Ashley Rogers didn't expect to have a cesarean birth. Her pregnancy had been uneventful, and she had been planning a natural birth after her first child had been born via C-section years earlier. So in July 2021, when doctors told her a C-section would be the safest way to deliver, \u201cI was freaking out,\u201d Ashley recalls. Luckily, in addition to her husband Marley, Ashley had her doula, Nadia Gramby by her side. \u201cI remember lying on the table and Nadia coming over. She whispered, \u2018It\u2019s going to be OK. You got this.\u2019 And I was totally fine after that!\u201d says Ashley, who gave birth to her son Makaio that day. For Black birth workers like Nadia, a doula based in Birmingham, AL, it\u2019s moments like these that crystallize the decision to dedicate their lives to caring not just for expectant mothers, but for expectant Black mothers. The United States has the highest maternal death rate of any developed nation in the world, and while rates are declining in most countries, the numbers have been steadily rising in the U.S. over the past three decades. For Black women, the statistics are even more daunting. In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births\u2014nearly three times the rate for non-Hispanic white women. \u201cI was called to this by God,\u201d Nadia says. After working in human resources for 15 years, she became a certified doula five years ago. \u201cI never looked back,\u201d she says. Today Nadia is a birth and postpartum doula and childbirth educator, meaning she offers her clients emotional support before, during and after birth as well as childbirth education, which makes them aware of their rights in the birth room and beyond. She\u2019s also studying to become a certified professional midwife, which would enable her to manage the medical care of mom and baby before and during birth. Additionally, Nadia serves as a mentor for other doulas, helping them with the business side of birth work and striving to fill the gaps in traditional doula training. \u201cMost of the things that are happening in our communities are not addressed in a lot of doula trainings,\u201d Nadia says. \u201cThey give you these scenarios of people who have these perfectly put-together families. But I meet people who don\u2019t have support systems already in place.\u201d For Nadia, being a childbirth educator doesn\u2019t begin and end with her clients and mentees. She finds herself answering questions about childbirth even when she\u2019s at the nail salon. And she typically shares information via social media most days. \u201cIt\u2019s another avenue for my clients to get information but also for people who may never meet me or who live in other countries to get information that is free,\u201d Nadia says. \u201cSometimes people can\u2019t afford a doula. Social media makes it more accessible, and you can go back to that information as many times as you\u2019d like. You can pull it up while you\u2019re in labor.\u201d It was through Facebook that Ashley connected with Nadia the summer before Makaio\u2019s birth. \u201cWith my first experience, I didn\u2019t have a lot of say so,\u201d Ashley explains about why she decided to bring a doula into her second labor. She was also haunted by stories and statistics of Black women suffering fatal complications during pregnancy or delivery. \u201cSeeing what other Black women went through,\u201d she says, \u201cI wanted to have someone to be there with me.\u201d Nadia says one of her top priorities is teaching clients how to speak up for themselves throughout their pregnancies. When Ashley was unhappy with her healthcare provider, Nadia helped her find a new one. \u201cYou can leave your doctor at any time,\u201d Nadia says, adding that this is something many expectant parents don\u2019t know. Doulas can support the couple throughout the process Nadia stresses that even pregnant people who have the support of a doula need support at home, too. \u201cA doula doesn\u2019t come in to replace a partner or a husband,\u201d she says. Ashley\u2019s husband and Nadia worked as a team throughout her pregnancy to ensure she was eating properly and drinking enough water. He also helped Ashley with the exercises Nadia wanted her to do to prepare for labor and delivery. \u201cShe really involved my husband, which he really appreciated,\u201d Ashley says. \u201cShe brought us together and was that glue.\u201d When it was time for labor and delivery, Nadia was there to speak up for Ashley in the birth room. \u201cI didn\u2019t have to do a lot of the communicating, and that helped me because I was already nervous,\u201d Ashley says. Nadia used essential oils and music to help quell Ashley\u2019s anxiety during labor. She even encouraged her to dance with her husband. And Nadia\u2019s calm tone and demeanor helped when Ashley's natural birth plan didn\u2019t go as expected. Black doulas as advocates In 2020, the CDC launched Hear Her, a campaign aimed at raising awareness of urgent maternal warning signs during and after pregnancy: these include dizziness or fainting, changes in vision and extreme swelling in the hands or face, among others. The program also seeks to improve communication between pregnant and postpartum patients and their health care providers, which Nadia views as part of her job as well. \u201cA lot of what I do is encouraging people to stand in their truth about what they need,\u201d Nadia explains. She adds that this can be especially difficult for Black women. \u201cWhen you have been told not to speak up and you don\u2019t want to be viewed as the angry Black person, sometimes you push down your feelings, and that carries over into the birth room,\u201d she says. In 2015, the American Nurses Association introduced a new standard called \u201cculturally congruent practice,\u201d a model to be followed by health care professionals that emphasizes a community\u2019s inherent heritage and acknowledges the historical trauma that may affect health outcomes. The ANA has reported that it believes nursing practices adhering to this standard can improve health care access, promote positive outcomes and reduce health disparities in vulnerable populations such as the LGBTQ+ and BIPOC communities, among others. Nadia, however, doesn\u2019t believe that\u2019s enough. She believes more Black birth workers are needed. \u201cThere is a difference between cultural competency and actually being a part of the culture,\u201d Nadia says. Having someone who looks like you in the delivery room makes a difference, she adds: \u201cIt\u2019s a necessity; it\u2019s not a luxury. I don\u2019t advise any Black woman to have a baby\u2014especially in a hospital\u2014without a doula, specifically a Black doula.\u201d That said, Nadia believes it takes a village to lower the Black maternal mortality rates. \u201cOne of the challenges for doulas and midwives is that a lot of the responsibility has been placed on us,\u201d she says, adding that community members need to get involved, too. To do that, Nadia suggests informing the pregnant people in your community of their options and rights and empowering them to be their own advocates. \u201cDoulas and midwives," she says, "can\u2019t do it all.\u201d Nadia Gramby What gives you hope ? This is going to sound so clich\u00e9, but the short answer is God. What\u2019s in store for your future? I foresee witnessing so many miracles in my business and in the lives that I will be a part of. I am focused on building the right relationships so that I will have everything that I need. When I have everything that I need, I can give everything that I\u2019m supposed to give to the people that are called to me. So, what I see in my future is being in alignment with God\u2019s will for my life. Why is thinking about the future important? You need to know what you\u2019re planning for. Everything that I\u2019m doing now is to build my future. My future says that I will have birth centers, a large staff and that I will train other midwives. I need those doulas and trainees to be a part of my journey. Ashley Rogers What gives you hope? Because of social media and seeing so many Black advocates for doulas now, I do feel like there is hope for my daughter and even my son, that they will know that there are options out there for you to have that support. There is someone who will advocate for you. What\u2019s in store for your future? I just passed my real estate exam. I wanted to always have a space where I could control my schedule to be there for my kids and be able to be more involved with them. Why is thinking about the future important? For the generation that\u2019s behind us, my kids and other kids that\u2019s coming, I feel like it\u2019s important to create a platform for them and give them opportunities. This story was created as part of Future Rising in partnership with Lexus. Future Rising is a series running across Hearst Magazines to celebrate the profound impact of Black culture on American life, and to spotlight some of the most dynamic voices of our time. Go to oprahdaily.com/futurerising for the complete portfolio.