Not enough women of color are working as childbirth professionals. There is not one simple easy answer why in the United States more white women work as doulas, childbirth educators, midwives, lactation consultants, and other birth professionals than women of color.
Next time you attend a conference or workshop for childbirth professionals, look around, you can really see the lack of diversity. It is an ongoing important conversation of how to be more inclusive in this field.
Reasons why the numbers are low for nonwhite childbirth professionals include lack of awareness about the field. Lacking the means to pay for trainings and workshops. Also, lacking access to the network or sisterhood of birth professionals that can help advance their careers.
It is important that more women of all ethnic backgrounds are able to become childbirth professionals. One reason is because they can build a career that offers a stable income with so much potential for growth. They also will be able to do work that is valuable, fulfilling, and has prestige. And they may be able to connect to nonwhite expecting families more effectively than a Caucasian birth professional is able to. This in turn can help make a difference in maternal health disparities.
Scholarships to assist women of color to further their education as doulas, midwives, and other birth professionals are available. See:
National Association to Advance Black Birth Midwifery Scholarship
Birth Workers of Color Scholarship
What is important to examine is are woman of color that are birth professionals beholden to only serve other woman of color? Often scholarships programs have this as a requirement. The reasoning makes sense. Women of color potentially can make a greater impact because they are able to relate and understand more about their ethnic group.
Something not often discussed is the economic class of women of color and the role class plays in determining community. As well it is important that education, training, and the career that one pursues leads them to achieve a higher class or standard of living.
The subject is uncomfortable, but it sometimes seems the unspoken expectation is that if you are a Black woman or a Spanish speaking woman working as a childbirth professional then you should serve underserved poor women of color. While it is very important that underserved pregnant women receive care by someone that is culturally relatable and sensitive to their needs, serving this population could have a direct impact upon one’s income and upward mobility.
The work provided by doulas, childbirth educators, lactation consultants, midwives, etc. is a growing niche market that middle and upper class families are willing to pay top dollars for. A doula in New York or San Francisco may charge families $1500-$2000 to support them at their birth.
Underserved communities are not often able to pay at the top of the scale for doula or other childbirth professional services. Nonprofit groups sometimes help to supplement the fees of doulas and lactation consultants through grants and donations for those that cannot afford them, but many times childbirth professionals are expected to cut their fair market fees.
So a woman of color serving an underserved community may have her income capped if she solely serves them.
As well people of color have thriving middle and upper classes. It is possible that a woman of color’s community may not be defined as needy. And even if she comes from a needy community is she obligated to serve them. Community is self defined and can change over time.
Where are the women of color birth professionals is an ongoing conversation that has many angles.
Birthnetwork National chapters are a great way for women to organize their communities to provide support for birth workers, and we encourage all birth workers and community members to participate!
The short answer is racism, which effects all area of people activity, with the birth professional not being exempt, but a mere microcosm and perpetrator of this same behavior. Women of Color attempting to penetrate Midwifery and Birthwork are face with innumerable challenges and difficulties, financial being one of them. If we as Birthworkers of Color don’t serve the women in our communities who are low-come, guess what happens to them, they become the statistics. They are the disparities that are existing within Maternal and Child Health for the same reason that there are too few women of color who are Birthworkers and Midwives; RACISM, which is the mistreat of a non-white person on the basis of race; which lack ACCESS, quality INFORMATION, and DISPARITY can all be attributed. Yes, serving women of color who cannot afford $1000 for doula support, because she is a single mom, or has a partner, but both are underemployed, taxes the doula, but should this woman not get served? Serving women, building community; helping women transition to motherhood, was not something that women of color PAID for. It was a mechanism built into the family, built into the community. It is white people who seek and continually seek to CAPITALIZE of every possible area of life. I am not saying that a Doula should not be compensated for the time and energy that she spends with a mother and with a family, but this is something that has been deeply rooted in the culture of non-white people across the planet, and it only the promotion of a capitalist paradigm that has set the standard for Doulas, Quality Childbirth Education, Midwives, access to home birth/birth center, and Lactation Consults, to be some only afforded to the “haves” which ironically are primarily white, and the “others” well, they will have to take what Medicaid, or their insurance will provide, even if it comes with abuse and more mistreatment.
I run a non-profit whose mission is the increase the number of professional Midwives and women of Color entering the Maternal Health Profession. We train women of Color to be Community Birthworkers, a program that is often a stepping stone into the Midwifery, IBCLC, and other professions. These women don’t enter this field to become “rich.” They do it because they have a desire to see women of color have access to the same quality of care and support afforded to white women. They desire to lift up women of color to a place where they can see the power within themselves and use that to alter their present reality; They do it to see that teen mom believe that she is not defined by her circumstance, but can make an impact on the world; They do it to give that single mother a community that she never had; to be that sister friend that rubs her back and massages her when she has no one else to rely on. This is why most of us do this work.
I am not saying that all white women seek to benefit financially from being a Birthworker, but I am saying that often the priorities of women of color and white women are not parallel. Our mission and our purpose in doing this work is not from the same source; as being a woman of color and not being far removed from the realities of the clients who we serve is vastly different. Our clients sometimes needs extend well beyond a birth plan; well beyond the labor and delivery room; well beyond that 1 prenatal meeting. Our clients realities are painted with the brush of racism, and coated with a glossy layer of White Supremacy.
This article, though having points of relevance, can be construed in many ways. You state, “serving this [lower income] population could have a direct impact upon one’s income and upward mobility.” As I mention above, (and women of color correct me if I am wrong), but many of us don’t get into this work to become “rich.” If we took the attitude that I won’t gain upward mobility by serving lower income population, the disparities that presently exist will have continued to increase and health equity decrease.
It has been primarily men and women of color who have created organizations, peer-reviewed research, programs, and initiatives to address the health disparities of women and babies of color in Maternal and Child Health. Efforts that have gone without pay; tireless efforts, and countless hours. SACRIFICE! Because one believed that they were “called” to do this work for a higher purpose.
You ask why there is not greater representation at predominately white conferences, perhaps you should not ask people of color to explain racism, but rather ask, white women in the Birth professional, what are they not doing correctly that women of color are not attending their events. Often these conferences are deficient in cultural humility and cultural awareness; the assumptions are sweeping and misinformation about the disparities are great. As a woman of color, I try not to attend any conference, where the concerns that exists within an cultural context are not address or are simply glossed over and where the representation of persons of color who are speakers, on the panel, teaching the workshops are either scarce or nonexistent.
Further, why should we as women of color support organizations, that fail to place women of color on the boards or in leadership positions within the organization. I am not just talking the “one token” women of color that is placed to distract from the reality of racism that penetrates the core of this field, but a true commitment to social justice and equity within the structure and core of the organization. A commitment that seeks more than “upward mobility” but rather a desire for ALL women regardless of race, socioeconomic status, or marital status, to access quality maternity care and support.
I don’t know whether to applaud this article or not. There are many truths spoken here but so many misconstrued ideas, as well. I’m a part of a doula network of over 600+ doulas & birth workers of color. Taking into account that women if color are the extreme minority in society, them yes we will be a smaller population of women when you see us next to the whole. Also, we not to participate in the mainstream conferences & connections because most of them lack the cultural competence that relate.
THANK YOU for writing this and for explaining the challenges faced when one is only expected to work with low-income women of one’s own race.