CHARLOTTE, N.C. — In a room filled with mothers, doulas and health advocates, one message stood out: Support for mothers cannot end in the delivery room.

Across North Carolina, doulas are calling for urgent action as racial disparities in infant and maternal health persist, and in some cases, worsen.

“We empower these families to be heard,” said Iman Boykin of the National Black Doulas Association. “You will be heard. You will be able to give birth without fear.”

For Boykin, that mission is personal.

As a teenage mother, she says fear and uncertainty shaped her early experience with childbirth and ultimately led her to become a doula.

“To have a natural delivery, wanting to breastfeed at the age of 18 wasn’t common. And so I really began to research, and that’s when I found out about the amazing work of a doula,” said Boykin.

She says while childbirth can be a powerful experience, it can also expose deep inequities, especially for Black women.

New information shows Black infants in Mecklenburg County experience the highest rates of low birth weight, preterm births and even deaths.

“Black women as a whole are thought to be able to hold the threshold of pain so much more than any other race,” Boykin said. “So, when you have that, when it comes to our mothers, expressing things that they’re feeling in their body, things that they’re going through emotionally and spiritually, it’s not listened to. It’s kind of just pushed to the side.”

“So that’s why you see, you know, Black women and Black and Brown women, dying in birth 3 to 3.5 times higher than any other race,” she said.

Midwife Phebe Israel says those disparities raise serious concerns about the nation’s health care system.

“For us to be in America and supposedly a First World country, we have death rates of a Third World country, and that doesn’t really add up,” Israel said. “So there’s really conversation that needs to be had with the medical providers and the community and the actual people doing the work.”

According to the North Carolina Department of Health and Human Services, while overall infant mortality rates have improved over the past decade, disparities remain stark. The state ranks 10th in the nation for infant mortality, with Black and American Indian infants disproportionately affected.

Advocates say the issue goes beyond awareness, and requires policy change and community collaboration.

“I am wanting to call people into this space so we can really make a difference,” Boykin said. “To keep talking about it doesn’t do anything.”

“We really need to align with organizations and people and those that are making the policies so we can make some changes. So the numbers 3 to 3.5 times more deaths happening in Black and Brown families can decrease,” she said.

The conversation took center stage during Black Doula Day, where doulas, mental health professionals and mothers gathered to raise awareness — and push for solutions.

“Black boys deserve to grow old. Little Black girls deserve to grow old. And we deserve to see our children do that,” said Israel.

State health officials say several factors contribute to the disparities, including low birth weight, education, birth defects and access to care.

For doulas, the path forward is clear: stronger support systems, better communication — and action that ensures every mother is heard.

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