During her third pregnancy, Dominique Adeniyi, suffered stomach pains that didn’t feel normal. As the pain grew she repeatedly asked her doctors for help. They said it was probably just a stomach bug.

Instead, it was HELLP syndrome, a life-threatening form of preeclampsia that was shutting down her liver, Adeniyi told Austin Free Press. She ended up requiring an emergency C-section.

Adeniyi, the Birth Programs Director at Giving Austin Labor Support (GALS), had run into a common problem: a birth-related disconnect between Black mothers and their health care providers.

“It is hard for Black moms to communicate their symptoms,” Adeniyi said, “because their voices are not heard or cared about.” 

Statistics show that Black women are twice as likely as white women to report that a health care provider ignored them or refused a request for help. 

But it’s not always that way. Adeniyi said she had a different experience with her second pregnancy, when she had a home birth with a midwife. 

“My midwife made me feel like she was listening to all the parts of my body, the physical, mental, spiritual pieces,” Adeniyi said. “My midwife was my she-ro. The care she gave me changed my life.”

Listening to mom

A growing network of midwives, doulas, and community organizers across Austin are supporting Black mothers through pregnancy and childbirth. They provide what modern medicine often lacks: sustained social support.

While obstetricians handle most U.S. births, midwives attend about 12%, figures show. Midwives provide clinical support for in-hospital or at-home births, while also providing prenatal and postpartum care. 

Austin midwife Leena Pacak says her role is not to instruct clients how to give birth, but to help them trust their instincts. “Women have a lot of intuitive knowledge,” said Pacak, who co-founded Black Homebirth Matters. “My role as a midwife is to help bring that forth.”

Midwives often have deeper relationships with their clients than doctors and hospitals typically can develop. “To give you the best care I can, I want to know as much about you as possible,” Pacak said.

Some women also birth with support from doulas. “We provide physical and emotional support, and provide education to help prepare for birth and support decision making,” said former doula Kellee Coleman, who co-founded Mama Sana/Vibrant Woman.

Black Mamas ATX provides free doula services to local Black families. Executive Director Kelenne Blake said that doulas prepare clients to advocate for themselves.

The COVID-19 pandemic proved the efficacy of that advocacy. Black Mamas ATX tracked birth outcomes at a time when doulas were not allowed to accompany clients in hospitals.

“Despite not being present in the room, the people who had a doula relationship for the longest had the best maternal and child health outcomes,” said Blake.

Healthcare falls short

Black women are three times more likely to die from pregnancy complications than white women, studies show. A highly educated, wealthy Black woman is more likely to die from childbirth complications than a white woman with fewer resources. Even Houston-born billionaire singer Beyoncé experienced life-threatening complications during childbirth. 

For many Black Texas mothers, these risks reflect longstanding inequalities in healthcare access, insurance coverage, and provider bias. Texas has the nation’s highest rate of medically uninsured residents at almost 20%. Crucial prenatal care often begins late due to limited access to providers and to insurance. Black women are more likely to fall into the “coverage gap” that affects those ineligible for Medicaid yet unable to afford private insurance. 

Even with coverage there can be problems. During pregnancy, a woman interacts with numerous medical professionals. Those providers often have limited communication with each other, which can result in missed warning signs.

Patients also experience better communication when they share their providers’ backgrounds. Just 11% of the nation’s obstetrician-gynecologists are Black. Female BIPOC health providers are even rarer. 

Social support

Studies show that one in five women experiences perinatal mental health issues. Increased social support from partners, family members, or trained birth workers significantly improves maternal and child health.

At her own hospital birth, Coleman was accompanied by two doulas: her Mama Sana co-founders Paula Rojas and Jeanette Monsalve. Throughout a tumultuous pregnancy, Coleman’s doulas provided information about stress management, nutrition, and exercise. 

When she was 42 weeks pregnant, a major decision had to be made. Coleman’s doctor recommended administering a drug to induce labor. “That’s just not what I wanted,” said Coleman. “I wanted everything to be as natural as possible.”

The doula team stepped in to offer alternatives. After trying acupuncture, spicy food, and yoga, a double breast pump finally did the trick without drugs. 

Once Coleman was laboring, her doulas helped her manage pain, advocating for her to stand and move about when the doctors preferred that she stay in bed. “They reminded me of what I wanted, what my choices were, and helped me think through it,” she said. 

Community care

Austin-area community groups are addressing maternal health challenges. The Maternal Health Equity Collaborative (MHEC) convenes organizations that provide perinatal support to help prevent maternal deaths among Black and Brown families in Central Texas.

Supported by the Merck for Mothers Safer Childbirth Cities initiative, MHEC’s partners include Black Mamas ATX, Mama Sana Vibrant Woman, GALS, Healing Hands Community Birthing Project, Partners in Parenting Luz de Atabey Midwifery Project, Black Mamas Village, and Delivering Unto You. 

“Before COVID-19 each organization was working independently,” said MHEC’s Aspen Kennard. “The collaborative helped each organization to develop services and programs that complement each other.”

MHEC’s partners served more than 7,000 Austin-area families In 2025. They helped deliver lower medical interventions, fewer pre-term births, and fewer low birth-weight babies.

Birth Teams 

MHEC organizations use JJ Way strategies that prioritize education, respect, empowerment, and communication across care teams. Developed by Florida midwife Jennie Joseph, this approach leverages continuity of care to improve health outcomes. 

Inspired by her friend and mentor, Joseph, Elena Colón founded Austin-based Luz de Atabey Midwifery Project, or LAMP. Based on Joseph’s methods, it provides free, holistic prenatal and postpartum care to LGBTQ+ families and families of color.

LAMP’s model “pushes back on the medical hierarchy, where the clinical provider is the most important,” said Colón, “instead centering community health workers.”

Filling the gaps

Despite progress, advocates say these grassroots efforts are not enough.

Texas lawmakers have proposed several measures to improve the collection of maternal health data by the Texas Maternal Mortality and Morbidity Review Committee but progress has been slow and spotty. 

Citing a high caseload, that state committee proposed bypassing the review of maternal deaths between 2021 and 2023, drawing criticism from advocates. That coincided with Texas’ near-total abortion ban, taking effect in 2022, which was accompanied by an uptick in severe maternal complications.

While policymakers debate solutions, community organizations continue to work to fill the gaps. Maternal and child outcomes can improve dramatically when mothers have someone to explain medical information, provide perinatal care, and advocate for their physical and mental health. 

As Austin’s growing network of midwives, doulas, and others make clear, nobody should have to navigate a pregnancy alone.

Disclosure: Kellee Coleman is a member of the Austin Free Press board.

Support for Austin Free Press’s reporting on health news comes from the St. David’s Foundation. Sponsors do not influence AFP’s editorial decisions.