West Orange Doula: 5 Stigmas Pregnant Black Women Face

WEST ORANGE, NJ — In New Jersey, there’s a startling disparity in black and white infant deaths that may stand as high as three-to-one, state officials say. But according to Michelle Gabriel-Caldwell, a doula and childbirth educator from West Orange, there’s a way to get that ugly number down.

Educate and empower parents.

Gabriel-Caldwell, who holds a full-time job as a chemical engineer, also serves as doula coordinator for The Birth Center of NJ, as well as an Evidence Based Birth instructor. And the mother of two has heard her fair share of eyebrow-raising stories from black, female clients.

“Too often, black women are seen as broken and will be labeled as such,” Gabriel-Caldwell told Patch.

This stereotype can manifest in many different ways, she said. Some women are asked insensitive questions such as “Do you know who the father is?” Others face more sinister stigmas, such as being labeled “high risk” and facing greater odds of inductions and cesareans.

But it all contributes to a racial gap that New Jersey First Lady Tammy Murphy once called “shameful.”

Recently, state health officials began fighting back against the infant mortality gap. One of their tactics has been to hire dozens of doulas across New Jersey in an effort to get crucial health services to women “in their own backyards.”

• See related article: Doulas Hired In New Jersey Cities To Fight Baby Mortality Gap

It’s a tactic that Gabriel-Caldwell supports.

Gabriel-Caldwell, an engineer at a chemical additive company, said she got into the “birthing business” because of a simple reason… she’s needed.

“As a mother of two who had natural physiologic births in a hospital space and at home, my birth experiences were not traumatic,” Gabriel-Caldwell said. “So I know firsthand there are options not given to other black women. Honestly, some of these options aren't given to most women regardless of race. The freedom to eat and drink during labor. The freedom to walk and rights of refusal of drugs, IV's or constant monitoring in low risk situations.”

But having another shoulder to lean on such as a doula can be a big boost for expectant mothers, she said. And that includes after the big day comes, too.

“Immediately after birth, I work with families to ensure skin to skin and breastfeeding initiation,” Gabriel-Caldwell said. “We talk about the benefits to mom and baby while working on a plan for success. Additionally, two more home visits ensure correct latch and proper feeding techniques. We also tackle any other postpartum issues as they arise, particularly anxiety or depression.”

“When we remove the stigmas of birth and the routine procedures predicting that every person needs a heavily medicalized approach, we can start saving lives,” she asserted. “But perhaps equally important, we can empower all women in their own birthing spaces.”

'STIGMAS BLACK WOMEN FACE DURING PREGNANCY'

Gabriel-Caldwell offered Patch the following list of “stigmas of black birthing persons.”

1) “Undereducated” - Barriers to prenatal care and birthing options are often seen as a lack of willingness on the part of the black parent to either seek proper care or learn more about their options. The truth is black families aren't given the same options as white families. The conversations regarding alternatives are barely spoken since the assumption is we either can't afford them or don't understand them. As a doula, my first step is providing the necessary childbirth education, clear discussion on interventions, birth options and alternatives. My goal is to empower birthing parents with the information needed for true informed consent.

2) “Black Women Are Difficult” - We are seen as angry, loud and difficult. When the reality is we are not heard! Listening to our daily stressors, micro-aggressions and challenges of navigating health care built on systemic racism is the first step to changing this narrative. We only want the best for our families and our voices simply aren't heard. Having had two children myself and helping hundreds of women navigate the birthing spaces in NJ and NY, I listen to black women. Understanding their values and concerns should be of interest to medical providers, so when that doesn't happen their doula is there to amplify their voices.

3) “Black Bodies Are Imperfect” - Reading any risk factor for a condition from hypertension to diabetes a common risk factor is simply being ‘an African-American.’ More black women are labeled ‘high risk’ than any other group during pregnancy. This leads to greater chances of inductions and cesareans sometimes unnecessarily. When we are seen as a mass of imperfections straight from birth it is no wonder we have greater risks during labor itself. Once hired, I reassure my clients that pregnancy is not an illness! That their bodies aren't broken, the system is broken. I work with them to ensure they stay ‘low risk’ and are seen as an individual and that blanket statements about black women are merely stereotypes.

4) “Black Women Don't Have Partners” - Pregnancy is normally a very special time in a person's life. For black women in relationships, they spend an enormous amount of time convincing people they aren't alone. This 'poor pregnant black girl image' is one that most married or partnered women have to shake. Answering questions like "do you know who the father is?' is something very few white women are asked during prenatal visits. My husband and I teach a childbirth education course with the partners in mind. It provides them the tools they need to support their wife or partner during this beautiful time in their lives. Coaching and advocacy from the partner also helps amplify the birthing person's voice!

5) “Black Women Don't Breastfeed” - This unfortunately is tied to slavery after being seen as "wet nurses" for white families the stigma of breastfeeding has been passed on through generations. Formula is also heavily pushed and advertised in our communities. This leaves black babies vulnerable without the benefits of breastfeeding, especially if the option was a viable one. As a result, many healthcare providers just assume it's not wanted or rarely offer support when things get difficult.

Send local news tips and correction requests to eric.kiefer@patch.com

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