Doula Zuri Davidson remembers a client whose baby was sunny side up. This occurs when the baby’s head is down and its spine rubs against the mom’s spine. It normally makes for a longer and more intense labor process.

Davidson’s client was going through a lot of pain, and she noticed the dismissive behavior from hospital staff.

“The communication was just terrible, how she was being treated. Anytime we asked for things, it was almost like we were annoying, or asking for too much, or doing too much,” said Davidson.

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“It just wasn’t helpful. She was already trying to cope the best she could given the baby’s position. So, ultimately, it led to a C-section, but that urgency wasn’t there, the compassion wasn’t there, from the nursing staff to the providers. In that case, it was a Black nurse in that space as well.”

Davidson became a Birth and Postpartum Doula almost three years ago because of fears she experienced during her own pregnancy.

The Indiana Department of Health’s Division of Maternal & Child Health released a 2021 report on the state’s infant mortality rates.

Disparities among Black mothers and babies

There were 536 infant deaths – the death of an infant before his or her first birthday – across Indiana in 2021, making the infant mortality rate (IMR) of 6.7 per 1,000 live births significantly higher than the 5.4 U.S. rate.

In Indiana, the white IMR was 5.4 per 1,000 live births, Hispanic IMR was 8.1 per 1,000 live births and Black IMR was 13.2 per 1,000 live births.

The report also found that in Indiana Black infants are more likely to be born with low birth weight.

Black and Hispanic women are more likely to not receive early prenatal care in the first trimester.

Black women are less likely to breastfeed after being discharged from a hospital.

White women are more likely to smoke during pregnancy.

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“In all honesty, I have not been in a hospital to accept a birth in over a year. I intentionally did that to step away, to do more education about maternal health, and I can’t tell you anything that has gotten better,” said Joslyn Cunningham, founder of Blissful Birth Doula Services.

“I think that there are more people aware that this is an issue, and there are now more conversations on how to fix it, but the issue is bigger than doulas. It’s bigger than ob-gyn’s. It is a systemic issue as a whole.”

Causes of infant mortality rates in Indiana

The largest cause of IMR in Indiana was perinatal (the number of weeks immediately before or after birth) risks at 43.1%.

Birth defects made up 23.5%; SUIDs (sudden unexpected infant death) made up 16%; Assaults and injuries made up 4.9%.

Recommendations from the state’s health department suggest improving overall health for women of childbearing age.

Promoting early and adequate prenatal care, increasing breastfeeding duration and exclusivity, and decreasing early elective deliveries before 39 weeks. Decreasing prenatal smoking, and substance use would also help.

Other recommendations include supporting birth spacing and interconception wellness along with promoting safe sleep with infants.

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Changing the way Indiana approaches women giving birth

Joi Crenshaw – a certified professional midwife (CPM), providing perinatal care and attends home births around the Indianapolis area – was the Indiana Birth Coalition’s first Black CPM who also offers postpartum services to her clients.

She said Black women are still not listened to and have to deal with microaggressions in Indiana health care systems on top of the stress of giving birth.

It can cost them and their babies their lives.

“I have clients that don’t trust the hospitals, and they are looking for care that is individualized and personal. Last year, we served over 2,000 families, which doesn’t sound like a big number, but our small practices in the landscape of births in Indiana are a big deal,” said Crenshaw.

“You know, there’s policy and recommendations, but I would love for us as Black women to reclaim our power in the birthing. Whatever they choose, you don’t have to go to a hospital to have your baby knowing these rates are out there.”

Cunningham said there needs to be more of a community effort within Indiana to support Black women and babies.

“From midwives to ob-gyn’s and nurses or hospital systems and doulas, we are not actually building relationships with other people in the birthing network. Even with legislators, we have to learn from one another,” said Cunningham.

Contact staff writer Jade Jackson at (317) 762-7853 or by email Follow her on Twitter @IAMJADEJACKSON.