There are some experiences and realities that pregnant and birthing people face that are left out of popular narratives or texts like What To Expect When You’re Expecting. From racism in a gynecologist’s office or the delivery room, to navigating race- and class-based microaggressions while pregnant, there are countless ways in which the lived experience of marginalized folks who are pregnant, or plan to become pregnant, are impacted by surveillance and discrimination. But even though these experiences are common to marginalized pregnant people, I have yet to thumb through a mainstream pregnancy resource that offers advice on how to deal with these situations, even though they impact the emotional (and physical) wellbeing of both parent and baby.
As a doula who primarily worked with pregnant and birthing people in underserved communities long before I was pregnant, I supported people through difficult or emotionally laborious moments brought on by systemic inequity and structural violence. As a Black, nonbinary femme, I experienced some of those moments myself when I was pregnant.
Whether I was facing racism in an exam room or coping with body dysphoria as my pregnancy progressed (amongst all the other complicated moments during pregnancy that you do hear all about in all the bestsellers), the intersections of race, class, gender, and ability merged with my experiences as a pregnant person and the effects were often stressful. Thankfully, I had the support of an incredible trans doula of color who taught me to advocate for myself in ways that my own doula training couldn’t have prepared me for.
My partner and I knew from the beginning that we would find a doula to support me through pregnancy, birth, and the postpartum period. Since I’m a doula myself, I know firsthand how important it is that people have access to doulas to get critical support during a transitional and transformative time in their lives. My goal was to find a nonbinary doula of color to support me.
While pregnant I suffered from hyperemesis gravidarum (a condition that affects between 0.3 and 2.3 percent of pregnant people and causes extreme nausea and vomiting which can lead to dehydration, weight loss, and sometimes even hospitalization), in addition to exacerbated chronic pain issues. I ultimately had to leave school and my job in order to stay home. I was vomiting several times a day, every single day. I was barely able to walk, I couldn’t bathe myself, some days it was difficult to use the bathroom on my own, due to the pain and weakness. Eventually, the search for a doula led me to Luar who happened to be a high school friend of my partner.
Prior to becoming my doula, Luar was my friend. As a trans, nonbinary, Latinx full spectrum doula—meaning that they support pregnant and birthing people through experiences that range from birth and postpartum care to abortions— Luar’s birthwork was heavily informed by their radical politics and knowledge of how oppressive structures impact the lived experiences of marginalized folks. As fellow doulas, before I was pregnant myself, we would exchange books and share stories about healing and coping under white supremacist, heteronormative patriarchy.
Although I had a lifetime of experience dealing with white supremacy and patriarchy, navigating it all as a pregnant person exposed me to even more instances of microaggressions, exclusion, and discrimination. Most spaces and services for pregnant and birthing people are heavily gendered and rarely actively inclusive of people with non-normative gender identities. They mostly center the narratives of heterosexual cis women who are white and have access to quality medical services.
For example, my own pronouns are they/them/their and before my pregnancy I was adamant about others referring to me in that way. Throughout my difficult pregnancy, though, I lacked the energy to constantly correct and educate people who would misgender me. By the time I went into labor I’d given up and started to ignore when people would use she/her/hers pronouns for me. And to this day I accept she/they—not because I want to be referred to as “she,” in that way, but because it requires less emotional labor from me. I was already dealing with institutional racism, and the physical pains and complications of a difficult pregnancy, so I had to prioritize how I spent my energy.
Fortunately, I had Luar, who is more than just a skilled and knowledgeable doula whose work was informed by their reproductive justice activism and advocacy. Luar is also someone who could relate to me on a deeply personal level as someone who is also nonbinary and who experiences race- and gender-based discrimination in some settings. They understood what I was going through when I would talk about microaggressions or instances of racism and misgendering. They understood when I would call them crying, worrying about whether or not my next visit to a medical professional would be racially-charged and include culturally-insensitive comments.
Since my plan was to have a home water birth, preparation was different than just packing a hospital bag. Every step of the way, Luar researched and prepared according to my birth plan, regularly checking in to make sure I felt comfortable and well-informed. They were always available to text or chat and remained ready to stop by with food or herbal teas, going above and beyond to make sure I felt safe and supported through my difficult pregnancy. They were particularly careful about learning signs of dehydration or other complications that could arise given my constant vomiting. We had an emergency plan ready to go that they were well-versed in in case of the need for a hospital transfer.
By the time I went into labor, Luar had given me the tools I needed to feel empowered, confident, and strong. Most of my twenty-two hours of labor at home were a blur but one thing that stands out in my mind are the moments when Luar would help me or my partner navigate what was happening with grace, patience, kindness, and love.
After being in labor at home for about a day, I ended up having an emergency transfer to an emergency room due to some complications that arose and required more specialized attention, and Luar stood by me every step of the way, correcting anyone when they would misgender me, advocating for me according to my birth plan when I couldn’t move or speak, helping me through every obstacle I faced.
Although everything turned out fine with me and the baby, I went through a complicated, exhausting, and frightening labor. Thanks to Luar’s support and advocacy, the doctors and nurses had been using the right pronouns and referencing my birth plan, and my partner felt comfortable and supported as well. Every nurse or doctor I spoke to made a comment about my pronouns and birth plan thanks to my doula’s advocacy in the hospital.
The support of my doula didn’t end after I’d given birth. Upon returning home, I was blessed with Luar’s continued support. As my postpartum doula, Luar would come over to help clean, cook or bring food, or take care of whatever other household or personal care things I needed. I knew that no matter what I was going through, no matter what I needed, Luar would be there to help me or my partner navigate it all. Luar didn’t just help with my birth and recovery. Their work as a doula has made me a better doula! Every single thing I’ve learned about what it means to be a radical birth advocate and compassionate doula I learned from Luar. Watching Luar provide care with love, passion, and knowledge was inspiring as a doula and life-changing as the person who received their care.
It breaks my heart, and fills me with rage, that so many conversations about birth and postpartum doulas are framed by heteronormative ideas about the world. Doulas are for everyone. There has even been research on how doulas improve pregnancy outcomes that reveal that doulas are changing and saving lives in marginalized communities. Thanks to Luar, I know this from a personal perspective.
I was able to get through a difficult pregnancy and birth thanks to a trans, nonbinary doula of color and, as a nonbinary doula who understands the importance of inclusivity, I make an effort to explain this need to others whose ideas about birth work are cis-heteronormative or informed by white supremacy. I tell others about birth workers like Luar, the doula who changed my life and showed me that having a doula with shared experiences, can help pregnant people make it through alienating moments. Pregnancy is a journey that is different for everyone and each pregnant person faces their own obstacles. When those obstacles include dealing with issues related to your racial or gender identity, there are added layers of difficulty. I’m thankful that my doula could understand me and support me through those obstacles in an honest and genuine way.
Jesi Taylor Cruz is a writer, doula, community activist, and researcher based in New York City whose work lies at the intersection of public health, political philosophy, and psycholinguistics with an emphasis on issues related to mass incarceration and how structural violence impacts lived experiences.