by Crystal Good, writing for the “When All Are Counted” Project

When I gave birth to my first child at 20 years old, it was a challenging experience. The episiotomy, epidural, and creepy OBGYN made me feel uncomfortable, and I gave birth in a hospital under harsh fluorescent lights. However, the birth of my healthy 9lb 10 oz baby boy made it all worth it.

It wasn’t until I had my second child at 23 that I had a better birthing experience. I had the support of a doula, Pia Long, a Black doula from a local midwifery practice and part of the tradition of Black midwifery in West Virginia. At the time, Pia was the only Black doula in the state. With her guidance, I had more control over the birthing experience and could make more decisions.

A lot of life experiences have happened since then. I now carry the weight of being one of the few Black print reporters in West Virginia and the publisher of the state’s only Black newspaper, Black By God. My work with the “When All Are Counted” Project has made me acutely aware of the existing data showing racial disparities in infant mortality rates in the United States.

In West Virginia, Black infants die at almost twice the rate of white infants, a crisis that demands attention and action. Importantly, as I wrote in a previous blog post, this is data compiled by the March of Dimes and amplified by Dr. Lauri Andress—not the West Virginia Department of Health and Human Resources.

During a recent WV Legislature interim committee meeting, Dr. David Didden, Medical Director of DHHR’s Office of Maternal, Child, and Family Health, was asked outright what was being done to address Black infant mortality rates.

His response? Here’s all the paper reported: “Didden said the problem is well known and being addressed.”

I am committed to exploring and sharing data, or lack thereof, and reporting it in useful ways that hold people and agencies accountable while providing helpful information to birthing families.

And that, in part, is why I’m not studying to become a doula. I can advocate better if I am closer to the families most impacted.

Research has shown that chronic stress from living with racism and discrimination can lead to poorer health outcomes for Black mothers and their babies. This is why having healthcare providers that look like you is so important. My experience with childbirth and the lack of Black doulas in West Virginia has led me to become a doula.

During the 2023 legislative session, I became convinced of the importance of pursuing this certification. The silence—the lack of data and representation in our state capital—was deafening.

In addition to supporting Black birthing people, I am committed to providing doula support for LGBTQ+ birthing families. There is a lack of support for LGBTQ+ birthing families in the West Virginia health care system, and I want to be available to other communities that are marginalized in this regard.

Advocacy and Legislative Efforts

During the 2023 WV Legislative session, I was in email action groups with people addressing Black infant and maternal healthcare. Still, many individuals and organizations involved were those with whom I had previously had very negative personal experiences. It’s hard to participate in a conversation about the stress of racism with people who, in my opinion, act in their whiteness and disregard my position in that space. A recurring issue in advocacy around Black healthcare is that the people leading the conversation are often white women who have a history of diminishing the worth of Black advocates—the very people whom they claim to advocate for. I’ve been asked many times to work for free, doing the same work as those in comfortable positions who have never experienced the inequities I have, for which this work is supposedly centered.

True allies should do their homework. Depending on where we live, Black women make around 14 cents less on the dollar than white women. Fair distribution of resources shouldn’t be a continuous struggle.

So I walk into this work of becoming a doula with my eyes open. The data and funding aren’t there to support my work. But despite these challenges, I still want to help my community. Statistics show that having a doula present during childbirth can lead to a 31% decrease in the use of Pitocin, a 28% decrease in the risk of C-sections, and a 34% decrease in the risk of being dissatisfied with the birth experience.

During the legislative session, I watched the “pro-life” body of the WV legislature go mute when they heard: Black infants die at almost twice the rate of white infants. 

Again, deafening silence.

One solution that did pass was the removal of the Certificate of Need. It passed the House, but two of three Black delegates in WV opposed it: Delegate Walker and Delegate Hornbuckle. Del. Walker pointed out in her floor speech that the bill did not adequately address the underlying issues contributing to the high mortality rates among Black infants and mothers.

Another solution, House Bill 3415, was also introduced by Delegate Young, which aimed to support mothers during and after pregnancy. It was a noble effort but made no progress.

Seeing the need, I started a conversation about introducing a possible bill to introduce a version of the Kentucky Certified Professional Midwife law in West Virginia. This bill would issue licenses to certified professional midwives who have obtained a nationally accredited credential and require education consistent with U.S. accreditation standards. It would also create an Advisory Council, integrate certified professional midwives into the healthcare system, and increase cost-effective maternal care services for underserved populations.

This bill is crucial, especially given the high Black maternal and infant mortality rates in West Virginia, and would greatly benefit Staysha Cantrell, WV’s only Black midwife who is not currently considered a licensed provider, despite being a member of a Professional Organization of Certified Professional Midwives. 

Introducing this bill would have provided certification and helped address the issue of high Black maternal and infant mortality rates and underserved and poor childbearing persons in our state who need culturally competent providers. I am committed to advocating for this bill next session and supporting marginalized communities in their fight for better healthcare.

Seeing the lack of attention and urgency given to this issue was disheartening, especially since it disproportionately affects Black families. Limited solutions were being proposed for the high Black infant and maternal mortality rates in West Virginia.

As a doula and an advocate, my work is to provide support and guidance to Black mothers during pregnancy and childbirth and advocate for better access to resources and opportunities, such as medical care, for Black communities. Doula support can help provide emotional, physical, and informational support to birthing people and can be especially important for marginalized individuals who face discrimination in the healthcare system.

My experiences with childbirth and my work with “When All Are Counted” have made me acutely aware of the racial disparities in maternal and infant healthcare. I will continue to work towards improving maternal and infant healthcare for all, including Black and LGBTQ+ birthing families.

And by becoming a doula, I hope to support birthing people more hands-only while advocating for policy change at the state level.

I hope that more Black people will consider becoming doulas to support and guide Black mothers during pregnancy and childbirth and to help bridge the gap in access to quality healthcare in underserved communities. 

The West Virginia Perinatal Partnership’s trainings to expand the reach of doula services offered to pregnant and postpartum women in underserved and vulnerable communities will continue throughout 2023. Register here:

Crystal Good (she/her/hers) is a writer-poet, performer, and publisher whose work seeks to trouble the Appalachian narrative toward inclusion and a more truthful representation. She is the founder and publisher of Black By God THE WEST VIRGINIAN, a print and multimedia publication centering Black voices to address the information gap. Crystal tweets @cgoodwoman.


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