Thanks to the generous support of the Cambia Health Foundation, the University of Washington Department of Obstetrics and Gynecology is excited to announce the launch of The Collective, a community-engaged doula program pilot that will provide no-cost culturally concordant doula care for Black birthing patients at UW Medical Center - Montlake.

 The project is an initiative of the Health Equity Institute for Healthy Pregnancy, Children and Families (HEI) a recently launched joint initiative between UW Medicine and Seattle Children’s, and led by Drs. Barbara Goff, MD, and Leslie Walker-Harding, MD.

The HEI’s mission is to foster healthy pregnancies, children and families by reducing structural racism that causes harm. The HEI will do this by advancing research that improves health outcomes for parents, children and people who are pregnant — especially those facing health inequities; and developing and implementing upstream interventions that can positively impact health outcomes, mobilize resources and influence policy and practice. Each step, from initial exploration to implementation, centers community voices, ensuring parents, their children and their closest allies identify and lead the most impactful and sustainable community interventions.

A birth doula is a trained health worker who provides emotional, physical and informational support for pregnant people before, during and after labor. Research has shown that doulas can help reduce the impacts of racism on pregnant people of color by helping provide culturally appropriate, person-centered care.

 The Collective was started by Nailah Dodd, a native of Seattle who first worked as a doula before training to become a hospital-based certified nurse midwife to provide care for patients of color in a space where patients of color do not often see themselves reflected on their care teams. Along the way, the mentorship of community midwives and birth workers served as her compass as she witnessed firsthand the difference that providing racially concordant care in a hospital in Harlem made for patients.

 After completing her training and working as a doula and midwife on the East Coast, Nailah returned to her hometown of Seattle in 2021 and joined the University of Washington Division of Midwifery as the only Black hospital-based certified nurse midwife in Seattle at the time. With the knowledge of a long legacy of phenomenal community-based support for Black birthing people in Seattle, she recognized that in the face of the crisis of Black maternal mortality and morbidity, a much-needed bridge between community-based support and large hospital systems was yet to be built. A need and opportunity existed for UW Medicine to incorporate the expertise of community-based organizations and birth workers in providing culturally concordant care that evidence shows improves maternal health outcomes. With the support of UW Medicine and Seattle Children’s HEI, The Collective was born.

“Black birthing people, like all patients, deserve safe birthing spaces where they see themselves reflected in their care team,” says Nailah. “The shock waves from a birthing experience radiate into not only the life of the birthing person, but far beyond into our community. What an amazing step forward it would be to ensure that these shock waves are ones of healing and positivity. That is the guiding mission and the heart of The Collective.”

Community participation is key to the Collective’s success. The project team will include community-based organizations that are helping to design and implement solutions to address community-identified challenges faced by Black birth workers. The focus of the initial phase of our work is listening to the doula community and families and planning a program that reflects their needs and priorities. 

Planned activities between January 2024 and June 2025 include engaging in formative work with community-based organizations, leaders and doulas to better understand the landscape of local community birth work. This will include conducting a formal stakeholder analysis and developing a community advisory board, which will guide the development of the program to be launched in 2025.