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Through community-based care, doula SeQuoia Kemp advocates for radical change

By Martha Swann-Quinn

Published August 21, 2022 at 6:00 AM EDT

SeQuoia Kemp advocates for change in maternal care through her work in Syracuse, New York. "We need a radical change in maternity care," Kemp says. "We need help from midwives and OBs who understand that birth is not just physical — it's also psychological — and we need to make sure everybody in the room is ok." Here, she leaves a client's home in Syracuse after a prenatal consultation.

SeQuoia Kemp was 14 years old when she attended her first birth — standing at the foot of the bed, she watched as her cousin was born.

"From that moment on, I knew I wanted to help deliver babies."

She's gone on to become a doula, providing support to birthing mothers, their partners and families before, during and after pregnancy and childbirth in her Syracuse, New York, community for more than a decade. And in a time where maternal mortality rates in the United States are staggeringly disproportionate, with Black women dying in childbirth at three times the rate of white women, doula care and maternal advocacy have become more important than ever. Now, with the recent Supreme Court decision to overturn Roe v. Wade, Kemp sees the need for doula care rising.

Of the recent ruling, Kemp says, "Reproductive justice was a framework developed by Black and Indigenous women who recognized a duty to show up for one another, to defend our right to bodily autonomy and organize for a more just and humane society. My work is built upon that framework and legacy."

Home visits are a regular part of Kemp's daily routine. Here, she guides Aireonna Reese, who had a difficult labor with a previous pregnancy, through a series of prenatal stretches during the early stages of labor.

In 2014, Kemp founded Doula 4 a Queen, a community-based doula practice that offers everything from prenatal support for expectant mothers to doula care for those experiencing miscarriage and pregnancy loss. The organization specializes in caring for Black women and their families and serves a diverse client base. Committed to a mission of service when doula support is so crucial to the outcomes of laboring mothers in her community, Kemp has never turned away anyone for financial reasons, and she always makes sure that those who come to her are connected with another doula if her organization is unable to take them on.

Personalized care plans and home visits are just some of the elements that Kemp advocates for in creating a positive birth experience for mothers in her community. Within the model of doula care she practices, these methods extend far beyond labor itself, and even beyond the laboring person — especially when birth trauma is experienced.

Caring for laboring mothers and their families can be a years-long process in many cases, and Kemp is well-versed in helping families navigate the effects of generational trauma.

Doula services can be especially important for mothers of color, especially in communities where the demographics of care-givers don't reflect the population they serve. "A doula can help to facilitate conversations and make sure that important information doesn't get overlooked," Kemp says.

"It can take a lifetime to heal from birth trauma — moms can be 40, 50, 60 years old and still reflect on that time that a doctor didn't listen to them; we're talking about lifetimes of processing that people have to go through to heal from their experiences during birth. That just shows me that this work requires generational healing, and this work is helping our families and our communities heal because the idea of having a doula is really new for Black women. Even though caring for birthing people is an age old tradition, slavery and white supremacy and so many other policies disrupted our practices and took us away from our ancestral practices. That requires healing for grandma, great-grandma, as well as the mother."

Left: Kemp helps her sister, Shakera Kemp, rest between contractions. Right: Shakera Kemp holds her partner's hand as she labors at a hospital just before the onset of the COVID-19 pandemic. When COVID-related restrictions limited partners' and doulas' participation in hospital births, Kemp saw an increase in requests for home births among clients who didn't want to labor alone.

Doula work is an act "of reclaiming something that was historically ours and has been taken from us by institutionalized care," Kemp says. "It's a return to the tenets of people within your community, serving you, giving you support emotionally, physically, spiritually. It's a return to taking care of our own to help our community heal."

The overwhelming majority of Syracuse's OBGYNs and midwives are white, making Kemp's role as a support person essential for Black women. And, she says, for many Black women and women of color, experiencing pregnancy in the country that hailed 19th-century physician J. Marion Sims — notorious for experimenting on enslaved Black women without anesthesia — as the "father of modern gynecology" can be incredibly difficult.

Kemp is especially passionate about supporting her clients through the postpartum experience and helping them process the birth of their children. "We know that these experiences stay with us for the rest of our lives," Kemp says. "As Black doulas, we're against the notion that 'it's not about you now, it's about the baby,' because that's where Black mothers fall through the cracks."

"There are studies that show that people who are cared for by people who look like them — who have a shared history, a shared lived experience — have better health outcomes," Kemp says. "If your family has a distrust of the medical system, it can be helpful to have someone with you to help you navigate the anxiety of going to the doctor. We know that when we go to the doctor, you're not just going into that room with your own experiences, you're also going into that room with the experiences of your family and the experiences of your ancestors — even if you've never gone to the hospital before yourself."

"It's kind of like what police do when they stop you," Jerry Jean-Louis, a new father, said of patients' rights. "You don't realize you're giving up rights by not saying things [...] You don't realize the power you have, as a patient. [...] They're invested in doing what's best for the hospital, [...] but from the patient's side, we don't realize that that's what's happening."

While some may associate doulas — who have worked alongside midwives and medical doctors for generations — only with birth support, for many who do the work, it extends far beyond labor and delivery. And Kemp is no exception. From attending prenatal visits to staying with families throughout the birth and visiting with families during the postpartum period, she's there, folding baby clothes, washing dishes, seeking donations for diapers and prenatal care items, supporting clients who struggle with domestic violence and those who need to navigate custody battles. Every client's needs are different, and Kemp says she tailors her care accordingly.

Jerry Jean-Louis cradles his newborn daughter minutes after returning home from the hospital. Of how Kemp helped his wife to advocate for her birthing rights, he said, "It wasn't SeQuoia advocating on [Aimee's] behalf and talking over her [...] it was SeQuoia talking to us, making us aware of certain things and, from there, Aimee was able to make the final call or ask the important questions."

"Some people just need to talk after the birth to help them continue to process [what happened] while other people might need me to be more hands-on, so I might wash dishes or fold baby clothes," Kemp says. "Each person's postpartum doula care looks different, depending on what they need from me."

Left: Kemp stops at a local pharmacy that sells herbal remedies. Running errands for the families she serves is one of many ways she works to support her clients throughout their pregnancies. Right: Kemp also accompanies clients to doctors' appointments, educates families about the benefits of vaccinations, and helps expectant mothers and fathers navigate the complicated world of maternal care.

"A lot of officials, when they talk about safety and when they talk about harm reduction, a lot of that focuses on 'Does mom survive? Does baby survive?' and what we focus on is we should not be merely surviving childbirth, we should be thriving, we should be feeling empowered — like we were honored and like we were an active participant in the laboring experience," Kemp says. "But the way our medical industrial complex works, that's not the focus. It's not 'How does she feel, emotionally? How does she feel, mentally? How does she feel, physically?' ... The focus, in maternity care in the United States, is on physical comfort and did you survive, and that's not ok."

"As community birth workers, we're trying to expand the definition of safety for our clients so safety is not the mere fact that you survived, it's the fact that you had an experience that made you feel good. Often, many of us are not having those experiences that we deserve."

And Kemp's vision for the future goes far beyond supporting and realizing more compassionate care for families. For her, the experiences of pregnancy and birth should be elevated far beyond their current place in our institutionalized health-care system.

Fabiola Ortiz and Sally Curran, who delivered two of their children via cesarean section, are pictured here in their home. "We want safety and we want joy," Kemp said of her hopes for her clients as they navigate the complex process of making decisions regarding labor and delivery. "There is power — even if something emergent happens — in saying 'I did everything I could, but we had to pivot.'"

"We want to see people's human rights be honored," she says. "An ideal birth is one that's not centered around violence and is not centered around the preferences and policies [of a hospital] but, rather, what is best for this birthing person and their families — and trusting that the birthing person, when they're given the proper information, will make the decision that's ultimately the best one."

"I love it when my clients say, 'That was good. I had a great experience,' " Kemp continued. "It makes me want to cry, because that's not the norm — but it should be. Moms should be smiling, raving about how good the nursing care was, raving about how their OB or midwife listened to them, supported them and made them feel safe."

Aimee Jean-Louis rests with her daughter after returning home from the hospital. Speaking to the high rate of deliveries by cesarean section, Kemp acknowledged that there are times where medical intervention is necessary for the health and safety of both babies and their mothers, but that the medical definition of harm reduction should encompass more than the physical experience.