A pregnant Black woman holds her belly and smiles kindly at the camera.
Image credit: cottonbro studio on pexels.com

Against the backdrop of the maternal health crisis in the United States, doulas, whose methods of supporting women and birthing people increase positive birthing outcomes, are part of the hope and promise for better maternal healthcare. 

In Chanel Porchia-Albert’s work with Ancient Song Doula Services, where she is the founder and CEO, she embodies the change that is so desperately needed in the United States. Through equipping people with knowledge so they can empower themselves and by being in community with the families she cares for, she is paving the way for more ethical and supportive birthing experiences for everyone, regardless of their race, their background, or their socioeconomic status. 

Her impact on maternal healthcare provision, maternal health policies and strategies in the United States and abroad, and methods for organizing to build political and social power around maternal healthcare are profound. She has served as a consultant on birth justice and provider engagement for the New York City Department of Health and Mental Hygiene, and is a member of New York City’s Commission on Gender Equity. She has served on several advisory boards, including Harvard School of Public Health and Columbia University Medical School. She has also served as a maternal health strategist in rural war-torn areas in Uganda. As a doula, she has attended more than 100 births at homes, in birthing centers, and in hospital settings.

Chanel Porchia-Albert, who was recently featured in a documentary film Ancient Song, spoke with NPQ about her career as a doula, her views on self-advocacy, and how her community-centered approach factors into her work to alleviate maternal health disparities.

Tonie Marie Gordon: Could you enlighten us as to how one becomes a doula?

Chanel Porchia-Albert: There are many different pathways to one becoming a doula. Traditionally, doulas were a part of our communities. They were members of our communities who supported the individual who was pregnant, from preparation before childbirth through the postpartum period.

Today, doulas take training with organizations or go through a certification process where they fulfill certain requirements. Here, at Ancient Song Doula Services, we have a rigorous 12-week course. Even after the 12-week course to become a doula, our students complete additional coursework and support individual birthing people to obtain their certifications.

TMG: What do doulas do?

CPA: A doula is someone who offers emotional and physical support as well as information so that mothers and birthing people can make informed decisions about their care. When we’re talking about working with Black, Brown, and Indigenous communities, we’re also talking about what it means to center the role of an advocate in the birthing room. This is important because of what members of these communities face when [they] are going to give birth. Regardless of insurance type, regardless of socioeconomic standing, Black women and birthing people still find themselves at a disadvantage when going into hospital-based institutions to give birth. So, as doulas, we’re helping with care navigation, preparation for childbirth, and education, which provides ways for people to advocate for themselves. We don’t advocate for folks; we give them the tools to advocate for themselves.

Sometimes we also act as a mediator or a translator. For instance, doulas can help people decipher what medical terminology means and what their options are so the birthing person, their family members, or their support team can come up with a plan that works best for them. The plan should align with what the mother or birthing person wants out of their birthing experience.

As a person who was coming into motherhood without a mother…I was seeking guidance that I would have gotten from my mom. Our midwife really guided us and affirmed us in beautiful ways, and so did our doula.

We need to understand that it’s not only about having a healthy parent and a healthy child, of course, we want that too, but it’s also about the experience of childbirth. How does the birthing person feel during that experience? Does the birthing person feel like their voice was heard? Does the birthing person feel like they were able to make an informed decision about their care? Does the birthing person feel like they were an active participant in their birthing experience? Or do they feel like things were happening to them?

So, the doula often acts as this individual who is helping the person who is giving birth to navigate situations as they arise. We have to keep in mind that these things are happening while a person is in labor—they’re having contractions, they don’t want to answer questions. They just want to be able to enjoy their experience and celebrate this beautiful child they brought into the world, and bond with that child. So, doulas try to take some of that [unpleasant] stuff out of it, so that people can have the experience they want for themselves.

TMG: Can you tell me about your trajectory, how you became a doula, your work, and the career accomplishments that have set you on this path to make maternal healthcare more equitable? 

CPA: I’m a mother of six children. My oldest son is 15, I have 14-year-old identical twin daughters, I have a 13-year-old daughter, I have a seven-year-old daughter, and I have a six-year-old son. My children really laid the foundation for the work that I’m doing. My first son was born at home, I had a homebirth midwife and a doula who were both Black. And I loved the way my midwife took the time to explain things to me and my family and made me feel comfortable enough to ask questions. Each visit was about an hour long. As a person who was coming into motherhood without a mother, that was important to me because I was seeking guidance that I would have gotten from my mom. Our midwife really guided us and affirmed us in beautiful ways, and so did our doula.

And, so, I was seven weeks postpartum, and I took doula training. There was an organization that doesn’t exist now called the International Center for Traditional Childbearing. At the time, that was the only doula organization that primarily focused on doulas of African and Caribbean descent and Indigenous doulas. Not just doulas, but midwives and healers of different sorts. They had a conference in Harlem that I attended, and it was amazing—it was transformative, it was the first time I had been in a room full of women where I felt like I was being held. I was a mother with a young child, but people were mothering me at the same time. And I just remember that feeling, and I was like…wait, why doesn’t everybody know that they have access to this? This should be common knowledge. So, I completed my doula training and I started to attend births.

I was attending births for low-income, Black, and Brown women, and I started to see the ways in which people are criminalized at [the] bedside. People were being criminalized for trying to affirm their choices; I saw the police being called on people’s partners or security escorting them out of the [birthing] room. I remember seeing folks illegally drug-tested, and parents being told that they can’t take their child out of the hospital with them. So, based on all that I was seeing, I put a call out on a listserv, and more than 20 people came to my house. I asked them if they were experiencing the same thing. And they said yes. So, I was like, okay, if I’m not the only one who is experiencing this, then how do we shift this? How do we change this?

I looked up everything on maternal health going on in my area. I went to every single event that I could possibly find, and I introduced myself to every leader of a perinatal organization. I asked them questions about the populations they serve. And because I was asking those questions and because people started to see my face everywhere, we [at Ancient Song Doula Services] got our first contract as a perinatal health organization. And it was the first time since I started doing this work that I was able to pay people for providing services they had been volunteering. As we continued to grow, it [Ancient Song Doula Services] moved from my house to a very small office. We started providing services. We started networking. We reached out to people, we reached out to clinics, we reached out to hospitals. We went to block parties and community health fairs; we were in the community. You need to be where people are.

I was interviewed by Vice President Kamala Harris, which was exciting. I talked with her about the ways in which doulas can shift the conversation, shift the way people think about care.

I think people can feel it when someone is being genuine or when they’re not. And I was going to the places a lot of people don’t want to go, I was going to the community centers in housing facilities, and hosting community baby showers. I would talk to folks and ask them what they need.

And since then, Ancient Song has grown to the point where we work on legislative policy from a city, state, and federal level. And that is because, as a doula, I realized that I could help people one-on-one, in an interpersonal way. But I also realized that I could have a much more profound effect if I change the whole system, if I can change the whole framework of how care is delivered. That’s a huge problem. Our maternal health infrastructure in the US is not working for anyone. So how do we shift the ways in which care is provided? We can do it through policy, like the policies around insurance reimbursements. From early on, people would ask if I took insurance and I would say no because doulas couldn’t take public or private insurance at the time. But I started taking pictures of people’s insurance cards. So, through that data collection, being able to see what types of insurance were coming to us, I was able to ask questions about care networks and access so that people weren’t paying out of pocket. And that’s literally how it all started in terms of policy work.

Through this work, I was interviewed by Vice President Kamala Harris, which was exciting. I talked with her about the ways in which doulas can shift the conversation, shift the way people think about care. But none of that really matters without system-level changes. None of that matters if the policies that are in place are not shifted to work from a culturally humble perspective where individuals are able to create care plans that work for them. None of that matters if the states that these institutions lie within are not willing to invest in their perinatal workforce. Someone having a doula doesn’t take away all these other obstacles.

TMG: I want to hone in on the concept of empowerment. How can pregnant people feel empowered? How can women of color come into clinical settings feeling empowered? 

CPA: The doula should have the tools and the information to help women and birthing people navigate the healthcare landscape. Doulas can be a guide, but we can’t determine the outcome of anyone’s birthing experience. Sometimes, we [doulas] see things within a birthing experience, and we don’t have the power to do anything about it. There’s this misconception that as soon as you have a doula, everything is going to be fine. It doesn’t work like that because we, too, are going up against certain barriers. We may be doulas of color; we may find ourselves in a hospital that is not friendly to doulas. We may find ourselves in positions where a physician isn’t amicable with doulas.

When someone finds out that they’re pregnant, the first thing that they want to do is confirm their pregnancy. Once you confirm that pregnancy, you need to decide who do I want to assist me through my birthing process. And you have to think about your own personal values and the things that you hold dear. The best way to know that is to ask questions. I tell people that when you make that first doctor’s appointment, there’s always this assumption that you’re going with that provider, even though the provider shouldn’t make that assumption. You call an OB’s office and make an appointment; you get there, and the nurse does all these measurements, checks your blood pressure, puts you in a room and asks you to undress so you can get an exam.

I don’t like to use terms like courageous and radical because if you see something you have a moral obligation to do something.

Before you do all of that…just sit, keep your clothes on, let the doctor come in the room and tell them that you’re interviewing folks. You can tell them that you’re trying to understand if this is the type of care you want for yourself and for your family. Ask questions like, what is your philosophy around birth? Is this a private practice, or a group practice? Lots of people don’t know that if you go to a group practice, chances are that any of the doctors could deliver your baby even if every time you go for a prenatal visit you see the same person. If it’s a private practice, what happens if the doctor is in an emergency, does the doctor have a backup physician? There are certain things that women and birthing people should think about in terms of what they want for themselves. And if the doctor you’re meeting with can’t answer you or doesn’t make you feel comfortable, you don’t have to choose them. Understanding that this is a choice is important because this is one of the most sacred times of your life and it is one of the most vulnerable times of your life. You’re going through a physical experience where you’re birthing a human being. It’s important that you trust your care team, [trust] that they have your best interests at heart.

I tell people that they have the right to go anywhere they want to go, you have the right to center how you want to bring your child[ren] into this world. So, whether it’s a birthing center, homebirth midwives, or hospital-based care, visit them, interview everybody, see what feels good to you, and then make a choice. The sooner you begin that process, the better. Don’t wait until the end of your pregnancy to find support. A lot of it is about that prep work in the beginning, just asking questions. Even if you’re taking a childbirth education class, ask questions, there are no dumb questions. Ask all the questions and think about what you want for yourself.

TMG: What do you see as positive signs for the future?

CPA: I’m hopeful for the individuals who I know and the organizations that I know and have been in the field, and with all the things that are going on have been there to support communities in amazing ways, sometimes with little to no resources. And they find a way to make it work, but we shouldn’t be in a space of having to make it work all the time. That’s not the goal. What I’ve witnessed thus far is a level of fear that I’ve never encountered before. There is this weight in the air, [it feels like] things are going in reverse. And the more we see things go in reverse the more you will see desperate outcomes in terms of higher infant and maternal mortality rates.

I don’t like to use terms like courageous and radical because if you see something you have a moral obligation to do something. It doesn’t have to be something where you’re marching down the street and holding up a sign. But there is a responsibility of talking to one another and getting groups together. Finding strategic ways to move the conversation forward, working with allies you’ve never worked with before, and coming together to shift the narrative. You can’t be laissez-faire about your decision-making. You can’t be laissez-faire and say there’s nothing I can do—there’s always something you can do. I started Ancient Song in my house without two cents to rub together. It just doesn’t take much to do something.

TMG: What do you want people to take away from the documentary?

 CPA: I did the documentary because I want people to see what community looks like. These are loving spaces; we’re shifting the narrative of Black women dying and being in crisis to showing moments of joy. There are people out there who are lifting each other up. When you see the scene where we’re passing around donuts to the people waiting in line, the line that you see there is nothing compared to the line that is typically there, that was just the beginning. When we arrive in the morning people are already standing in line. Some of these women are migrants, they’re coming into a place where they don’t have any community, and they don’t have resources. The food pantries are over extended, diaper banks don’t have any diapers, you can’t get any formula. At Ancient Song, we’ve always had a donation closet. At the height of the pandemic, we converted our entire office into a warehouse. We didn’t have anything in there but boxes of stuff to give away and that’s what we did every month. We were giving out PPE and other essentials, we gave out food, and groceries. We delivered boxes to pregnant people’s houses because they didn’t want to come outside. It has grown and it continues to grow; it’s about being in community. You need to be with the people every single day. I just wanted folks to be able to see that. See the people who are behind the work and see the people who are training. Those are the people who either live or work in that community and want to make a difference in some way.

Some want to complete our training because they’re social workers and they want to better assist teen moms, some of them work in shelters, some of them are lawyers, and they want to know how they can best support someone who is going through this process. And so, doula training is not just for somebody who just wants to be a doula.

I tell people all the time, you don’t have to be just a doula, be a researcher. Be someone who’s in policy who’s a doula, be a social worker, be the nurse who also knows how to give doula care. Be a teacher or a school counselor so when pregnant people in high school come to you, you can guide them in a meaningful way. Be that person. It doesn’t mean that you have to support someone at bedside, but you should have the knowledge, and the information and the education so you can assist someone. To me, everybody’s a doula already, if you’ve ever supported someone emotionally and physically from a nonjudgemental perspective, you’re already a doula. The only thing I do in training is to impart additional skills on people to lift them up and help them understand how to direct their energy in a certain way, that’s it.

TMG: Is there anything else you want people to know?

CPA: I want people to know that there’s hope. We are our ancestors’ hope in the present and we’re creating hope for the future. And we need to be living in hope and having grace with ourselves as we navigate spaces that oftentimes feel confusing and that are continuously shifting. We need to be gentle with ourselves. Don’t beat yourself up about something you don’t know. But once you realize you don’t know something, then change it. Figure out how and what you need to know to feel centered in your reproductive health choices.

Choice is so important, when you wake up in the morning, and you breathe the breath of life, you breathe it from a place of choice. You’re able to decide. And that is because you are human. We have to be diligent about centering not only our individual humanity but our collective humanity and reflecting it back to one another. You have to do it even when it’s hard, when you’re angry or you’re frustrated, because there are people who want to see you in despair, who want you to feel like there’s no hope, like the odds are against you all the time. Live your life, center love and hope, have grace with yourself, have grace with other people, and everything else will be alright. Just do good and live.