So… Dr. Doula, why do you doula?

My conversations with Zinzile were rich and fulfilling while I was in South Africa. I used every available opportunity to ask questions about her work in maternal health with the Human Rights in Childbirth Summit: South Africa 2015, her experiences as the Zulu Doula, and her expertise as a town planner and the co-owner of Azania Strategic Urban & Rural Developers (Pty) Ltd in South Africa. I always find it intriguing to consider others’ processes and perspectives… Zee has much to share.

As we were awaiting our meals at a restaurant one day, we were discussing some of the experiences we had had together. We had visited some new mothers and their newborns the day before where out of the six mothers who had birthed, four had birthed by cesarean-sections, which they call caesars. Zee explained the high rates of c-sections at South Africa’s public hospitals and even higher rates at private hospitals.

Modern technological advancements in maternity care include c-sections for mothers that face medical challenges. Still, as with any major medical surgery, there are possible complications that have prompted the development of global initiatives to reduce c-section rates in an effort to improve maternal health.

At some point, Zee turned the video on me, asked me about my motivation for being a birth mentor and doula (among all of the other hats I wear), and pushed record.  Here was my impromptu response:

Wait… What connection between South Africa and Africans of the Diaspora…?!

With all of the conversation surrounding the relationship between Diasporic Africans and Continental Africans, I think it is the perfect time to share a unique connection between Africans of the Diaspora and Black South Africans that I had never heard before.

Khwezi with Alfred and Nosipho in February 2015 

I first met Alfred in 2015 during my first visit to Clermont, KwaZulu-Natal, South Africa. I had spent the entire day before watching his wife Nosipho cook meal after meal (she was the umpheki) as the rest of us chopped and chopped and chopped the different vegetables for each meal. I honestly had never seen cooking pots so big, but they were necessary to accommodate the steady stream of people who were coming during umsebenzi In preparation for the funeral and celebration of the life of the loved one that would occur over the next few days.


I have not talked much about that experience… perhaps I will some day. It was there in Clermont that I noticed the many similarities to what I had experienced during the summers at my grandparents house in rural Alabama throughout my childhood. So many things felt familiar… Perhaps I will share more about that some time.

Anyway, I first met and had an opportunity to speak with Alfred after the funeral. I was excited to see both Alfred and Nosipho last month during our traditional Zulu wedding celebration. After all of the greetings and introduction to my husband, he told me that he had something he wanted to say to African Americans. I was curious about what he would say. And once I heard his message, I promised I would share it.

“My name is Afred Mandlakayise Ziqubu. I’m from Umlazi. Umlazi is South of Durban. This… Clermont being west of Durban. I want to say something about YOU coming here to South Africa to have the ceremony… the wedding ceremony. People don’t know what African Americans are. Most of African Americans went to America as slaves, our forefathers, but the difference between South Africa, KZN which is KwaZulu-Natal, the difference is that people were sent by King Shaka to go and learn the wisdom of Americans in America. Which makes you, when you are coming here, you are coming to your home… your real home… this is your roots, so YOU ARE WELCOMED.”

Oh… and I will add this for good measure. African peoples have always honored greatly mouth-to-ear, spoken history. All (yes, I said ALL) of those who retain a connection to their family lineage know their family name(s) for many previous generations. (I have taught 13 year olds who knew.) This knowledge is most likely not given to them in a book or on a piece of paper, but it is written on their hearts through the sharing of oral histories. It is from that place and sense of knowing that this message is shared.

Let the unpacking begin…

The Mis-Education of Birth Culture

“White people! White people! White people!”
“Why am I angry?”
“Why don’t I wanna deal with white women no more…?”
“I am angry because they act like I don’t exist…”
“That’s not my truth…”
“You won’t even acknowledge me…”
“You say you love me, but when you come to me, everything you tell me is about how frail I am and how weak I am…”
“If it was a man… that’s foundations for abuse and to continue to accept that…….”
“Some of the things being said sound… abusive…”
“Would you want to live with someone… would you want to be with someone, if they only saw your flaws?”
“If your only narrative that you can find moving forward has to do with ‘Black Maternal/Child Health and Mortality’… if you don’t find more that you can say… you ain’t my friend… I’m not gone play with you no more… ‘cause you don’t love me…”
“You say you think I’m great, but you don’t…”
“If you say you love me, don’t abuse me.”
“If you say you love me, I’m expecting to hear you talk about my greatness.”
“Just tell the truth.”

PDvideothumbnailIf you are surprised to see those phrases as the first words of my post, you are no more surprised than I was to hear the words coming out of my mouth as I watched the video from ProDoula’s “Speak Your Truth” Conference. “Why?” you may ask. Well, because (if you know me) then you know how measured I am with my words. If you know me then you would know that those frustrations I vocalized during the conference about birth culture in the U.S. are usually reserved for my closest and most intimate companions. And usually the only audience that I allow to hear my innermost TRUTH about these types of things or how I really feel are other Black people.

How appropriate that the conference was titled Speak Your Truth.

So here is another bit of TRUTH that I have only shared with my husband. (Not even Randy Patterson knows this.) When Randy first asked me to be the Keynote Speaker at the conference, I was hesitant. Again, you may ask. “Why?” Well, because I had vowed I would never talk about Black maternal and child mortality again. I had ZERO aspirations of talking about dying Black women and babies for an hour.

First of all, I know that there are scores of women of African descent that are championing efforts. They are constantly working to make sure that inequities and inequalities in birth culture that propagate negative outcomes for Black women and babies are addressed properly through legislation, the medical system and any other area needed. But I also noticed something else that has crept into birth culture.

What I noticed is that at first (as recently as five years ago) birth culture was fighting the use of language that specified African Americans’ challenges in birth, then SUDDENLY it became acceptable to speak about it as a major reason that birth culture needed to be overhauled. And SUDDENLY that was ALL the majority culture wanted to talk about when they talked about Black women. Our STRUGGLE had become normalized and accepted as OUR NARRATIVE and OUR TRUTH by many. That is only the smallest part of our story.

But I never told Randy all of that when she asked me to be the speaker. In fact, we chatted by Skype several times over the summer, before and after my volunteer birth work in the Dominican Republic.

I mentioned being hesitant earlier in this post, but I did not tell the full reason why I was cautious. The complete TRUTH was that I was concerned that there would be a point where ProDoula might request to know exactly what I planned to say during my Keynote.

I ran scenarios in my mind of what I would do or say if anyone demanded to know what I would be speaking about… None of the scenarios ended well. I can’t say I had a cause to be cautious about sharing it with Randy outside of my own personal baggage. So why was (is) that so important to me?

  • Because I value my investment into my mind and my intellectual property is one of my most prized assets in life.
  • Because my experience and history has shown that Black people do not always get credit for their work when they share it. (i.e. The Patent Office).
  • Because I do not desire my thoughts and words to be censored.
  • Because I know that my TRUTH requires some statements like those found at the beginning of this post.
  • Because there was no way I was going to justify myself and my experiences at a Conference called ‘Speak Your Truth.’

This was all happening in the late Spring and early Summer of 2017 after statements had been made that were offensive to many African American birth workers about the topic of Black maternal and infant mortality. Some Black birth workers had decided to be DONE with white women in birth work and their organizations, especially those who proclaim Ina May Gaskin to be the ‘Mother of Midwifery’ and other white women as the originators of birth support in this country.


Randy never asked for specifics about my speech. And the fact that she didn’t ask made me even more nervous, because I knew as her friend that she was trusting me with something that is extremely precious to her: the membership of ProDoula.

As if that wasn’t enough, when I arrived at the ProDoula Conference, I was (literally) cornered by a few of the Black doulas. There were a couple who stared me in the eyes and said matter-of-factly, “You know YOU are the reason we are here, right?” “Ummm… huh, really?” was the best answer I could muster. They had no problem repeating what they had said and explaining themselves further. Another Black doula later said, “I am here to see if you are the REAL DEAL or if ProDoula just brought you here to get us to come.” Blink! BLINK!*


How was I to respond to that? These sisters had come with a certain expectation and NOW I was REALLY NERVOUS! How can one talk about Black women in birth without talking about the STUFF that is usually only reserved for family? When I asked them if they had my back, I meant it as a serious question. In retrospect, I believe I was able to speak TRUTH because of the energy I felt from those melanated women who had stood up front on that stage. I could feel them holding me up. I knew that they understood that for Black women, our TRUTH is not always welcomed, because it disrupts the fallacy of what many in the majority culture have been told is the TRUTH.

I have watched the video Erica created a few times now. I am finding myself referring to the speaker as “she” and “her” as opposed to “I” and “me”… It’s a little strange hearing myself say so much of my TRUTH so publically. I am still amazed that the ProDoula membership received me and my challenging message so well.

WhatsApp Image 2018-02-02 at 00.08.44

The other piece of OVERWHELMEDNESS occurred after I left the conference. Randy called me a week after the conference ended and told me that Erica would like to come for a visit to get some additional video of me. YIKES! Both Randy and I have stayed in each others homes before, so the visiting was not a huge deal. What was a MAJOR deal was that THERE WAS MORE that Erica wanted to film of my life. I wondered what she could possibly hope to see or observe in my everyday life that could enhance what I had spoken about at the conference?

I will be honest. I have worked with many people who have not had the capacity to retain messaging through the editing process. I had no idea what to expect from Erica’s work, even though I understood that my almost two hour message would need to be edited down to a manageable length.

I sat with my husband and watched the video. Afterwards we looked at each other and said, “She did it…” I cannot fully express how it feels to know that even through the editing process, Erica was able to preserve this very challenging and necessary message, so that it can be shared with a larger audience.

When Randy asked me to speak at the ProDoula Conference, she only made one request. She said (and I will paraphrase a bit) that she didn’t want the ProDoula members to simply hear a keynote speech, but that she wanted to provoke them to action once they left. She acknowledged ProDoula’s effectiveness in equipping individuals to build sustainable businesses, but she also said she wanted to mobilize them in a different way. She said, “I want them to feel something after they leave the ProDoula Conference and I believe you are able to make that happen.”

There are seldom times when organizations with non-Black leadership are willing to promote a message that is important to Black people without making an effort to censor it to make it palpable to a more mainstream audience. ProDoula has remained true to form and trail blazed along a different path.

The last message I received from Randy today said: Let’s just get the message out there every and any way we can!”

Randy (because I know you will eventually read this post),

  • For the confidence placed in me to SPEAK TRUTH to the ProDoula membership…
  • For the honor you placed on the descendants of women of African descent who managed and maintained birth in this country for hundreds of years…
  • For the investments you chose to make that allowed the message to be preserved…
  • For the part you, Jerry and Erica played in helping share a message of TRUTH with a broader audience that may never have an opportunity to hear it…

I speak these blessings over you:

  • May your businesses continue to grow and prosper.
  • May your platform expand with each effort you make to leave birth better than you found it for all women.
  • May you be granted the deepest desires of your heart as you seek the highest good for others.


Connecting with Haitian moms

There is a unique phenomenon that I am trying to navigate with the Haitian moms in this setting. I will try to describe it to you.

If I had to guess, I would say that 1/4 to 1/3 of the women we are supporting are Haitian. At this public hospital, we are working with young doctors who either speak Spanish as a first language or as second language. Most of those who speak Spanish natively are Dominican and most who speak as a second language are Haitian. On any shift I have worked there may be two or three Haitian doctors. However, only the Dominican  doctors attempt to communicate with the Haitian mothers.

I know… Crazy, right? A Haitian doctor can be standing there hearing the mom speak in Kreole and not engage… or only engage en Español.

Navigating this medical environment en Español is a great challenge in itself. Making sure that I interact respectfully with the doctors is a priority. Some are very accommodating of our presence and invite us to participate in various aspects of the birth process and accept simple assistance with things when they find it makes their jobs easier. Others are more skeptical, so I am mindful about how I engage them.

Sometimes as I struggle to communicate with the doctors, a Haitian mom will begin to speak to me in Kreole.

May I take a moment to say how amazingly beautiful Kreole is? When they speak, it sounds like music and like honey rolling off of their tongues… Simply beautiful.

In those chaotic moments, when I have just realized that I did not understand what the doctor needed when they requested the lamp be turned on… or that someone bring a wheelchair… or understand what the doctor is saying after I ask what I am to be feeling for on the mom’s abdomen when I massage a mom’s belly to check for bleeding… or whatever else they say that is spoken so quickly that I am struggling to understand… I can get really caught up.

Often the Haitian mom we are attending to will begin to speak directly to me. In those moments, the only words I can muster are words in the language I have been trying to convey to the attending doctors: “Hablo Ingles… Hablo poquito Español… Repetes despacio, por favor…”

Before you think it is cruel of me to respond en Español, I must also make you aware that at least half of the Haitian moms I have encountered speak some amount of Spanish. So their effort to speak to me in Kreole is intentional and an effort to try to say something they did not want to share broadly with others.

When the Haitian mom’s begin to speak in their native tongue, I am hard pressed to find ANY of my Kreole… AT ALL… But the next thing they do is what hurts my heart the most. Most of them, after I respond in the only thing I can conjure up (which would be Español), divert their gaze from me and refuse to engage me again. It almost feels they sense a betrayal and now place me in the same category with those doctors who refuse to speak with them in their language in front of Dominicans.

ED07E891-B6B2-420B-926C-4312C8C5281F-4645-00000BAD006FD056Hold on…

I had to pause to make sure I downloaded Haitian Creole in my Google Translate App for work tonight. I realized it wasn’t downloaded properly last night while I was looking for a lifeline to the Haitian moms… and then I realized that it doesn’t provide pronunciation, so I hope I am able to remember some previous lessons about the Kreole alphabet.

I can tell you in another post about ways I am finding success with communicating with the Haitian moms. In this post, I just wanted to share this current challenge I am trying to figure out how to overcome over the next few days.

And please know that I do have a theory about why I am noticing this social cultural context in the hospital. I could be wrong, but it feels familiar. I notice a certain social context with the Haitian doctors as well that looks familiar. It’s not a complaint, just an observation. It could be for a myriad of reasons but I have my theory.

Perhaps I will share those thoughts in another post. I am headed to work now.

Send a sister some positive energy!🤰🏿🙌🏿🙏🏿👶🏾🤰🏾