Episode N^o 9 / Nyasia Bey

Nyasia Bey vividly remembers the trauma she experienced when she gave birth to her first child, and as a doula in Detroit, she wants to see to it that other women avoid going through what she did.

Bey became pregnant at 13 and gave birth at 14, before she even had her first sex education class.

“It was completely scary,” says Bey. “I remember being in active labor, so that’s when it gets really bad, and I remember a social worker coming in trying to talk to me while I was having contractions, and it was just like, what in the world?”

She was told that she couldn’t leave the hospital unless she received a shot of Depo-Provera, an injectable form of birth control that lasts for eight to 13 weeks. She says she wasn’t supported in her plans to breastfeed. Throughout the process, she says she felt that the medical staff were punishing her — yelling at her to shut up when she cried out in pain — for being a teenage mother.

Bey went on to have her second child at 16, this time giving birth in a hospital hallway when healthcare staff didn’t believe her when she told them that she was going into labor. She had her third child around age 20, and by then, she says, she was done with childbirth.

With little knowledge about her own body, let alone the language to advocate for herself to doctors, she felt completely powerless during her labor experiences.

“I was just like, this is horrible. There has to be another way,” says Bey.

What Bey has since learned over the years is that her experiences were hardly unique. Institutional bias, lack of access to prenatal care, and financial barriers all factor into vast health disparities faced by Black mothers. They’re more likely by far to experience premature births — the leading cause of infant mortality — and are up to five times more likely to die in childbirth or other postpartum complications.

In Detroit, these disparities are exacerbated by a dearth of urban hospitals, economic racism, and widespread water shut-offs, according to a  2019 article in The Guardian. 

This sobering reality is what drove Bey to found Ancient Wisdom Birth Services, an independent doula practice that provides professional in-home doula care and childbirth education. This service provides mothers and their families throughout Metro Detroit with support, no matter what type of birthing plan they choose.

Someday, Bey hopes to develop a full-service birthing center in Detroit where doulas, midwives and obstetrics professionals can work side by side to tend to the diverse needs of families.

What Bey was lacking during her pregnancies was education, and as a doula, that’s what she wants to provide for her clients. Doulas are not healthcare professionals but rather serve as companions to expectant mothers and their family members. They can provide health-related information and help mothers develop a birthing plan, whether it be a natural home birth, a vaginal delivery in a hospital setting, or provide comfort to those who will require an intervention procedure such as a cesarean section. The doula is often on hand during pregnancy, birth, and postpartum.

The goal is to provide emotional and physical support and, perhaps more importantly, to advocate on behalf of the mother.

“If you don’t know your options then you don’t have any options.”—Nyasia Bey

Bey says she first started thinking about a career in healthcare at 17 when she cared for her parents who both had terminal cancer. Before they died, Bey was impressed by the work of the hospice staff that cared for her mother.

She started working at a local hospital as a nurse assistant, where she became exposed to inequities in how marginalized communities, particularly pregnant inmates at a local jail, were treated while in care.

“That’s where I got to see so many women being chained as they were giving birth…many inmates would come there to give birth,” she says. “I thought it was so inhumane. Even talking about it now, I can see, touch, taste and smell that moment. It was just so horrific.”

“I learned a lot, just about healthcare in America. I saw so many people that looked like me and my family members dying from preventable diseases.”

“Institutionalized racism in healthcare, it’s overwhelming,” she adds.

In particular, she noted how Black women who were seeking abortions were treated.

“African American women in pain are definitely treated differently, and as a result they’re less satisfied with their procedure,” says Bey.

It was almost enough for Bey to walk away from the industry. She decided to take a break to homeschool her children.

She was pulled back into healthcare around 2013 or 2014 when a local newspaper ran a series on infant mortality rates in Detroit.

“They kept talking about the infant mortality rates being worse in Detroit than in Third World countries,” she says.

It was around that time that Bey dove deeper into researching the root causes behind these alarming figures. She decided to take a life-altering move to Alabama where she met a grand (also known as a “granny”) midwife who began to teach Bey about Black midwifery traditions in the South.

“That’s what lit the fire,” she says.

“I learned a lot, just about healthcare in America. I saw so many people that looked like me and my family members dying from preventable diseases.”—Nyasia Bey

What she learned was that long before modern obstetrics began playing increasing roles in the labor process, it was close family members who tended to the needs of women in labor. According to the nonprofit women’s health education platform  Our Bodies Ourselves (based on the iconic book), midwives were once commonplace in the United States. When West African women were brought to the Americas as slaves, they brought with them their expertise in midwifery. Following emancipation, African-American women continued this legacy for both Black and white women up until the early part of the 20th century, when the push for hospitalized deliveries performed by trained obstetricians began to take shape. This effectively pushed Black midwives out of the reproductive healthcare industry. While this move initially resulted in a drop in infant mortalities among women of all races, that decline has since inched back up with Black babies driving the increase, a  2018 NY Times article shows.

Despite this shift, midwives and doulas are presently filling a void within the African-American community. And like Bey, in doing so, they’re reclaiming a centuries-old diaspora tradition.

A growing number of Black women across the country are establishing birthing centers that take culturally-sensitive approaches to maternity and the birthing process. Roots Community Birth Center in Minneapolis is the only such Black-owned facility in Minnesota. In Cleveland, Birthing Beautiful Communities uses a “holistic birth equity model,” according to a recent  Glamour article, to address the root causes of infant mortality.

Both the approaches taken at the Minneapolis and Cleveland facilities are showing signs of progress. A 2019 Guardian piece on Roots Community Birth Center shows that in 2017, the center had no preterm births among its African American clients and a primary caesarean rate of 3 percent. The Cleveland center’s site, meanwhile, proudly displays a 99 percent infant survival rate, the Glamour piece shows. 

To Bey, Detroit is ready for a space of its own and she would like to lead the path to making that a reality.

But first, she has to continue building her practice.

“We are like bricks on top of bricks, helping one another.”—Nyasia Bey

At the beginning of 2020, Bey was looking forward to participating in the necessary births to become a certified midwife, a process that she says is expensive, which can often exclude Black women from completing the process.

When the pandemic hit, Bey’s priorities, like just about everyone else’s, changed. Like many fledgling entrepreneurs, she still has another full-time job, working as a surgical technician at Henry Ford Health System.

As the reality of COVID-19 set in, her hours at Henry Ford increased dramatically. She also began working as a temperature taker, screening employees at Blue Cross Blue Shield before they enter the workplace.

The extra income has allowed Bey to save up to purchase a home where she and one of her children can live. In her spare time, Bey is figuring out how to update the Ancient Wisdom website. Her goal is to have the capability to consult with clients remotely via video chat. She’s currently seeking the expertise of others who might be able to assist to that end.

Just like her views on the healthcare system have evolved over the years, so too has her vision about the future of her business.

If she’s to reach a new generation of expectant mothers in the time of COVID, she’ll need to arm herself with the technical savvy to do so virtually.