How Doulas are Supporting Black Mothers in Bakersfield Where the System Falls Short
This story was produced in collaboration with the Bakersfield Observer as part of the 2026 Ethnic Media Collaborative, Healing California.
Dani Wallace is part of The Labor League Kern County Birth Workers Collaborative, which aims to empower, educate and advocate for expecting parents.
It was around 6 p.m. on April 1, 2023, when Treana Adams, a Black Bakersfield mother, arrived on the delivery floor four centimeters dilated. Ready to give birth to her second child, she immediately phoned her doula Dani Wallace.
"I was very relieved when I actually saw her walk through the door," said Adams, a corrections officer. “Having somebody there that was standing up for me, understood the terms, and broke everything down so that I could adequately understand and make a decision for myself — that was very beneficial."
What followed was 12 hours of labor. Wallace held Adams’ hand through contractions, coached her breathing, massaged her back, and watched closely to ensure Adams’ birth plan was being followed. When her baby boy arrived, Wallace remained beside them to check the placenta and stitches. Wallace had been there for every minute of Adams’ labor and birth.
"Every pregnant friend of mine, I'm just like, ‘You should get a doula,’” said Adams.
Treana Adams
Cecil Egbele
Nationally, Black women die from pregnancy-related causes at more than three times the rate of white women. According to the CDC's Maternal Mortality Review Committees in 2022, 85% of these deaths are preventable. In California, the racial gap is even wider than the national rate: Black women die at nearly four times the rate of white women, according to the California Department of Public Health.
Pregnancy-related mortality describes the death of the mother during pregnancy or within a year of childbirth. When you head into Kern County, statistics around pregnancy-related mortality spell a crisis for all mothers.
"Our maternal health statistics, when we take a look at that data — unfortunately our rates are poorer than we see at the state average,” said Kimberly Hernandez, Kern County Public Health’s division director of health services.
Kern sits 53rd out of California’s 58 counties in overall health outcomes. The Southern Central Valley region, which includes Kern County, has the highest pregnancy-related mortality rate in the state at 27 per 100,000 live births — more than double the California average and nearly 50% higher than the national rate, according to the state health department.
For Black mothers in Kern County, the No. 1 agricultural-producing region in the country, the numbers are bleaker still. For this group, life-threatening birth complications are seen at nearly three times the rate of white women in the same county.
“We know we have room to grow in efforts around increased prenatal care in the first trimester, decreasing infant mortality, and decreasing low birth weight,” said Hernandez at the county health department. “And when we look more granularly, we continue to have higher rates in Black and African American mothers and babies born to Black and African American mothers."
The presence of doulas here is increasingly seen as an essential part of efforts to reduce maternal mortality.
Doulas Step In Where The System Falls Short
Lexus Block, 32, a behavior analyst and Black first-time mother in Bakersfield, called Wallace the moment she found out she was pregnant in 2023 — even before she found a prenatal doctor.
Lexus Block
Cecil Egbele
Later, when Block did visit her doctor, she told them that she had a doula. The doctor seemed surprised, Block said. When asked why she had a doula, Block told the doctor she was worried. “I don't trust you guys, to be frank," she said, noting the much higher risks faced by Black mothers in childbirth.
The American College of Obstetricians & Gynecologists describes a doula as a professional who is specifically trained in labor and childbirth support.
“Doulas don’t replace the ob-gyn, nurses, and other trained health care professionals who care for you in the hospital,” wrote OB/GYN Denise De Los Santos on her own choice to use a doula. Instead, “they act with your values, wishes, and best interests in mind. A doula can provide physical, emotional, and informational support in many ways.”
A 2018 statewide survey by the National Partnership for Women & Families found that 15% of Black mothers sought support from a labor doula, a reflection of the need for and the growing recognition of their role among women facing the highest risks in childbirth. Latinas followed closely at 10%, white mothers at 8%, and Asian mothers at 3%. Maternal health advocates have linked doula support to better health experiences.
“What we are trying to do as doulas is really bridge the gap between patients and physicians,” said Raven Thomas, co-founder of the Three Moons Doula Collective, an association of doulas and advocates in Kern County.
“Patients don't get a whole lot of knowledge from providers about how they should be feeling or what changes are going on in their bodies. We're trying to help people advocate for themselves, so they're able to say, ‘This is what I like, this is what my body does, this is how I'd like to give birth.’”
Since January 1, 2023, the California Department of Health Care Services (DHCS) has covered doula services under Medi‑Cal maternal care plans. Medi-Cal recognizes doulas who have been certified through 100 statewide organizations. As of the beginning of April 2026, more than 1,411 doulas have enrolled statewide.
In California, doulas are not licensed by the state, but to be covered under Medi-Cal, they must complete a minimum of 16 hours of training, CPR certification, and have supported at least three births. Training covers everything from the physical and emotional support of labor to postpartum care, breastfeeding, and understanding racial disparities in maternal health and reproductive care.
DHCS lists 26 doulas in Kern County. This past March, Wallace trained 29 certified doulas, while Raven Thomas’ Three Moons Doula Collective is set to train another batch in June.
“One of the big focus areas has been really improving access to doulas, as well as increasing collaboration between the traditional medical community and including doulas as part of that care team,” said Hernandez of Kern County Public Health. Hernandez believes Kern County has made meaningful strides in terms of getting doulas covered through health insurance plans and opening up the perinatal care community.
“They are more than just a support person. They are part of this patient's medical team.”
Making Sure Mothers and Babies Have a Successful Outcome
Some doctors see doulas as partners in care. Dr. Chibuike Anucha, who has delivered babies in Kern County for more than two decades, has worked alongside doulas and said some patients find it easier to speak more freely to a doula than to a doctor. “Some patients have a lot of belief in the doula, and they consider them another family member that looks after their well-being.”
Dr. Anucha
Cecil Egbele
“The doula, like the nurse and myself, are like a team. Our goal is to make sure that the mom and the baby have a successful outcome.” Dr. Anucha
Dr. Anucha is careful to draw a line, however: he said a doula should never tell her patient not to listen to her medical team. But there’s a role for a doula who advocates for a patient’s birth plan, who catches something the clinical team missed, who helps a woman feel safe enough to speak, he said.
“If for some reason I’m doing something that a doula doesn’t think is the right thing, she can call my attention. I would be glad to explain. I wouldn’t in good conscience do anything detrimental to my patient.”
What Happens When The System Doesn't Listen
Denisha “Dani” Wallace is a doula, a community health worker, a student midwife, and a strategic advisor for the California Coalition for Black Birth Justice. She accompanies mothers to appointments, prepares them with questions, coaches them to speak up, and steps in when the system won’t listen.
On a typical weekday in Bakersfield, Wallace is on the floor of someone's living room or in her childbirth education room, sprawled on the floor to demonstrate stretches for the lower back and hips — all the places that hurt most in the third trimester. When her client looks uncertain, she repeats the exercise slowly.
Adams, 32, the corrections officer, clearly remembers performing these exercises when Wallace came to visit. "We did yoga right here in the living room. We went outside and walked the neighborhood. She even incorporated my partner, showed him how to massage if something was hurting, how to help me stretch."
Adams’ first pregnancy at 19 culminated in a C-section, which she believes she never needed. For her second pregnancy she wanted a doula. She had Wallace.
As a Black mother of five, Wallace became a doula because she believes she is a living example of what can happen when the system does not listen. During her third pregnancy in 2008, Wallace felt she didn’t get the care or attention she needed while she was vomiting day and night. She experienced severe weight loss, and was unable to sleep, eat, or care for her other two children, she said.
Her son Jeremiah was born on April 10, 2009, and died seven months later. While there are no definitive answers, Wallace still wonders many years later if her son would have survived if her health complications during pregnancy had been addressed.
Nu’Ponica Barker, a caregiver with In-Home Supportive Services, describes a disturbing moment before the birth of her second child in 2023.
Nu'Ponica Barker
Cecil Egbele
As Barker remembers the incident, a resident doctor entered the delivery room, put on a long glove, and, without asking, performed a membrane sweep, an internal procedure where a doctor inserts a finger and makes a sweeping motion around the cervix to try to trigger the start of labor. Barker had explicitly written in her birth plan that she did not want one. (The Observer was not able to independently verify her account.)
“She didn’t ask me. She just did it,” Barker said, recalling what felt like a “violation.” Barker, who had her husband by her side in the delivery room, wishes that Wallace had also been in the room to advocate for her.
“I’m sure she would have caught that and been able to say, ‘Hey, no. That’s not what she wants. What are you doing this for?’”
Barker remembers the moment she heard Wallace’s voice outside the delivery room. She knew her doula was close. When Wallace came through the door, something settled.
“It was like night and day. She was there for me in a way that no one was able to do prior to that,” Barker recalled. “She mirrored what I wanted, what I needed. She brought a sense of calm and peace and assertiveness,” said Barker. “She was my backbone. Whatever I said, she was there to assert.”
In any given week, Dani Wallace is on the living room floor practicing yoga with a pregnant mother, on the phone with a hospital director making sure she gets into a delivery room, or mapping out her next advocacy plan so that another Black pregnant woman will be heard.
For Treana Adams, Lexus Block, Nu’Ponica Barker, and a growing number of Black mothers in Bakersfield, a doula was the difference between being heard and being ignored, between a birth plan honored or overridden. Between a greater likelihood of a mother who comes home, and one who doesn’t.
“I do tell people, if you're going to have a child, get a doula,” Block said.