Black Women Trained as Perinatal Doulas: A Key Strategy in Advancing Birth Equity

Photo credit: Cynthia Liu

When Venus Standard’s, MSN, CNM, APRN, LCCE, FACNM daughter started to read, she had an epiphany at her pediatric office: women, Black women could be doctors, evident by the newly deciphered titles on their badges, crushing the cut-and-dry notion she once had that men were doctors, women were nurses. Standard’s daughter is now in her forties and a doctor herself. 

“You have to be able to see and have it in front of you,” Standard says of representation. 

Spanning two decades, this idea has held true in several facets throughout Standard’s career in maternal health. Her interest in the field she calls an evolving process. 

In 1996, when her daughter went off to college, she went back to school too. Beginning with an in-depth massage therapy course, Standard later ventured into doula work and childbirth education. Standard noticed she was interacting with women during all points of their pregnancies except for having a larger role in the final stage, so she went on to complete nursing and midwifery school.   


Achieving birth equity through Black doulas 

Among her many accomplishments, Standard , assistant professor at UNC School of Medicine, Department of Family Medicine, has most recently invested herself in a doula training program— the Alliance of Black Doulas for Black Mamas– first funded by the C. Felix Harvey Award through the University of North Carolina at Chapel Hill. The program’s goal is to improve Black women’s maternal and birth outcomes by increasing their access to social, emotional, and educational support from professionally trained Black Doulas.

Doula cohort 1 from year one of the project

The initial one-year program was intended to sustain the training of twenty doulas and as of the end of January, they had supported 51 families. Now, Standard’s program has been awarded the Duke Endowment  which will allow them to continue their work over the next three years. The program will expand to train 120 doulas growing their reach to several hundred families per month. Their next cohort is scheduled to begin training May 6. 


Achieving generational wealth through professional development 

“Each one. Reach one. Teach one.” Their motto. While the striking numbers that reflect the health equity landscape in our country drive the doulas’ work, Standard uplifts her “dream team” explaining that the program is as much about helping new mothers and families as it is about encouraging her colleagues in their professional endeavors. 

“When you don’t see what you can be, you don’t think it can be done,” Standard says, recalling her daughter’s pediatrician’s influence. 

Again proud, Standard reports that one of their doulas recently got accepted into med school and four others have applied to graduate school. More have applied to undergrad programs. 

“I am so very excited about this,” Standard shares. 

With the new expansion of the doula program, she says that they will be better able to serve their doulas with the tools they need to launch their own businesses.

Doula cohort 2 from year one of the project

“I want to help diversity the maternal workforce,” Standard says.  “We’re building in some business management and development strategies. [The doulas] can serve the people of their community, and they can also market themselves and build a thriving business.”

They’re working toward contributing toward generational health and generational wealth, as Standard puts it. 


If it’s not in your backyard   

Standard was scheduled to present Black Women Trained as Perinatal Doulas: A Key Strategy in Advancing Birth Equity at the International Breastfeeding Conference, canceled due to rising concerns about COVID-19. In it, she planned to reiterate the disparities Black women suffer, while approaching that reality this way:

“It’s been documented over and over again that Black women die at three to four times the rate of white women,” she begins. “But if it’s not something that you deal with… if it’s not in your backyard, you don’t see it as a problem. If all of your clients are white, you don’t see the other things that are being done to other people.” 

Standard brings to the forefront the near misses too; mothers like Serena Williams and Beyonce who could have very easily died but pulled through because of their circumstances.  Some of those stories are documented in the CDC’s Hear Her campaign where mothers share how pregnancy-related complications or conditions have affected them and how they got help.

In a way similar to carefully choosing her daughter’s Black, female pediatrician, Standard has thoughtfully called those living out the realities of the Black maternal health crisis to speak to groups of medical professionals, bringing what they might not normally be exposed to, “to their backyard.” 

For instance, Standard invited Charles Johnson, husband of the late Kira Johnson to speak to the NC Medical Society, where most of the attendees were OBs, about the loss of his wife. 

“I wanted them to hear it firsthand,” she says. “The first and foremost reason I’m doing what I’m doing… is to merge the disparity from every three to four [deaths] to every one.” 


Representation fosters trust 

Standard goes on to share more about what she included in her International Breastfeeding Conference presentation. She highlights The American College of Obstetricians and Gynecologists’ (ACOG) statement on the use of doulas and limiting interventions.

“Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor,” it states. 

Because there is a “huge lack of trust” in the medical community among the BIPOC community, having a doula that represents your lifestyle and reality is extremely important,  Standard expounds.

The Dream Team

In the decades since beginning her work within maternal health, she says that she’s witnessed the growth of people being aware of their rights. 

“People are more aware that they have the ability to participate in their healthcare,” Standard says. “People are learning that they can ask questions and say no, or not now.” 

The doula is not situated to speak for the birthing person, rather to speak up with the birthing person, she explains. 

You can learn more about the doula program, the Dream Team and connect with the Alliance on social media on their website here

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