This is part of a series of stories about people working on solutions to New Hampshire's maternity care challenges. Catch up on more of our coverage here.
Across the country, Black women face higher risks of dangerous outcomes during and after pregnancy. According to the latest data from the Centers for Disease Control and Prevention, Black women are three times as likely to die of pregnancy-related causes than White women.
Here in New Hampshire, some are trying to address those disparities by bringing more diverse perspectives to doula care. A small but growing cohort of Black women in New Hampshire and the surrounding area are entering the profession, which has long been a largely white workforce. While they don’t work exclusively with Black clients, they say their perspectives about the challenges that Black women face when giving birth is an important asset.
Read on to get to know a few of the women who are leading this change.
Kizzy Bailey, Francestown
Kizzy Bailey has worked as a doula for the last four years. In her work, she doesn’t deliver babies, but she focuses on instructing new parents on what to expect — assisting them when the time comes and following up after birth to make sure they aren’t overwhelmed. Sometimes, she’ll help with their household chores, or make sure mom is fed.
“A lot of my clients, especially in the beginning, it's like, ‘I go to the doctors, I pee in a cup, they measure my belly, they say I'm OK, and then I leave,’” she said. “There's no nurturing there. And I get it. I know they have multiple people coming in throughout the day, but I feel like there should be more with that."
That's where Kizzy's work comes in.
"They update me after their appointments. I check in on them often," she said. "I tell them: Text me as much as you want. I like getting to know you. The more I know you, the better I can support you.”
"It makes a difference when you have somebody next to you telling you: It's okay to hate it, it's okay to not love it. It's okay to have a baby and be like, oh my God, what were we thinking? And doubt yourself. It's a normal feeling."
Much of Kizzy’s approach to doula care is informed by her own experiences — good and bad — giving birth in New Hampshire. When she had her first child in 2000, it wasn’t a great experience. Her partner wasn’t supportive. And she felt invisible to her medical team. She says the doctors and nurses only came to check vitals, not to check on how she was doing overall, and they didn’t inform her about when the birthing process would begin.
Kizzy felt like that lack of attention was in part because of who she was: a 23-year-old biracial woman, who didn’t grow up with a lot of money. (She jokingly describes herself as “the whitest Black girl in New Hampshire.”) She says she wondered if her doctors and nurses thought she was an irresponsible parent. At one point, around 3 a.m., she grew even more concerned and alone, so she called her mom. A nurse, she recalls, admonished her for waking her mother up.
“As soon as my mother got there — my mother is white — everything changed,” Kizzy said. “There was a nurse in there all the time. Everybody was being very gentle. When my midwife got there, everything changed. She was beautiful. She was the one that I was, like, locked into when I was pushing my baby out.”
But even after her baby was born, Kizzy still struggled. She had difficulty breastfeeding and she worried that she wasn’t enjoying motherhood as much as she was supposed to.
“I was touched out. Which happens when you have a baby. It's a very normal thing to hate breastfeeding, even if you are successful with it and end up doing it for a year,” Kizzy said. “Those first three weeks are the hardest. You're sore, you're healing, you're uncomfortable, and you have this body attached to you pretty much 24-7.”
She called a nurse to help her figure out why nursing her daughter was causing so much disconnection, and the nurse told her that most mothers liked breastfeeding.
“I hung up the phone and I stopped breastfeeding, and I was like, ‘I can't do this. There's something wrong with me. Obviously, I'm not a good mother because if most mothers like this, I hate it,’” Kizzy recalled.
When she had her second child, eight years later, it was a totally different experience. She had a more supportive partner, but she also had a more supportive medical team. And she felt like her concerns and questions were taken seriously.
“I was surrounded by people that are like, you've got this, you can do this,” Kizzy said. “It makes a difference when you have somebody next to you telling you: It's OK to hate it, it's OK to not love it. It's OK to have a baby and be like, oh my God, what were we thinking? And doubt yourself. It's a normal feeling.”
Camilla Thompson, Exeter
As the maternal coordinator for Black Lives Matter New Hampshire, Camilla Thompson is leading an effort to address maternal health disparities — including expanding more doula support for people of color. Camilla herself recently became a doula, starting this year.
“I have a two-year-old and, you know, it's going to be some odd years until she is a parent... And I don't know if she's going to be a parent here in New Hampshire, or if she's going to be somewhere else. But I want to make sure that the healthcare system is set up for her and not against her.”
She said she has long wanted to work in obstetrics, and her mom encouraged her to look into doula work when she was 15. She decided to get into the profession after having a traumatic experience while giving birth to her fourth child, where she didn’t get enough anesthesia during her C-section.
“I had to sit with that trauma for a couple weeks before I even spoke up,” Camilla said. “My son was born early January. It wasn't until the end of January that I finally decided to speak up against it, because I had to sit with that. It was — it's hard to, even now, it's hard to communicate in words what that feeling was like.”
As the C-section was happening, she said she had a hard time advocating for herself. At one point, she remembers sitting on the anesthesia table and saying that she felt like she was going to fall — but the anesthesiologist brushed away her concern. She did end up falling off, though a nurse caught her before she hit the ground. She says her husband had to speak up that his wife was in pain.
Camilla says it wasn’t just that she felt like her medical team wasn’t listening. She says she was embarrassed to seem like she was pushing back on her doctors, since she generally trusts science — and trusts the people who’ve gone through so much training to take care of her. Plus, she had delivered all of her babies at the same hospital, and she really loved working with them before.
“I think that I was embarrassed to say something, because I loved them so much, and I didn't want them to think that I was blaming them, or I wanted anything out of it, or I was trying to cause an issue,” Camilla said. “I think that's why I sat with it for a long time. But the nurses on labor and delivery were so helpful and they advocated for me as well. So, you know, trust yourself, trust your people, and always try to find a better outcome because we learn more when we know more. Right?”
These days, Camilla also works as an abortion doula. She has had two abortions, and she uses that firsthand perspective to offer care to people seeking answers on what’s going to happen during and after that procedure. She’s also looking at becoming a death doula.
In all of these contexts, she says doula work is about helping people advocate for themselves.
“I have a two year old and, you know, it's going to be some odd years until she is a parent,” Camilla said. “And I don't know if she's going to be a parent here in New Hampshire, or if she's going to be somewhere else. But I want to make sure that the healthcare system is set up for her and not against her.”
Nnenne Odukwu, Somerville
Nnenne Odukwu is similarly inspired to improve the healthcare system for the people she loves, in her work as both a nurse and a doula. She’s based out of the Boston region but works with New Hampshire moms.
She’s always wanted to handle deliveries since she was a kid, delivering babies with her dolls during recess and she says her nursing background influences how she approaches her doula work.
“I got my first job in cardiac surgery. So then seeing how many people of color, especially women of color, have cardiac issues after pregnancy, I was really intrigued,” Nnenne said. “I saw a lot of particular women on that unit as well. That a lot of their cardiac issues of needing surgery came up directly postpartum.”
Nnenne said people in the medical field didn’t really understand why she wanted to become a doula rather than a midwife. (Midwives are medically allowed to deliver babies, where doulas cannot; Nnenne says among some people, midwives are more respected than doulas.) But doula work was more intimate to her.
As a nurse, Nnenne wants to make sure people have autonomy over their healthcare – preparing them to understand risks and benefits of decisions they’re making. As a doula, she’s filling in the gaps between what medical providers are thinking and translating it to her clients, so everyone is on the same page.
Even as Nnenne and others work to expand access to doula care, they say there’s still work to do. A lot of people are deterred by the cost, and insurance coverage can be tricky. Nnenne says it can be hard to make sure her rates reflect her care and work while also wanting to serve the people who need this care most.
“A lot of the issues that we see are not less not necessarily all race based, but they're definitely class based,” Nnenne said. “In order for me to feel paid and be able to offer this service, I need to offer a certain kind of amount. But at the same time, to the people who really desperately need this, who are immigrating to this country, who don't really speak the language, who don't understand the system to begin with? They're the ones who also need this in real time.”
So for Nnenne, she’s paying attention to how people of color can walk into a delivery room or medical office already apprehensive about the care they’re going to get and she wants to let them know she’s with them.
“Honestly we're rarely ever talking about like, their pregnancy as a whole,” Nnenne said. “We're really just talking about their lives, you know, just like the things going on, like, ‘How are you feeling? Are you feeling seen? Are you feeling heard?’ And sometimes, you know, like I let them take the lead.”
And if they don’t feel heard, Nnenne says, she just listens.
Cheyenne Bell, Greater Boston
Cheyenne Bell says she knew that this line of work was for her since she was 14, when she helped her mom give birth to her little sister. She officially obtained birth doula training in 2023.
She’s worked in a lot of different hospitals around the Greater Boston region, and she said it’s been a mixed bag. Some are really supportive of doulas, where others are not, and that’s where she sees discrepancy of care.
“People are afraid to say no or to push back or to offer an alternative opinion,” Cheyenne said. “I think doulas help moms, especially Black moms, feel that empowerment to at least be able to be like, ‘Wait, hold on a second. I have instincts here, too. I know something about my body, about my baby that you don't know, but let's work together in this.’ ”
She said it’s not that doulas can promise a trauma-free birth, but they can assist in making sure the birthing parent’s voice is heard.
“The Black moms that I work with are fearful of not being listened to, not being seen. Especially because the Black maternal health statistics [are] so poor – that we're three to four times more likely to die than any other other mom out there,” Cheyenne said.
Given those disparities, she said for many of the moms she works with, doula care isn’t just a “nice thing” to have — it’s a matter of life and death.
“It's more of like, ‘I want to make sure I survive this, I have a good experience, that's someone's going to listen to me, that's someone's going to be there for me,’ ” she said.
Cheyenne said many of her clients are intentionally seeking a doula with whom they can build a connection. So that means if there’s a mom further away, she wants to make sure she’s there and available to support them in any way she can. Sometimes during the births things can feel rushed so doulas, Cheyenne said, can really help their clients make the space to figure out the right decision for them.
She says this kind of support isn’t just important for Black moms, but also for anyone who might not have a lot of family or friends around to support them through the birthing process.
“We don't have the village that we used to have where we had the moms, aunties, grandmas all around to be able to help and support and impart that wisdom. We don't have that anymore,” Cheyenne said. “Everyone's more in their own silos, or families are so far away, and different things like that. So doulas would kind of help bring that community into where they are getting this kind of hands-on support to kind of show them how to take care of their baby, how to take care of themselves.”
We want to hear from you: What do you wish you knew before you had a baby here? What made a difference for your family when you, or your partner, were pregnant? Where were you surprised to find support — or, where did you feel like you needed more help? Let us know at voices@nhpr.org, and your stories could help shape more of our journalism on this topic.
