These Black Doulas Are Taking On Iowa’s Maternal Mortality Crisis

In the overwhelmingly white state, Black women are dramatically more likely to die giving birth.
June 15, 2021, 3:32pm
Selchia Cain-Hinton
Selchia Cain-Hinton. (Photo by

Janae Gray of Black Lives of DSM)

Something Selchia Cain-Hinton wants people to know about birth work is that doulas don’t catch babies. 

“That's just something that we don't do. That's not our expertise. There's an extreme level of expertise and years of training to be a midwife and an OB [obstetrician],” she said. 

“We cover and provide that emotional and physical support with evidence-based education throughout the entire pregnancy. So, that's from conception, labor, birth, and then the immediate postpartum period. So, that's what a doula does.” 

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And sometimes, what a doula does is make breakfast.

July will mark a year since Cain-Hinton, 28, was certified as a holistic fertility doula through the National Black Doulas Association. The Des Moines, Iowa, resident is also working toward certification as a birth doula through DONA International, the world’s first, largest, and leading doula certifying organization. 

Additionally, she is a co-founder of the Iowa Black Doula Collective alongside Ebonie Bailey, of Davenport, and Jazzmine Brooks, of Ames. The organization will celebrate its one-year anniversary in August, and it’s working toward nonprofit status.

Iowa’s population is 90 percent white, and Bailey and Brooks were the state’s first and third certified Black doulas, respectively. The collective’s mission is to create access and provide education to support diverse birth families there, and Bailey and Brooks—who collectively have about a decade of doula experience between them—both act as mentors to Cain-Hinton. 

Selchia Cain-Hinton (​Janae Gray of Black Lives of DSM)

Selchia Cain-Hinton (​Janae Gray of Black Lives of DSM)

“When I step into a birth experience, I'm not stepping in alone. I'm stepping in with the experience and knowing that I can call on mentors to help guide me through things that I don't know,” Cain-Hinton said. 

In fact, the recent birth of Bailey’s fifth child was meant to be a learning and mentoring experience for Cain-Hinton, who acted as her doula. That was the plan, anyway.

“Of course, when you make a plan, God laughs in your face,” Bailey said. 

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Within the same 24-hour period that Cain-Hinton supported her first birth—which she did virtually, due to COVID-19 restrictions—she received a 1 a.m. call from Bailey. It was time. 

But then, Bailey, who was having a home birth, went into precipitous labor, meaning she delivered her baby within three hours of experiencing regular contractions. It hadn’t happened with any of her previous four deliveries, and she noted most people labor between 12 and 24 hours before delivering. 

By the time Cain-Hinton arrived at Bailey’s home, the baby was there, and mother and child needed to go to the hospital. This changed the birth plan, and Cain-Hinton did what doulas do: She rolled with it. She helped Bailey’s husband pack their bags and held down the fort for the couple’s other four children. 

“My being a doula meant a lot of different things in that space,” Cain-Hinton said. “I went from serving Mom during that time to serving her partner and making sure that he felt supported because of the things that were happening with the home birth, to actually serving their family, and being there when their kids woke up and making breakfast.” 

“Selchia’s just been a blessing, not only to myself but helping my other kids adjust after baby was born,” Bailey said. “Selchia is a part of our family. My kids trust her, I trust her.” 

The three women are equals in the Iowa Black Doula Collective, but Bailey and Brooks describe Cain-Hinton as the face of it. She’s the one who does most of the media interviews, responds to emails, and has built the program’s digital identity. 

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Brooks loves that Cain-Hinton is not afraid to ask for help. She noted a lot of doulas isolate themselves in birth work, whereas Cain-Hinton has no issue reaching out to her mentors no matter how late in the evening it is or early in the morning.

“She relies on us, and I feel like there is a sisterhood between us and she is definitely that person that brings us together,” Brooks said. “She’s the calm one, she’s the rational one; you have me who is super Black and extra—pro-Black everything—you have Ebonie who is the balance on the other end, and you have Selchia, who brings us together.” 

Selchia Cain-Hinton (​Janae Gray of Black Lives of DSM)

Selchia Cain-Hinton (​Janae Gray of Black Lives of DSM)

Being able to support one another is a reason the Iowa Black Doula Collective was formed. Brooks noted that having an in-state support system has been crucial for her, especially during longer births. Another reason was to bring awareness to the fact that Black doulas exist in Iowa.

“Most of the doulas here are white women, and most of them are stay-at-home moms,” Brooks said.

Each of the women operates her own doula service—Cain-Hinton’s is Amethyst Beginnings Doula Services, where she provides free consultations—but the collective gives them a platform to reach more people with their advocacy. Through the Iowa Black Doula Collective Facebook page, they host Facebook Live videos with other birth workers, reproductive advocates, and specialists. They also share articles and statistics and, most importantly, make it easier for people to find Black doulas in Iowa.

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 According to the Centers for Disease Control and Prevention, Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women. That rate is even higher in Iowa: A 2020 report by Iowa’s Maternal Mortality Review Committee found that pregnancy-related maternal mortality was 9.4 deaths per 100,000 live births overall, but that number rose to 36.9 per 100,000 live births for Black women. The morbid statistics aren’t new to Cain-Hinton. She approached Bailey about becoming a doula in January 2019 because she wanted to make a difference in the delivery room for Black women. 

“The reason that Black birthing people are dying is due to racism and bias and Black voices not being valued,” she said. 

“And I'm not going to say that the [higher] mortality rate of Black women and people of color and birthing people of color is new; it's not,” Cain-Hinton said. “It's just getting more visibility than it has before and people are starting to pay attention.” 

A famous example she gave was that of Serena Williams, who nearly died after delivering her daughter, Olympia. The tennis star has a history of pulmonary embolisms and told a nurse about her condition. She requested blood thinners and a CT scan when she noticed familiar symptoms, but the nurse overlooked her concerns. Williams was eventually given a CT scan that showed multiple small blood clots in her lungs, after which she finally received the blood thinners she requested. Her total hospital stay was extended another six days—including another surgery—followed by six weeks of bed rest.

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“All the money in the world wouldn't have made a difference,” Cain-Hinton said. “She still wasn't heard. She still wasn't trusted by her physicians and supported and people weren't listening to her about her body. And she is far more well-off than any person of color in the state of Iowa.”

“So, when you start to hear those stories and then you start to look at how just non-diverse Iowa is, you start to see a gap. I started to ask myself, ‘How can I help? How can I step into the gap?’ Because the need is great. The need hasn't changed.”

Becoming a birth worker allows Cain-Hinton to provide a much-needed service in a state where people of color have difficulty finding people in the healthcare sector who look like them. 

“Black doulas are helping to level the playing field that are caused by this racial bias and the healthcare disparities,” Cain-Hinton said. “We're there to advocate and make space for and value the voices of our clients in space where they're oftentimes undervalued or not heard.” 

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Correction: This story has been corrected to reflect that Cain-Hinton is certified through the National Black Doulas Association. We regret the error.