By Shayna Mace | Photos by Hillary Schave
At Harambee Doula Care and Holistic Services, director of doula programming Chandra Lewis says their focus is “the Black birthing body.” Harambee’s essential doula and midwife services, along with perinatal education, are filling an important need for the primarily lower- income, Black pregnant people they work with.
“We serve everyone. We just prioritize the Black birthing body and those that would be unable to pay. The ability to pay and cost of services have become a barrier to equitable access. And we wanted to combat the lack of support, education and awareness we were seeing in the community. So, we founded our community-based doula programming to combat that and strengthen community knowledge and partnerships, and to advocate for systemic change in our maternal health outcomes here in Dane County,” says Lewis.
About 90% of the people the community-based organization serves are eligible for, or are on, Medicaid. Lewis explains that their offerings, which are intended to complement a pregnant person’s primary care provider appointments, include prenatal and postpartum midwife appointments, birth doula services and lactation education. All are free or low-cost to eligible participants. Project Babies, another local community-based direct services organization, provides Harambee with diapers and car seats, and community donations supplement Harambee’s supplies, which include cribs, clothing and other baby needs that they give away to clients.
Building trusted bonds between a pregnant person and their care team is crucial, says Lewis. The reasons are many, but one is this: “… Black infants are two to three times more likely to die in Dane County than white infants,” she states.
The other is a historic lack of trust in the medical system.
“… We hear about Henrietta Lacks, we hear about the Tuskegee experiment … . Those stories are passed down. We don’t go to the doctor because we may not make it out of the hospital,” says Lewis. “A lot of what we’re hearing initially [from clients] is, ‘I’m looking for a doula because I’m afraid I won’t live.’ ‘I don’t want to go to the hospital and be by myself.’ Or even, ‘They don’t listen to me during my appointments and I want to make sure I’m heard. I want my wishes honored.’ There is definitely medical distrust in the community, and we do a lot to fix those relationships … here in Madison, provider by provider. Think about it: Your OB may only have 15 minutes with you — that’s not a lot of time to build a trust-based relationship with someone. So [we do] a lot of advocacy and empowerment.”
Harambee is the perfect fit for Lewis, who initially pursued studies to become an OB-GYN before transitioning to a different path.
“I realized [that was] not what I wanted to do because I felt like I wouldn’t have enough time to make an impact — and I wanted to make an impact in maternal health disparities,” she says.
Lewis, who is also a certified full-spectrum doula, grief support specialist and childbirth educator, now brings that keen sense of clarity to her work at Harambee.
“[My] lived experience informs all of what I’m doing today because I’ve been on Medicaid, so I understand the limited choice of doctors even accepting Medicaid … . I’ve [also] had private insurance. The time that’s spent with you when you have public insurance versus private insurance is different, and everyone deserves dignity of care, no matter their insurance level. Being on both ends of the spectrum, I want to bring equity to maternal [and] child health here in Dane County.”
