From Birth Rooms to Boardrooms: How Advocacy Shapes Maternal Health

When we think about advocacy, our minds often jump to legislation, policy hearings, or public rallies. Advocacy doesn’t only happen at the Capitol or in boardrooms, it starts in the birth room. As a doula and doctoral student researching maternal and infant health equity, I’ve seen how small moments of advocacy in labor can ripple outward, shaping the way families experience care and even influencing broader systemic change.

Advocacy in the Birth Room

Inside the birth space, advocacy looks like protecting the birthing person’s voice when things get overwhelming. It’s slowing down decisions so families can understand their options. It’s ensuring that informed consent is not just a signature on paper, but a conversation that honors dignity and respect.

Research confirms that this kind of advocacy matters: doulas have been shown to improve outcomes, reducing the likelihood of cesarean birth, increasing breastfeeding initiation, and enhancing overall satisfaction with care (Bohren et al., 2017). These findings demonstrate that when patients are informed and supported, outcomes improve not just clinically, but emotionally.

Advocacy Beyond the Bedside

The patterns doulas witness in real time, families feeling rushed into interventions, lack of culturally responsive care, or gaps in postpartum support, are not isolated incidents. These scenarios are reflections of systemic inequities. By documenting and sharing these experiences, doulas become the eyes and ears within healthcare, translating individual stories into evidence that can influence policy.

The CDC has consistently reported that Black women in the U.S. are three times more likely to die from pregnancy-related causes than White women, even when education and income are taken into account (CDC, 2022). In Texas specifically, the Maternal Mortality and Morbidity Review Committee found that 90% of pregnancy-related deaths were preventable (MMMRC/DSHS, 2024). These statistics highlight why bridging the gap between bedside advocacy and systemic change is urgent.

From Birth Rooms to Boardrooms

Policy change does not begin with legislation, it begins with truth-telling. Every time a doula listens, affirms, and advocates in the birth room, that story has the potential to influence systems-level change. When doulas join local maternal health coalitions, testify at hearings, or collaborate with hospital committees, they bring lived truths into spaces where decisions are made.

As I often say: policy shifts don’t just happen in boardrooms, they start in birth rooms.

A Call to Collective Advocacy

True advocacy means linking arms across roles, doulas, nurses, OB/GYNs, policymakers, and community leaders so that every family has access to safe, equitable, and compassionate care. By honoring the voices of families in real time and carrying those truths into larger conversations, we ensure that change is not just aspirational but actionable.

Birth worker with family.

References

• Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 7(CD003766).

• Centers for Disease Control and Prevention (CDC). (2022). Racial and ethnic disparities in pregnancy-related deaths. https://www.cdc.gov/maternal-mortality/disparities

• Texas Department of State Health Services (DSHS) & Maternal Mortality and Morbidity Review Committee (MMMRC). (2024). Joint Biennial Report 2024.

Disclaimer

The information provided in this blog is intended for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Doulas are not medical professionals and do not provide clinical care. Always consult your healthcare provider before making changes to your wellness or prenatal routine.

From my cradle to yours,

The Regal Quill