'We Know What the Research Says:' Transforming Peripartum Care for Black Birthing People

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"We all know the stories,” says Cindy McMillan, CD(DONA), NCPSS, CBFPC, CBE, BDT, DBD, co-founder and executive director of Sistas Caring 4 Sistas: Community Based Doulas for Social Justice. “We're hearing them, we're seeing them, and it's becoming more prevalent every day.” Doulas and other advocates for birth equity are acutely aware of the inequities and injustices present for birthing people in the United States, including the fact that maternal mortality is three times more likely for Black women than White women. Overall, there are over 700 perinatal deaths in the United States each year, and 80 percent of these are completely preventable.

Cindy's Greenville, North Carolina, organization is a partner on the PCORI-supported ACURE4Moms Study. Being a patient during the most important moments in life, such as pregnancy, parenthood and the birth of a child, should mean resting in the assurance that you’ll be cared for. That’s why organizations like Cindy’s are working to transform peripartum care for Black birthing people and families to be truly patient-centered. “Our goal as doulas is to not only support our families emotionally and physically,” Cindy shares. “We also want to make sure they have a voice.” She emphasizes that stepping foot into a hospital to birth their baby is the one time that families should not have to worry about trauma they may experience, or whether they will come out alive.

Saleemah McNeil, CLC, M.S., MFT, is chief executive officer of the Oshun Family Center in Philadelphia and co-principal investigator of the PCORI-funded study Comparing Two Ways to Improve Heart Health for Black Birthing People. “We are here because we want to change the narrative for Black birthing people,” Saleemah shares. “We're very intentional about our approach, not just going for direct services as doulas and therapists and lactation consultants. We need to dismantle the system.”

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“We know that just one single intervention is not working,” agrees Karie Stewart, MPH, MSN, CNM, APRN, co-principal investigator on the PCORI-supported project Does a Black Midwifery Program Improve Maternity Care for Black Women? “We need a collaborative effort.” These efforts have included making sure that Black women in Karie’s Chicago community have Black midwives, as they have requested and as they prefer. It also includes providing evidence-based group-setting care, and collaboration with Black Doula Community Services to provide doula care for project participants up to one year postpartum.

These three community activists—Cindy, Saleemah and Karie—are among the many Black women fighting for birth equity in the United States. They are supporting and fortifying the networks of diverse birthing support needed to change our healthcare system to do right by birthing people, and especially women of color. In part through their respective PCORI-funded projects, they are not only coordinating excellent perinatal care in their own communities but paving the way for a more just system throughout the country.

Through their PCORI-supported projects, these researcher activists are providing their community and the country as a whole with evidence of “how prenatal care should be provided for our Black moms and babies,” as Karie says. “We know what the research says,” she adds.

“We are tired,” says Saleemah. “But we are still very energized by the work that we're doing as we chip away piece by piece to come together not just from the bottom up, but from the top down.”