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Doulas Like Maya Jackson Want to Heal Durham’s Black Maternal-Health Crisis

High school senior Jazmir Taylor was excited about being pregnant. The petite 17-year-old Durham teen looked forward to having her baby, graduating, and then enrolling in college to study nursing.

“She found out she was pregnant in late December,” says Jada Martin, her 18-year-old sister. “She was very excited and started to get even more excited when it was time for him to come, two months before. She knew it was going to be a boy and had already picked out his name: Juelz. She wanted it to start with a ‘J’ because all our names start with a ‘J.’”

Martin says while her sister was pregnant, she slept a lot, ate, and laid around the house. She had prenatal care and regularly went to the doctor for checkups.

Jazmir Taylor gave birth to her son on September 3 at Duke Regional Hospital on Roxboro Road. Mom and baby went home on September 7. The next day, she started complaining about pain and went back to Duke Regional.

“She was saying she couldn’t breathe, basically,” Martin says. “They couldn’t get her blood pressure down.”

On September 10, Jazmir Taylor died in the hospital where she had given birth just a week before. She was a month shy of turning 18.

Taylor was the youngest of five children. The teen’s devastated family isn’t sure what killed her, and officials at Duke Regional haven’t talked about her cause of death. Now her parents are taking care of baby Juelz—who just turned one month old—as they await Jazmir’s autopsy for answers.

“She didn’t deserve this,” Martin quietly says.

In a statement to the INDY, Duke Health officials said although the hospital could not comment on individual cases due to patient privacy concerns, “our hearts go out to families grieving the loss of a loved one.”

“We are dedicated to providing excellent care to all of the communities we serve,” the statement reads. “We acknowledge the racial disparities in maternal health that we experience in our state and nation and have a long-held commitment to eradicating these disparities as one of the most important missions in our care of patients.”

Black maternal health advocates say Jazmir’s death is just one example of how the Black maternal health crisis plays out in Durham.

Every year, about 700 women in the United States die from childbirth or pregnancy complications, according to the CDC, giving this country the highest maternal mortality rate of any developed nation in the world. Within those numbers, the health disparities faced by expectant Black women and women of color are even more disturbing. Black women are about three times more likely to die due to pregnancy-related causes than white women, and often report being mistreated during their pregnancies.

According to the NC Center for Health Statistics, last year in Durham County, Black women were 1.6 times more likely to die in childbirth than white women. Black maternal-health advocates say the maternal mortality rate in Durham County is relatively low, owing to health, technological, and educational resources that are not available in rural areas. Yet in 2018, the Durham County infant mortality rate among Black newborns was more than three times higher than white babies.

Improving health outcomes, from the grassroots

A battery of local organizations led by Black women are trying to address the crisis by wrapping expectant mothers in a bundle of services to keep them and their babies alive and healthy.

Equity Before Birth, a new nonprofit started in August, works to decrease Black infant and maternal mortality rates by identifying Black-owned and Black-led businesses to sponsor prenatal care and postpartum support for expectant Black moms. Of particular interest for the organization is supplementing the incomes of low-income mothers who don’t have paid maternal leave, Executive Director Joy Spencer explains. The nonprofit is sponsoring three pregnant mothers this year by supplementing their incomes and providing them with birth doulas.

“Giving birth is very strenuous on the body,” Spencer says. “We have a lot of working-class women who have no choice but to work hourly wage jobs without a paid maternity leave plan. They have to go back to work, two, four, or six weeks after giving birth, before their bodies heal. But if they are given time for their bodies to heal, it improves their health outcomes over time, and spending more time with the baby promotes the baby’s health.”

A second agency, Endayo, emphasizes wellness in its support of Black women with birth doulas, life coaching, and workshops. The goal is to create safe spaces and emotional support that affirms, empowers, and uplifts Black moms-to-be by focusing on their life experiences and wellness practices.

The nonprofit Helping Each Adolescent Reach Their Spark, or H.E.A.R.T.S., educates and equips teen parents to become independent and self-sufficient. Birth doulas are at the center of Mobilizing African American Mothers Through Empowerment, also known as MAAME, which trains doulas and advocates quality maternal care for Black, Indigenous, and women of color. Meanwhile, a group called the Renée offers a discussion-based community to address issues of pain in Black maternal care.

The nonprofits are anchored by Sankofa Birth & Women’s Care, the only practicing Black-owned midwife center in the state.

Maya Jackson, a trained doula, says she founded MAAME in 2018 to decrease maternal-health disparities among Black women.

“The United States has the worst maternal-health outcomes among the developed nations in Europe and Asia. The United States is at the bottom,” Jackson says. “A lot of it has to do with our society not valuing birthing people as much as it values politics. We say we’re pro-choice and love babies, but the system doesn’t reflect that. A big issue in North Carolina is Medicaid has not been expanded. We have a lot of families who are falling through the cracks.”

Spencer, the Equity Before Birth director, says the goal is to fill those cracks in order to catch anyone who might slip through.

“What we want to do is bridge the gap between the community and medical institutions,” Spencer says. “We need the experiences of the people who have lived through these situations to be valued.”

Spencer points to an unofficial network of women whose own pregnancy experiences have taught them how to wrap support around expectant Black moms that’s not acknowledged by the medical system: making sure new moms have access to food, doulas who help before and after birth, transportation, car seats, and even something as mundane and yet essential as shoulder rubs.

“There’s a lens and unique perspective that those who only know of the situation through formal educated might not be able to see,” she says.

According to a study published in a 2019 edition of the Reproductive Health Journal, women of color who gave birth in hospitals and expectant mothers who face social, economic, or health challenges reported higher rates of mistreatment. Expectant moms who reported the highest rates included women who had unexpected events like cesareans and those who disagreed with healthcare providers about the right way to care for themselves or their baby.

The 2,700 women who participated in the 2019 survey reported being shouted at or scolded by a health-care provider, being ignored, or their requests for help being refused. Some of the expectant moms also reported violations of physical privacy, and health-care providers threatening to withhold treatment or forcing them to accept treatment they did not want.

It also found that expectant mothers—no matter their race—were more likely to be mistreated by health-care providers if their partner was Black.

The study surmised that how people are treated during childbirth can affect the health and wellbeing of the mother, child, and entire family.

For Jackson, it’s basic.

“If the mom is thriving, the baby is thriving,” she says. “If mom is stressed, the baby is stressed.”

A life cut short

Jazmir Taylor was laid to rest on September 16, following a funeral service at the River Church in South Durham. There were nearly 100 people in attendance, including at least 20 expectant mothers between the ages of 16 and 30 who were part of Taylor’s circle of friends. Whit McWilliams, a doula who recently moved to Durham, attended the memorial service. She has some ideas about what likely happened to the radiant teen.

“She was young, Black, and on Medicaid,” McWilliams says. “That weighs on her story. The health-care providers just wouldn’t listen to her.”

The words of some of Taylor’s friends that day stuck with her.

“The community response at her funeral was heartbreaking but powerful,” McWilliams says. “Those who were pregnant were saying, ‘I need some type of support because what happened to her has scared me.’ And others were saying, ‘Man, this is another thing we have to worry about. We know about police brutality and the street violence that’s always there, but now the medical system isn’t safe for us, either.’”

A short history of Black midwives and maternal health

Maya Jackson, the founder of Mobilizing African American Mothers Through Empowerment, traces the doula and midwife tradition back to when enslaved African women worked as midwives literally birthing America.

“They were either helping massa’s wife deliver the baby, or then wet nursing white babies while our babies starved,” Jackson says.

After Emancipation, newly freed women continued their work as midwives, particularly a group known as the “Granny Midwives” who delivered thousands of Black and white babies across the South, including North Carolina, she says.

Jackson explained the Black midwife’s work was diminished during the Great Migration that began in 1916, when Black Americans migrated North and there was a demand for a more “sanitized” and “safer” hospital care in the maternal-health field.

She also notes that some maternal health-care providers still subscribe to the notion that Black women cannot feel pain, which dates back to the tragic misuse of Black women’s bodies by the doctor James Marion Sims, the father of gynecology.

In her latest book, Caste: The Origins of Our Discontents, Pulitzer Prize-winning author Isabel Wilkerson chronicles how Sims arrived as his discoveries in Alabama by conducting savage experiments on enslaved Black women that ended in disfigurement or death.

“He refused to administer anesthesia, saying vaginal surgery on them was ‘not painful enough to justify the trouble,’” Wilkerson wrote. “Instead, he administered morphine only after surgery, noting that it ‘relieves the scalding of the urine,’ and ‘weakened the will to resist repeated procedures.’”

With total control over Black bodies, Wilkerson added, Sims would “force a woman to disrobe and get on her knees on a table. He would then allow other doctors to take turns with a speculum to force her open, invite leading men in town and apprentices to see for themselves.”

The medical profession’s attack on Black women’s bodies continued into the late 1970s. It took many forms, including a notorious eugenics program in North Carolina. According to a recent report co-authored by Duke professor William A. Darrity Jr., the 10-year program of forced sterilizations was designed to “breed out” what administrators considered a “surplus population” of unemployed Black women.



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