‘beck and call’ of white women and families that have no idea of their own racism, classism and sometimes heterosexism.”
With much work, education, and outreach, my hope is that doulas will become embedded in our cultures and be seen as the norm, not hampered by this capitalist system, yet financially and spiritually sustainable.
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