In the Spring of 2018, Quatia Osorio made a big decision: she was going back to school. The Providence, Rhode Island, resident had decided to enroll in a nurse-midwife program, to build upon the work she had been doing as a maternal health worker and doula in her community. Then came the question of what her absence would mean.

"I realized that I would be leaving my work, but I didn’t want there to be fewer services for mothers of color,” she told us. “Right now, there are only two black, women birth doulas in the entire state of Rhode Island.”

Maternal health in the U.S. is harshly divided across racial lines. According to recent reporting on government data “black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies.” And Osorio believes that the lack of accessible and culturally-relevant medical services available to black communities and other communities of color is a driving factor of the crisis.

The numbers on today’s maternal health outcomes are accompanied by a long history of violent racism towards Black, Indigenous, and POC women and pregnant people in the medical system. This history includes gynecological experimentation on black women in slavery and the forced sterilization of Latinx and Native American women in the United States.

These legacies persist in contemporary accounts of poor treatment, discrimination, and microaggression in the health system, leading many people of color to experience the medical system as a site of fear and trauma. Across the country, black midwives and doulas have become outspoken about the need for specific care for black women in the midst of a reproductive health crisis. As policy-makers begin to pay attention to the impact of doulas and midwives - an example being HB5609, a bill in the Rhode Island House of Representatives that would expand medical coverage to include perinatal doula services - having culturally-relevant training programs for birth workers of colors becomes even more imperative.

"Reproductive justice is a cornerstone of our framework to dismantle those negative determinants and biases that continually manifest themselves in poor birth outcomes and mental health issues,” states Osorio. “One of the ways this continues in the medical system is poor or negligent referral relationships with cultural humility- and cultural sensitivity-trained mental health therapists, poor or negligent life skills training, and little or no proper maternal health education, advocacy or support within these systems.”

Feeling the weight of her community’s need, Quatia decided she would host a training series for mothers and others interested in being maternal health workers or supporters. The money to put on this series would be an issue, but Quatia was committed to seeing it through, even spending her own money to make sure the classes had all the proper equipment.

"We had to spend, like, $600 on a model Pelvis. I thought I wouldn’t be able to fundraise for it, because, who is going to believe me that we need to spend $600 on a model Pelvis?!”

That year, Osorio received a Seed grant to create a community-led and focused maternal health support service to promote education, awareness, advocacy to reduce poor birth outcomes in communities directly affected by environmental and social determinants of health. The purpose of this group was to help train a more diverse population of doulas and community childbirth educators in Providence.

Out of these trainings, a new collective - Umoja Nia - was formed. Their vision is to create, engage, and promote a cohort of multicultural, professionally-trained maternal health birth workers including community health workers, doulas, birth assistants, and midwives to promote and activate community-level maternal care to those in need. For Umoja Nia, “those in need” especially includes members of vulnerable populations: disadvantaged or stigmatized teen mothers and other low-resource, and low-income families outside of regular routine services - especially those that overlook their emotional and psychological well-being.

After forming, Umoja Nia applied for a Grow grant from the Grassroots Fund last fall to continue and build upon their work. All Grow grants undergo a participatory review process, where activists and community members from across our region weigh in on which projects are most in line with our funding priorities and Guiding Values. Umoja Nia’s application was one of the highest scoring applications from the fall round of this process.

At the Grassroots Fund grantmaking committee meeting last fall, participants took a pause to address some of the questions from grant reviewers on Umoja Nia’s application: was this project “environmental” enough? The resounding answer from the room was “Yes.” While it may be hard to categorize this work within our current notions of “environmental activism,” there was no doubt from the grant reviewers that this project was foundational to creating the healthy, just and environmentally sustainable communities we seek to nurture in our region.

While Osorio might be stepping back from her immediate role in this work, she knows that the commitment to providing holistic, compassionate, culturally-relevant care will continue to grow - and she and Umoja Nia have set up the systems to ensure it will be met with resources and support.

Interested in joining this conversation? You can register here for our Webinar about Shifting Power in the Environmental Movement on Wednesday, April 10th.