Louisiana doula protects BIPOC women from abuse through birth work and beyond

Having endured the trauma of a lost pregnancy at the hands of her obstetrician during her teenagehood, Angelica Rideaux vowed that she would work to protect BIPOC women from emotional and physical abuse.

In 2021, she enrolled in Community Birth Companion, a non-profit doula training program serving those in Southwest Louisiana. 

“During the training, I was loved on by women who looked like me, and had the same purpose of ending racial bias in maternal child health care,” Rideaux recalls.

She now serves as a doula for BIPOC families around Louisiana  with the ultimate goal of becoming a Certified Professional Midwife (CPM). Currently, there are only three Black CPMs in Louisiana, according to Rideaux. In 2021 Baby Catcher Birth Center, the state’s first Black-owned, CABC accredited free-standing birth center opened.  

Most recently, Rideaux was accepted as a member of the Power Coalition for Equity and Justice’s She Leads: Community Activist Fellowship 2023 cohort: a “network of women activists who are disrupting the current power structures and realizing change in their communities.”

Rideaux’s accomplishments go on. She earned one of the most recent Accessing the Milky Way scholarships to support her completion of the Lactation Counselor Training Course (LCTC)

Because Rideaux is a hands-on learner, she reports the online format of the LCTC challenging. Even so, Rideaux says she likes challenges. 

“So I am going to push past that,” she states. 

She says she has found the office hours helpful; they make the experience of online learning feel less isolating. 

Working her way through the course, Rideaux has been surprised by how many myths have been put to rest. Specifically, she says it was “mind-blowing” to learn that water consumption is not solely responsible for milk production. She plans to share the knowledge she continues to gain among her colleagues and the families she supports.    

Rideaux sees the LCTC as an important piece in making her future in midwifery more well-rounded, effective and supportive. 

As Rideaux continues on her journey to know more to better serve her community, she reminds us of some important concepts to reflect on as we move through our own work to improve maternal child health outcomes. 

First is that discomfort is necessary for change, and sitting in discomfort, having those difficult  conversations is part of bringing an end to racial inequity.

Secondly, creating healthy environments for women and children, especially those in BIPOC communities,  is not a trend. Rideaux comments that while she wants everyone to be culturally aware and competent, she hopes that the impetus comes from “hearts to get the situation resolved” rather than for “the dollars” or for “the accolades” or for an illusion of doing good.  

In Equity is more than a buzzword, the author writes: “Those committed to equity should understand that the harm of racism cannot simply be ‘undone’. The ramifications of colonization, enslavement and segregation penetrate almost every aspect of our society, including our education systems. Merely boosting representation is not an effective way to increase equity in predominantly white institutions.”  (Paytner, 2023)

It’s a reminder that improving maternal child health outcomes for the BIPOC community is part of a revolution, as Rideaux describes it. 

A lot of us are on the ground getting this work done, never receiving any kind of media coverage,” she begins. “We are soldiers in this war, and the goal is to get everybody on the same path for equity and justice. We  want everybody to feel like they are humans because that’s what we are first and foremost.”  

Learn about ending obstetric racism by visiting Birthing Cultural Rigor, founded by Dr. Karen A. Scott, MD, MPH, FACOG. 

Understanding value and accessing capital in Black maternal health

In Kimberly Jones’s 2020 viral video, How can we win, which comments on looting during the protests sparked by the death of George Floyd, she asks us to consider the why behind peoples’ actions. To explain, she delves into an economic history of Black people in America and the ways in which capitalism and racism are messily entangled.

Capitalism was one of the first ideas acknowledged during opening remarks at the Black Birth Maternal & Infant Health Symposium at Saint Kate- The Arts Hotel in Milwaukee, Wis. last month.

Photo by Anna Shvets

Geraud Blanks, Chief Innovation Officer for Milwaukee Film and one of the organizers of the event, thanked all of the sponsors who showed up.

“Accessibility is the key to inclusion,” Blanks said. The Black Birth Symposium was completely free to participants including parking, lunch and the space.

Blanks went on to share feedback from a 2022 Black Birth Symposium participant, driving home the importance of investment. It read: “I really hope all the medical facilities get on board with this event. They say that this is the most important issue impacting Black women but I didn’t see everyone at the event. Our community watches to see who puts their money where their mouth is. This also helps build trust in our communities. We don’t need another billboard ad, we need your dollars to go to events like this that really make an impact in our communities. We are watching.”

The thread of capitalism held through the keynote conversation with Tiffany Green, PhD, Assistant Professor Population Health Sciences and Obstetrics & Gynecology at UW-Madison and Jeanette Kowalik, PhD, MPH, MCHES, president and owner of Jael Solutions Consulting Services, LLC.

Dr. Green urged Black and Brown individuals to understand their value.

Photo by nappy on Pexels

The Center for American Progress’s piece Women of Color and the Wage Gap points out that, “When looking at women’s wages across broad racial and ethnic categories among full-time, year-round workers, Hispanic women experience the largest pay gap, having earned just 57 cents for every $1 earned by white, non-Hispanic men in 2020.  Black women also experience wide pay gaps, with data on Black women alone revealing that—despite consistently having some of the highest labor force participation rates—they earned just 64 cents for every $1 earned by white, non-Hispanic men in 2020. This number dips slightly to 63 cents, reflecting a slightly larger wage gap, when data on multiracial Black women—meaning Black women who also identify with another racial category—are included in the analysis.”

With these inequities in mind, Dr. Green and Dr. Kowalik acknowledged the difficulty in accessing capital, for both individuals and grassroots organizations.

Dr. Green asked participants to consider not giving away their knowledge. You are a part of the community; how can you take care of the community if you’re not taking care of yourself, she posed. Ask for what you are worth, she further advised.

In the arena of maternal child health research, Dr. Green explained that it is well within reason to ask hard questions to funders and leaders like: What is the budget for this grant? What problems are you addressing? Are you stigmatizing the community? May I co-author or co-create?

Photo by Christina Morillo

An audience participant brought up the phenomena of large funding institutions being insular and wondered who holds them accountable. What is the metric? she wondered.

“Folks like us… with our boots on the ground… doing this work every day, have to fight and jockey to keep ourselves alive,” she pointed out.

The authors of First, Do No Harm: Why Philanthropy Needs to Re-Examine Its Role in Reproductive Equity and Racial Justice address ways in which funders can “embody the equity they aspire to see and build through the operationalization of cultural rigor to advance structural equity and racial justice and to sustain community engagement in research.”

Building upon her previous comment, the participant added that spirituality and emotional intelligence are not valued in science. She called on us to “restore ancient knowledge”, to “transform and decolonize what we consider competence”, and to “honor the people who brought their lived experiences.”

Dr. Kowalik applauded the work of The Birth Justice Fund – Rapid Response Fund (BJF-RRF), an organization addressing the challenges in accessing capital in under-resourced communities. BJF-RRF is a three- year opportunity to advance community power efforts led by Black, Indigenous, and People of Color (BIPOC) birth justice (BJ) organizations to address implicit bias and structural racism and their impact on maternal and infant morbidity and mortality. The second wave of funding opens this month. Apply here.

Dr. Greene said, “Black scholars need a seat at the table. When you have the lived experience, you ask the right questions. That’s what makes the science better.”

Source: United States Breastfeeding Committee.

The authors of Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future echo Greene’s call and write that “public health and policy priorities need to center on listening to Black women, and funding Black, Indigenous, and People of Color (BIPOC) organizations and researchers conducting innovative projects and research.”

More to explore on the intersection between racism, capitalism and research in maternal child health 

‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?–  propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021. 

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says.  “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is  moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.

Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

Breastfeeding is a “weapon of mass construction”, a phrase coined by Camie Jae Goldhammer, MSW, LICSW, IBCLC, (Sisseton-Wahpeton).

In her Reclaiming the Tradition of Breastfeeding: the Foundation of a Nation webinar, Goldhammer describes how breastfeeding has the power to heal those suffering the effects of generational trauma, specifically through the release of oxytocin, subsequently allowing mothers and their babies to feel empowered and independent.

Photo by Luiza Braun

Kathleen Kendall Tackett’s work also illuminates how breastfeeding can heal trauma. Her videos, How Birth Trauma Affects Breastfeeding and Breastfeeding Can Heal Birth Trauma and Breastfeeding’s Healing Impact on Sexual Assault Trauma discuss the mechanisms behind why and how breastfeeding can be helpful for trauma survivors. Essentially, breastfeeding allows for the down regulation of stress responses, specifically adrenocorticotropic hormone (ACTH) and cortisol, and similar to exercise, improves maternal mood, decreases the risk of depression, decreases hostility, and improves the mother infant bond.

Jennie Toland, BSN, RN, CLC offers commentary on the role lactation care providers play in offering trauma-informed care in this piece.

This Invisibila episode, Therapy Ghostbusters, shares the incredible story of how a Cambodian practitioner worked to help heal an entire community from generational trauma. It took him over a year to simply earn individuals’ trust.

“…That’s pretty unique,” the podcast hosts point out and offers insight into how our nation approaches care for individuals with specific mental health needs and cultural considerations.

Goldhammer quotes Round Rock elder Annie Kahn:  “When a mother nurses her baby, she is giving that child her name, her story and her life’s song. A nursed baby will grow to be strong in body, mind and spirit.”

This connection to the past that Kahn refers to, also offers a form of healing. Breastfeeding is an example of Indigenous food sovereignty, “a part of living culture” and facilitates the revitalization of traditional knowledge. (Cidro, et al 2018)

The revitalization of breastfeeding spans the Black Indigenous People of Color (BIPOC) experience and is a channel to champion equity.

Ifeyinwa V. Asiodu,  Kimarie Bugg,  and Aunchalee E.L. Palmquist write in Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future:

“Breastfeeding is an especially important public health issue in Black communities, particularly given that Black families and communities continue to experience the highest burden related to poor maternal and infant health outcomes, including higher incidence of preterm birth, low birth weight, maternal mortality and morbidity, infant mortality, and lower breastfeeding rates. Owing to lifetime exposure of racism, bias, and stress, Black women experience higher rates of cardiovascular disease, type 2 diabetes, and aggressive breast cancer. Given that cardiovascular disease and postpartum hemorrhage are leading causes of maternal mortality and morbidity, increasing breastfeeding rates among Black women can potentially save lives.”

Photo by Emily Finch

More specifically, studies show that the experience of racial discrimination accelerates the shortening of telomeres (the repetitive sequences of DNA at the ends of chromosomes that protect the cell) and ultimately contributes to an increase in people’s risks of developing diseases.

It has been found that higher anxiety scores and inflammation are associated with shorter telomere length.

Because physical and psychological stressors trigger the inflammatory response system, one way to counter this reaction is by supporting ongoing breastfeeding relationships; when breastfeeding is going well, it protects mothers from stress. (Kendall-Tackett, 2007)

Another study found that early exclusive breastfeeding is associated with longer telomeres in children.

Photo by Luiza Braun

The authors of Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future continue, “Yet breastfeeding is rarely seen as a women’s health, reproductive health, or a public health strategy to address or reduce maternal mortality and morbidity in the U.S. Inequities in lactation support and breastfeeding education exacerbate health inequities experienced by Black women, specifically maternal mortality and morbidity, and thus a greater investment in perinatal lactation and breastfeeding education and resources is warranted. Breastfeeding is an essential part of women’s reproductive health.”

Journalist and maternal child health advocate Kimberly Seals Allers’ approach is one “For Black people, from Black people.”

“…The call to revive, restore and reclaim Black breastfeeding is an internal call to action,” Kimberly Seals Allers begins in Black Breastfeeding Is a Racial Equity Issue.  “… Breastfeeding is our social justice movement as we declare the health and vitality of our infants as critical to the health and vitality of our communities.”

Specifically through her work with Narrative Nation, Seals Allers and colleagues are promoting health equity “by democratizing how the story of health disparities is told,” centering BIPOC voices. Additionally, through her Birthright podcast, KSA uplifts stories of  joy and healing in Black birth.

Especially after the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery, organizations made statements about their commitments to dismantling structural racism and focusing efforts on equity.

Equity has become a buzzword; in fact, one author brands the sentiment “Fakequity”. This year, United States Breastfeeding Committee (USBC) National Conference and Convening presenters expressed their fatigue with the word.

“We want to see action,” they said.

Nikki & Nikki LIVE offer their Allies, Advocates and Activists Equity in Lactation webinar which covers the meaning of equitable in lactation care, how to show up for the marginalized and how to make a lasting impact.

In other efforts, the CDC has identified breastfeeding as a priority area to address health inequities.

Photo by Luiza Braun

NICHQ’s Achieving Breastfeeding Equity campaign also focuses on closing breastfeeding disparity gaps, viewing their efforts through an equity lens.

Director of policy and partnerships at the National Women’s Health Network Denys Symonette Mitchell offers commentary on a way forward with key policies that will ensure investment in breastfeeding to ultimately advance health equity.

Watch Racism and the Colonial Roots of Gendered Language in Public Health and Biomedicine with Dr. Aunchalee Palmquist, PhD, IBCLC for more on these issues.  

 

——–

As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us about how you are contributing to working toward healthy equity.

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Musings on unity beyond National Breastfeeding Month

This year’s National Breastfeeding Month (NBM) celebration has come to an end, but our momentum as maternal child health advocates– striving for equitable care for all– powers on. 

The 2020 NBM theme, Many Voices United, called on us to come together to identify and implement the policy and system changes that are needed to ensure that all families have the support and resources they need in order to feed their babies healthily. 

Photo by Tim Mossholder on Unsplash
Colorful Hands 1 of 3 / George Fox students Annabelle Wombacher, Jared Mar, Sierra Ratcliff and Benjamin Cahoon collaborated on the mural. / Article: https://www.orartswatch.org/painting-the-town-in-newberg/

Achieving this shared goal requires daily self-work and individual introspection so that our collective can be as effective as ever. No matter how socially-conscious, open-minded, anti-racist, (insert adjective), we think we may be, we still have learned biases and prejudices that require near constant attention. Much like I remind my children to brush their teeth every morning and every night, as a white, binary woman, I must remind myself to examine my biases and my privilege daily.  

With NBM’s theme of unity in mind, this Upworthy video features an art installation that demonstrates our society’s interconnectedness. With a piece of string, the installation shows an intricate, densely-woven web created by individuals wrapping thread around 32 poles with identifiers arranged in a circle. 

“You can see that even though we all have different experiences and we all identify in different ways…We are really one,” the project’s creator says in the video. 

The sentiment and the product are truly beautiful and fascinating. While appreciating the beauty of unity, it’s important to keep our critical thinking and progressive attitude sharp, refraining from slipping into too comfortable a space where change cannot happen.  

Recently, I’ve seen a few statements on unity circulating social media that I’d like to embrace with a “Yes!” Instead, I find myself reacting, “Yes! But…” 

My worry is that these well-intentioned mantras we live by– much like some might argue certain microaggressions are well-intentioned– are also dismissive. 

  1. We all bleed the same blood. 
  1. Children are not born racist.
  1. I will teach my child to love your child. Period. 

Let’s break those down starting with “We all bleed the same blood.”  Some things to consider:

First, Ashley May for The Thirbly writes,

“Black breasts do not exist separate from Black bodies and the situated existence we navigate in this world nor the racialized experience of motherhood. Racism and classism intertwine to act as a containment, working to make some of us feel as if we are walking in quicksand. Add to this the complexities of new motherhood and the needs of the postpartum body and now we have a cocktail for failure. Literal milk plugs. So, although her precious body may be able to produce milk, her situation prevents her and her baby from receiving it. Even the intention to breastfeed cannot save the milk of the mother who cannot find time for pump breaks as she works the night shift as a security guard. Or, perhaps she cannot figure out why pumping is not working, but she doesn’t have the time to seek the educational or financial resources to help her problem solve.” (underline added by OMW) 

Racism affects People of Color (POC) at a cellular level. Studies show that the experience of racial discrimination accelerates the shortening of telomeres (the repetitive sequences of DNA at the ends of chromosomes that protect the cell) and ultimately contributes to an increase in people’s risks of developing diseases. 

It’s epigenetics; the environments POC of are growing in affect their biology.  

Children are not born racist, but white children are born into a racist society that they will benefit from. 

From the very beginning, white children have a better chance of survival than Children of Color; African Americans have 2.3 times the infant mortality rate as non-Hispanic whites

What’s more, Black children are three times more likely to die when cared for by white doctors, while the mortality rate for white babies is largely unaffected by the doctor’s race, a recent study found. 

White children are born into being part of the problem and just the same, can be part of equitable solutions. 

I will teach my child to love your child. Period. 

Love is action, and even if it’s easier said than done, there are so many ways to teach our children about race, inequities and injustice. Afterall, “If Black children are ‘old enough’ to experience racism then white children are ‘old enough’ to learn about it.” – Blair Amadeus Imani

  • Be careful what you say. As a young girl on my way to ballet class one day, my mom, while locking the car doors,  pointed out the barred doors and boarded windows in the neighborhood we rolled through. 

“That’s how you know this is not a safe neighborhood,” my mom warned me. 

No questions asked, I noted the building facades, and then I noted the Black people. Because there wasn’t any further conversation, I made the connection that Black people must be “not safe” and ultimately, that there must be something wrong with Black people if they’re confined to neighborhoods “like this.” 

Imagine the impact we could make if we showed our children that there is nothing inherently wrong with Black people that ending racism can’t solve.

As a nation we are apathetic, made apparent by a recent poll. The survey shows that only 30 percent of white people have taken concrete action to better understand racial issues after George Floyd’s killing. 

The poll also shows that White Americans are also the least likely to support the Black Lives Matter movement, with 47 percent expressing support.

Is it because we don’t claim it as our problem? Is it because we misunderstand the problem? Is it because it’s easier to point fingers at others than ourselves? 

I’d like to leave you with this video of writer Kimberly Jones where she provides a brief history of the American economy told through an analogy using the board game Monopoly. I urge you to watch it, and then watch it again, and again, and again. 

There is no time for complacency within these truly abhorrent systems. When we start to lose sight of that, envision the tangle of yarn from the aforementioned unity art installation and remember that vastly different experiences are networked together.