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The Midwife's Path to Justice



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Kellman focuses her work on three tiers.

At the individual level is the care for clients such as Davis, whom she continues to meet with during postpartum home visits. But she also hopes to build a model that spreads across the country.

"We are working on changing the entire landscape of maternal health in St. Louis outside of our village," she says.

At times, that has meant dragging large health-care systems toward more cultural awareness and changing practices that have silenced Black voices. In 2019, she fiercely battled Mercy Health when the provider, after working with Jamaa, revealed plans to open its own clinic with midwifery services in Ferguson. Kellman says they violated an oral agreement not to copy her operation, and she calls the move "colonization 101." Mercy retreated, issuing a public apology and altering its plans so as not to compete with Jamaa. The two organizations continue to meet on a regular basis, and Kellman says she is pressing them to undergo cultural awareness training.

Ultimately, she knows it will take more than Jamaa to shift societal norms and improve conditions for Black mothers and their families. To that end, she is training a new generation of doulas. So far, nearly 150 have passed through the program. Jamaa had its largest graduating class yet in November when about 40 people completed the training.

Eboni Hooper-Boateng was among a small group who joined in person while others participated online. They met in a hotel conference room in order to spread out and maintain social distance.

"It was wonderful," says Hooper-Boateng, 30, of Ferguson. "It really was life-changing, and that may sound exaggerated, but it really was."

She expected to learn the ins and outs of being a doula, but she says the training also included lessons in the nation's racist history of experimenting on Black people and the gynecological horrors endured by Black women. Kellman traced the biases to inequities of the modern health-care system. The idea was to recognize the ways those long-running biases have been baked into the system so that they can be combated.

Eboni Hooper-Boateng says the doula training at Jamaa was "life-changing." - COURTESY EBONI HOOPER-BOATENG
  • Eboni Hooper-Boateng says the doula training at Jamaa was "life-changing."

In her day job, Hooper-Boateng does outreach to underserved communities for the St. Louis County Department of Public Health. She had previously worked for an HIV/AIDS awareness organization where health was always part of the discussion.

"We often hear about people giving their consent" in regard to medical decisions, Hooper-Boateng says. "If you're not really sure what all your options are so that you can really make an informed decision, then what is that consent that you just gave?"

Now that she's been through Jamaa's training, she sees the job of a doula as empowering people with enough information and support to make the best decisions they can for themselves and their families. At the same time, she says, the training has empowered her as well.

She has begun her own business, registering the name as Birthing You Doula Services, and hopes she will eventually make it her full-time job. She sees it as part of a larger shift.

"Birthwork is a movement," Hooper-Boateng says, and it's the first step toward building a more just world.

"If, from birth, there is injustice," she asks, "what is there to say about the rest of life?"

We welcome tips and feedback. Email the author at or follow on Twitter at @DoyleMurphy.
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