For Maddison Brodeur, becoming a doula was more than a job. It was a way to reconnect with her roots.

Brodeur, a Sacramento native and former Miss Black Sacramento, graduated from UC Santa Cruz with degrees in sociology and community studies. She has always been involved in leadership and advocacy.

She became interested in birth work while learning about racial justice and Black maternal health. Just 22, Brodeur already is making a difference in maternal health. Newly graduated and trained as a doula, she is part of a new generation of Gen Z Black women changing birthing care in their communities.

Doulas are non-medically trained professionals who provide health education, advocacy, and physical and emotional support for pregnant and postpartum people before, during, and after childbirth. Doulas are not licensed as clinical providers and do not deliver babies.

“This isn’t just about one birth,” she says. “It’s about healing lineage, reclaiming our bodies and birthing practices, and building a community care system that centers Black women.”

The Centers for Disease Control and Prevention reports that 50,000 women in the United States face pregnancy complications each year. Black women are at least three times more likely to die from pregnancy-related causes than white women. This gap is linked to structural racism, historical trauma, and unequal access to care. Local data shows these disparities continue in California and Sacramento County.

“We train doulas to understand what happens to us as Black women when we walk into these medical systems, ” says Linda Jones, co-founder of Black Women Birthing Justice, who has been a birth and postpartum doula for the past 35 years. “You can’t take a ‘nice little white girl doula training’ and think you’re prepared to walk into a hospital with Black clients. It’s different.”

Gen Z Steps Forward

Brodeur’s path to birth work started in classrooms and community programs, not hospitals. As a first-generation college student, she began at UC Santa Cruz studying biochemistry. After taking a course on pregnancy, birth, and postpartum care, she switched to sociology and community studies, which helped her see the historical and cultural roots of maternal health.

She says she was one of the youngest people in her doula certification program at Black Women Birthing Justice, a Bay Area group that provides free doula training for Black women.

“They are trying to minimize the maternal health outcome disparities,” she says, noting that Black women in America die at three times the rate white women due to birth or pregnancy complications.

She’s working on getting her business and herbal licenses for her tea-based postpartum support services. Brodeur plans to start by offering free doula services to people in her community.

“Right now, my services are going to be free for my community members, just as I’m getting experience,” she says.

Jones says most new doulas trained by Black Women Birthing Justice are between 20 and 30 years old. She also stressed how important community is for doulas and spoke about the challenges of the job.

“I don’t think many of them understand how hard this job really is emotionally, physically, spiritually. You’re holding somebody’s whole life situation while helping them bring a baby into the world,” says Jones, who is also the community collaboration strategy director of Mothers for Mothers Postpartum Justice Project. “At Black Women Birthing Justice, we don’t train people and send them off. We mentor them. We debrief with them. We create a community.

“This is not a job you can do alone. You need people around you to help you process the trauma.”

Kairis Joy Chiaji, founder and director of the Children of the Sun Doula Project, says she also sees more young Black women interested in becoming doulas.

“ I’m also actively recruiting, like right now I’m actively reaching out to my children’s friends as well,” Chiaji says, adding that Children of the Sun has trained some teenage doulas.

She explained that younger women stand out in the field because some have not had children yet, so they do not bring personal fears into someone else’s birth experience.

“You’re not bringing your baggage into someone else’s birth. You’re going in with education and facts,” Chiaji says.

Brodeur believes birth should not feel clinical or lonely, that it should involve the mother’s community. She wants to bring tea culture, holistic healing, ongoing care, emotional support, and respect for ancestral practices to her work. These are all part of a larger effort to restore dignity and safety in birth for Black women.

“Doulas don’t just connect the mom to her body and the baby,” Brodeur says. “They connect the whole family. They help with the birthing plan, with postnatal care, breastfeeding support, and emotional care.”

​From Historical Trauma To Healing Work

A doula is not a doctor or a midwife. Doula is a Greek word that means “woman-servant.” Today, many Black doulas are redefining the role. For them, it is not about being subservient but about serving with care, respect, and a sense of community.

There are many types of doulas, including those specializing in prenatal, labor or birthing, postpartum, abortion, and death.

The need for doulas among Black women has deep historical roots. For centuries, Black, Indigenous, and other women of color relied on community-based birthing practices, midwives, doulas, and support from family and neighbors. When medical birth became institutionalized, and through events such as enslavement, forced sterilization, and medical racism, those traditions were disrupted.

However, says Dr. Khiara M. Bridges, a professor at UC Berkeley School of Law, says the field is experiencing a visible resurgence, especially among young Black women.

“What I’ve observed is an increase in awareness about the efficacy of doulas,” she says. “Training programs have proliferated. Students, activists, people who otherwise might not have entered this field are becoming doulas so they can help save lives, or at least make childbirth more empowering instead of another site of degradation.”

Bridges notes that several of her students have become doulas as part of their social-justice work.

Brodeur connects her passion for this work to her family history. As she searched for her own roots, she saw how important doulas are.

 “I don’t know a whole lot of family birth stories. I really only know my mom’s stories,” she says. “But even those are tied to bigger things, like her telling me that my grandma was raised in a home on a plantation in Mississippi. There’s so much history there that I’m still uncovering. It makes me realize how disconnected a lot of Black families are from our birthing traditions because of everything we’ve survived.”

​Medi-Cal Policy Opens Doors

A promising change for expanding doula care is that more state public insurance programs now include doula services. In California, doulas can now get paid through Medi-Cal. This major change could help low-income mothers who could not previously afford private doula care.

“There’s an enormous amount of evidence showing that doulas improve health outcomes. That’s why so many states have begun covering doula care through Medicaid,” Bridges says.

Jones, who was part of the group that wrote the bill allowing doulas to receive Medi-Cal reimbursement, says they pushed for more pay for California doulas.

“When the state proudly said they wanted to pay doulas $450 for everything — prenatal, birth, postpartum — we said absolutely not,” Jones says.

Now, having been placed on the same pay scale as doctors and midwives, doulas can earn between $1,500 and $4,000.

“Our battle now is making sure the process goes smoothly, [that] they stop denying claims, stop paying old rates, stop playing games with doulas’ pay,” Jones says.

However, experts warn that insurance coverage alone does not fix deeper inequalities. The health care system still faces structural racism, underfunded birthing care in marginalized communities, and low pay for doulas and other frontline workers.

“There are many causes of the disparities that we see,” Bridges says. “I group them into two buckets: interpersonal and structural.”

Interpersonal factors such as implicit bias, medical dismissal, and poor communication often are the most publicly discussed. Bridges referenced Serena Williams’ birth story, where her life-threatening symptoms initially were ignored despite her explicit concerns.

“Those interpersonal contributors reflect a deficiency in the doctor-patient relationship,” Bridges says.

However, she emphasized that focusing solely on interpersonal bias can make us forget the deeper forces.

“What’s doing the heavy lifting when it comes to killing Black people past pregnancy are structural factors,” she says. “Poverty is killing Black people. Residential segregation is killing Black people. And racism, both the stress it causes and its impact on how our bodies age, is killing Black people.”

In California and across the nation, community-based doula training programs have grown quickly in recent years, especially those for Black, Indigenous, and other marginalized groups. Many people say this growth is due to more awareness of racial disparities in maternal health, greater acceptance of alternative birth support, and new laws that allow doula coverage under state public insurance.

“Community doulas are holding a lot. Their clients may be unhoused, in a domestic violence situation, or food insecure. All of that comes into the birth room,” Jones says. “If you work with private clients who can pay $3,000 or $4,000, that’s one world. Community doulas are in a completely different world.”

For many young Black women such as Brodeur, being a doula is a way to reclaim history, health, dignity, family, and community.

“I want to reclaim the birthing space our ancestors had,” Brodeur says. “We don’t have to push through fluorescent lights in a hospital. We can design a process rooted in dignity, culture, and healing.”

Chiaji advises younger people passionate about doula work, which she describes as a “calling,” to believe in themselves and not succumb to imposter syndrome. 

“My advice is just do it,” she says. “Because you can get into a space, you do the training, and then you come up against that imposter syndrome, or you run up against people who just don’t believe that you have what it takes.”

She also advises younger people to understand their responsibilities as a doula and stick to that.

“Stay in your lane; we are not midwives,” she Chiaji says. “We are nonclinical protected practitioners. For Sacramento, I want to say this loud and clear: there is no Black doula in this region that I would not recommend. There isn’t any Black doula in this region who isn’t fire. We’re out here, and we’re ready to serve.”