Over the past month, we checked in with our 2024 grantees to learn how their funded programs, projects, and initiatives are progressing – and to better understand the impact they’re making across Los Angeles. Now, we are excited to share these interviews, with stories of growth, challenges, and community transformation.

Birthworkers of Color Collective received funding through the LA2050 Grants Challenge from the Goldhirsh Foundation to support training culturally competent doulas to address racial disparities in maternal health outcomes. Below is an edited transcript of our conversation with their team.

LA2050: Birthworkers of Color Collective diversifies and expands our local Doula workforce. How do Doulas – and in particular, culturally competent Doulas – facilitate improved birth outcomes?

Birthworkers of Color Collective: Doulas, and in particular culturally-competent, social justice-informed Doulas, play a crucial role in improving birth outcomes by providing emotional, physical, and advocacy support to individuals throughout their pregnancy, labor, and postpartum. Many of the families that we serve have experienced trauma as well as systemic barriers and biases within the healthcare system which has led to a lot of mistrust, and hesitancy when working with medical providers. Our Doulas are specifically trained to be aware of access barriers and to build that trust by offering compassionate support and person-centered care throughout folks' journeys.

Doulas who come from the same communities, share the same backgrounds (cultural, ethnic, religious, socioeconomic, language, etc) really understand the unique dynamics that our clients are experiencing, and offer support in a way that makes sure that folks are heard, seen, and empowered in the process.

Doulas are critical and essential members of the care and support team. The research is showing that Doulas can have a positive impact on people's pregnancy and birthing experiences and reduce the likelihood of costly interventions. This is critical for communities of Color, especially for Black and Indigenous families, who experience disproportionate levels of perinatal/infant mortality and overwhelming health disparities. Even here in LA County, there have been many cases of families being dismissed, their pain overlooked by healthcare providers.

LA2050: How are you navigating the challenges of our current healthcare landscape, and what successes have you seen?

Birthworkers of Color Collective: Doulas are navigating unique challenges within the current healthcare landscape. Although support and awareness of the benefits of doula support are growing, there are still tensions in the form of systematic racism and microaggressions when we enter hospitals and healthcare facilities with our clients. Doulas are often viewed as adversaries to medical systems and providers, as we advocate for client-centered care amidst hospital protocols and policy. In addition, with the rapid expansion of doula coverage among Medi-Cal and private insurance, Doulas are navigating new challenges of financial barriers, insurance billing, and contracting with managed care plans. These dynamics make community doulas especially vulnerable to exploitative contracts and negotiation practices and potential financial and legal concerns. We must ensure that doulas are lifted up as an important partner in the fight for maternal and infant health equity but not the sole solution. That requires consistent investment in the leadership and support of community based doula groups like ours.

A big piece of the advocacy work Birthworkers of Color Collective and our partners are leading around the new Medi-Cal Doula benefit is shifting the narrative. The California Department of Health Care Services just released a letter signed by multiple managed care plans affirming that doulas are an essential member of the care team to be welcomed in the hospitals, and not treated like visitors. Hospitals and providers who back the letter are helping to usher in this new wave of welcoming Doulas as a valuable part of the care team, and it didn’t happen by chance it was a result of the hard work and advocacy of many doula organizations, stakeholders, and community organizers.That's a really huge win since even a couple of years ago, and especially during the beginning of the COVID-19 pandemic, doulas were not allowed to enter hospitals or support their clients in labor.

We are also so proud of the sheer number of doulas that we have been able to help through the Medi-Cal contracting process over these last years, and especially the last six months with this funding. In the beginning of 2023 when the Medi-Cal benefit first started, we started with two medi-cal approved doulas growing to 15 Medi-Cal Doulas, and counting as we have collective members reaching out to us weekly for next steps. While also training hundreds of doulas in the approval process by providing multiple monthly PAVE trainings for doulas in the larger community needing educational and/or hands on support. As a result of the outreach and presence at community events, we have also had such an influx of individuals and families requesting doulas, and it's really beautiful to see.

LA2050: What do you hope to achieve in the last six months of the grant, and how can the broader LA2050 community support?

Birthworkers of Color Collective: Looking forward, we want to train even more doulas so that every neighborhood and every community in Los Angeles has local doulas ready and available to serve. We invite everyone who is interested to take a Doula training and get involved. We've experienced an influx of agencies and community-based groups sponsor their staff, students, and their volunteers to get involved in our training. We love that we can promote this foundation of reproductive justice and birth justice to incorporate the work that they are doing. So, we would love to invite folks to participate, to come to trainings, and to share and amplify the opportunities that we have available.

We’ve been doing a lot of community based outreach, especially in parts of the county where we want to continue to expand. We go to various resource fairs, hospitals, clinics, community organizations and centers, community baby showers, and it's really special to be in community with folks. We really love being invited to different events, and having folks come to our events. People tend to think that doulas or our work are just for maternal or infant health spaces but honestly we love to connect this work to all areas of where and how we live, work, play, learn, and create—-it’s all interconnected!

Although we are seeing a lot more folks learn about the benefits of doulas in general, we can always have more support amplifying that message. We want doulas to be a household name and must have for every pregnant and birthing family in Los Angeles. We're curious about creative ways to market to like broader audiences, such as bus ads, radio promotions, and billboard campaigns. So if folks out there have that expertise in tech or marketing and want to help birth justice activists, that would be amazing.

We are also seeking support in growing out our organizational capacity, as well as economic growth and sustainability for BWOCC and for doulas as a whole. Many of our doulas are the first in their families to start a business and are in need of continued business coaching and support. We love the idea of partnering with institutions, organizations, and small business advocacy groups!

As a growing non-profit organization, with big dreams we are seeking funding and business partners who want to invest in the next generation of birthworkers in Los Angeles and our advocacy efforts.

To anyone reading this, whether you're a birth worker or not in the birth field at all… if this intrigues you, reach out to us. We would love to figure out a way to collaborate in a meaningful way!

Interview Participants:

Christina Lares, Programs Manager, christina@birthworkersofcolor.com

Andrea Howard, Medi-Cal Doula Program Coordinator, doulabenefit@birthworkersofcolor.com