Updated: Mar 2, 2020
“We work with families that have been pretty much marginalized in the healthcare world. We work with Black families and we believe in culturally congruent care, that’s what the organization is really known for.”
Healthy Moms, Healthy Babies
When a Black woman walks into the hospital to give birth, she’s automatically treated differently. How she’s talked to by the staff, the services (or lack thereof) she’s offered, and her wishes for her birth are all rights she has to fight for on top of giving birth. This disparity in maternal healthcare within the United States is something Clara Sharp noticed from an early age. She repeatedly saw her friends and family go through traumatic birth experiences without the support system present to let them know they deserve better treatment. With a background in teaching and the years of experience she had helping women give birth, she decided to use her knowledge to start Ahavah BirthWorks 6 years ago to train the next generation of Black doulas to provide culturally congruent care.
“Part of the trainings that we do is saying these are some of things to look for, these are some things you need to ask your doctors about. This is what you can expect when you go to the clinics, this is what you need to have together before you go. We really empower people with knowledge so they can fight for themselves.”
Ahavah’s doulas support women every step of the way, from pregnancy to birth to post-partum. They make sure their clients are aware of how they should be treated in a hospital and which services they should be offered at each visit. Exams as simple as measuring your belly are not provided to Black mothers at nearly the same rates as white mothers. However, when the other women around you also received subpar treatment during their pregnancy, you often have no way of knowing the treatment you’re receiving isn’t ok. This is why having an advocate who has a shared cultural experience to you is necessary to address the complex legacy of historical trauma surrounding birth in the Black community.
A Warrior for Black Woman
There’s a common misconception that being a doula is a cushy, well-paying job and is like being a wedding planner for childbirth. When working with Black mothers however, a doula isn’t just there to help you plan the perfect birth. Doulas must navigate the complex systems of institutionalized oppression that have created trauma surrounding what should be a happy occasion; having a baby. Ahavah knows finding the right person for the job is critical, so they spend a lot of time investing in prospective doulas. However, even when they find the right person there are many barriers in the way. It’s a job that doesn’t pay very well but has demanding hours, meaning to make a living doulas often must find a flexible second job. In spite of the low pay doula training can be very expensive.
“It’s not enough to just have white people come in and do home visits; you need Black people to work for your organizations. That culturally congruent care is so important and that’s what the community says they want. We want to fix our own problems; we just need the funding and we need the training.”
Ahavah trains doulas, but it’s not a certified training. While in Minnesota you don’t have to be certified to be a doula, you do need to be certified in order to get reimbursed through Medical Assistance (MA). Even if you get certified, the reimbursement system makes it a financially unstable career path. The reason for this is two-fold. First, reimbursement means they only receive payment after a baby is born. Since they work with mothers before they give birth as well, this means they have to wait 9-months before getting paid.
Second, the actual amount they’re reimbursed for per birth is very small when you take into account all the work they do leading up to the birth. Last year a State bill they supported increased the amount doulas are reimbursed from $400.11 to $771 per birth. While this may seem like a big increase, it doesn’t change the fact that they’re doing unpaid work for 9-months. Ahavah helps to mitigate some of the financial burden by matching prospective doulas with scholarships, having a network of doctors and nurses they can bill under for insurance purposes, and by having a fiscal agent that allows them to pay doulas ahead of time. As an organization they make money by leading trainings about culturally congruent care and how to recruit doulas from the Black community for Hennepin County and the Hennepin County Healthcare System. However, the most impactful work is done by community organizations like Ahavah, which is why investing directly in them is the best way to decrease disparate birth outcomes.
The trust Ahavah’s doulas establish with their clients decreases their stress during pregnancy, which is correlated to healthy birth outcomes. In addition to working with the mothers, they also have a staff person, Rick, who works with the fathers to help them support and decrease the stress of their partners during pregnancy. With so many reasons to invest in Black doulas, Ahavah wrote a bill to increase funding. The bill will be brought forward this upcoming legislative session. It has lots of bi-partisan support, so they’re hopeful for the outcome. Allocating this funding to Black doulas would also save the State money, since healthier babies means less babies in NICU’s. However, the much more important reason to support this bill is the generational impact having more healthy babies and moms has on the Black community.
Written by Anna Schmiel (NEON Community Engagement Coordinator)
Photo Credit: Tina Thomas (NEON Business Coordinator + Spaces)