Doulas and Nurses: Saving Black Babies
By Dianne Anderson
Motherhood requires maximum attention, energy and education, but mostly, it’s about keeping the baby alive.
Black moms are doing double duty in that department.
As a Registered Nurse in cardiac stepdown unit, Shamiesha Ebhotemen works the space between ICU and regular floor where every day is a tough workday. But, she feels that advocating for Black women and their babies is a much harder calling.
On the nursing registry, she regularly goes into hospitals across Orange County, Long Beach and Los Angeles, and says 95% of the time she’s the only Black nurse working that day.
Equal work opportunity is important, but her main concern is that Black moms and babies are not getting the help they need.
“You almost feel like a bodyguard for families of color. I’ve wanted to leave the hospital for years, but if I leave, who’s going to advocate on their behalf because everybody is afraid to speak up,” said Ebhotemen, RN, CLE, founder and executive director of the nonprofit Her Story, Inc.
After giving birth in 2017, she said her floor nurse knew she wanted to breastfeed, but basically put a baby formula bottle on the counter, and walked away.
“I’m a brand new mom, she talked to me in nurse talk and said she didn’t have time. She didn’t give me instruction,” Ebhotemen said, adding that substandard and racially biased health care is one reason behind the higher death rates for Black babies.
But breastfed babies are more likely to have a stronger immune system, and Ebhotemen, also a nurse since 2011, feels it’s a matter of life and death.
At this point, about 75% of moms start off breastfeeding, in three months it’s down to about 65%, and by six months it’s about 50%. Some of it may be the associated stigma, but she feels a lot of confusion could be cleared up if Black moms understood the health benefits.
No one knows exactly how Sudden Infant Death happens, but she said SIDS would be reduced through breastfeeding because babies automatically wake up more frequently than with formula.
With formula, babies fill up fast and stay full, but also go into a deep sleep. They may roll over and get stuck, unable to breathe. Worse, some mothers put rice cereal and other foodstuffs in bottles to make them sleep all night.
“A two-month-old physiology is not supposed to sleep through the night,” she said. “They’re not realizing how many babies choked to death from that practice, it gets clogged up. I’m seeing people mix applesauce with water and rice and calling them knock-out bottles.”
So concerned about misinformation and outreach to Black moms, last year she called together a power team of the sisterhood to start the nonprofit, Herstory, Inc.
They encourage women of color, especially Black women to get doulas, get prenatal help, during labor and postpartum because Black moms are dying during childbirth at extraordinary rates, even in the best hospitals.
Black women are still dying at three to four times the rate of white women.
A doula in the room is a trained birthing professional, and knows when to speak up.
“So many things go wrong, if you have been in labor for ten hours you may not be in the right mind to ask the questions you should be asking,” she said.
There are numerous high-profile cases and wrongful death lawsuits, including one filed earlier this year, the family of Kira Dixon Johnson against Cedar Sinai Medical Center.
She said doctors wouldn’t listen after her C-Section when they tried to say that something was very wrong. Ebhotemen said it has nothing to do with social economic status or education.
“She was bleeding out in her catheter and her husband was begging the nurse for help. No one did anything until three hours later and her MRI showed her belly full of blood,” she said.
Working moms think they don’t have time to express milk, but pumps today are built for moms on the run, literally. One of her clients hiked and pumped at the same time, and pumps can be hidden so no one knows when they are expressing.
In Orange County, she started her nonprofit because there was only one Black doula there for the last 20 years, who will now be part of their new pilot program. Recently, they received a sizable grant through Equity in OC, an Orange County Health Care Agency initiative, in collaboration with MOMS Orange County to create BIRRTH WOMEN OC, (Birth Initiative for Reproductive Rights, Transforming and Healing Women of Color).
Doulas can be expensive, so she is hopeful that a recent policy change will open up services for more moms.
Starting January, The State of California Department of Health Care Services website states that doula availability will open for moms on Medi-Cal to provide personal support throughout pregnancy, childbirth and postpartum experience. Services must be recommended by a physician or other licensed practitioner.
In starting her nonprofit, which is nearly one year old, she reached out to BreastfeedL.A. and earned her international board-certified lactation consultant certification. To complete mentorship hours, she was placed back at the same hospital where she had delivered her baby.
“At that same unit, I saw the same thing. Four years, nothing had changed. If you were a person of color, you were still aggressive, nobody was taking the time,” she said.
Even as a nurse, Ebhotemen said she needed someone to show her the best way to breastfeed as a young mom, that it is a major step to ensure the mom’s health and the health of their baby.
“That’s why I said, let me figure out a way to help moms so she’s not up at 3:00 in the morning trying to figure out what’s wrong,” she said.
For more information, see https://herstoryinc.org/
For Medi-Cal information, see https://www.dhcs.ca.gov/provgovpart/Pages/doula-Services.aspx
For more information, see https://www.breastfeedla.org/