Birth work, especially in communities of color, can be both emotionally taxing and expensive.

As medical providers, midwives must also be Registered Nurses in Illinois in order to practice legally, leaving many midwives of color in debt and unable to work in community midwifery turning to work at hospitals or private agencies instead. Doulas, who typically provide emotional support to a mother and family during the pregnancy year, are not currently covered by Medicaid, one option that would make their services easier for low income families to access.

All this is in a state where racial disparities in maternal health are worse than national averages.

A recent study of New York women from the Maternal and Child Health Journal found that doula services led to lower rates of low birthweight and mothers reported that they felt doula support gave them a greater voice, while another found that states that have the highest integration of midwives in health care systems have better outcomes for maternal and infant health.

“I think people are done being mistreated by our systems and I think that has put a fire into the community,” said Qiddist Ashe, 25, a birth and postpartum doula, childbirth educator, and herbalist. “People see the need [for birth workers]. And now I think it’s about that culture shift and making more opportunities possible.”

This story was produced by City Bureau, a civic journalism lab based in Woodlawn. Learn more and get involved at

Read all stories in our special Maternal Health Issue here.