No Woman Should Have To Go It Alone: Black Birth Experiences in Oregon


Originally posted on Western States Center's blog:

by Walidah Imarisha

 A collection of young Black girls giggle nervously and talk in low whispers as they fill up the front row of Oregon’s House Chamber. They glance over at the representatives who are there for today’s public hearing. They shift in their seats and then their eyes are drawn to a Black woman who steps forward, her stride confident and proud, her head, wrapped in vibrant fabric, held high.

She is Shafia Monroe, founder and director of the International Center for Traditional Childbearing (ICTC). The young women are from ICTC’s Sistah Care Spring Break Camp, which teaches young women about reducing infant mortality. The campers are at the Capitol Building to lobby in support of Oregon House Bill 3311. HB 3311, put forward by a coalition of organizations including ICTC, requires the Oregon Health Authority to explore ways to improve birth outcomes for all women in Oregon, especially women of color.

The Sistah Care campers are hoping this bill will mean the difference between life and death in their community.

These young women know intimately that race is still a huge indicator of whether our babies live or die, according to the Urban League of Portland’s State of Black Oregon Report 2009, which found that infant mortality rates for Black babies in Oregon were closer to Botswana and Sri Lanka than to the rates for white babies in the U.S. These disparities, experienced by women of color worldwide, are what ICTC, an international organization, addresses.

According to Monroe, the young women were asked earlier that week in at the Sistah Care camp if they knew anyone whose baby had been born too early. Out of the 10 young women, three raised their hands: “My grandma,” “my aunt,” “my mom.”

“They know,” Monroe said sadly. “They know this young that this is a real issue in our community.”

ICTC’s mission is to create a future where no one has to raise their hand in answer to that question. They focus on Black infant mortality prevention, breastfeeding promotion and work to increase the number of Black midwives, doulas, and healers. A doula is a woman who provides non-medical support during pregnancy, labor, birth, and postpartum.

For the 20 years that ICTC has been supporting Black women giving birth in Portland, they have heard anecdotally about the negative experiences they were having at the hospitals. They decided to survey the area’s Black women about birth experiences, to see if the stories ICTC was hearing were representative.

ICTC then linked up with Western States Center, a regional nonprofit dedicated to building a strong social justice movement in the west. ICTC and seven other organizations in Oregon, Idaho and Washington were part of The Center's reproductive justice project, Groundwork.

ICTC ultimately was able to gather 245 surveys, making it one of the largest surveys of its kind in Portland. The results confirmed what ICTC doulas and staff already knew; that Black women are not getting the support they need before, during or after giving birth.

ICTC found that almost one third of Black women surveyed gave birth alone. Seventy percent of the women had not taken a birth class or participated in birth education. And in a state where breastfeeding rates among new mothers surpasses the national average by a significant margin, Black women surveyed fell below the national rates by nearly 10 percent.

Over half of the survey participants reported some type of negative experience at the hospital. Examples listed included lack of information or feeling disrespected or humiliated, feeling discrimination or racism, or feeling in danger. Surprisingly, a significant number of women who had those experiences indicated they would give birth at the same hospital again.

Monroe mused, “I think it speaks to women of color feeling like they don’t have any other options. If five generations of your family has been born in this same hospital, that’s where you go.”

Over 70 percent of the women surveyed who had insurance had public insurance through a governmental entity. “This makes it even more pressing that our state government addresses these issues,” Monroe emphasized.

Monroe feels that having a doula, especially a doula of color, could change many of these statistics. “A doula who is from the same culture, who can speak the same language, can help support a woman through the birth process, can advocate for her in the hospital, can help her and even her family adjust to breastfeeding and all the other changes that come with a baby.”

This is why ICTC is advocating so intently for HB 3311. Monroe hopes that it will address the disparities in health care access, reduce the devastating numbers of infant mortality and low birth weight, and help provide payment for doulas under state insurance so that all women can have an advocate with them when giving birth.