Michigan doula finds ways to help moms and babies living in maternity deserts in rural Southwest Michigan

Bianca Nash-Miot, a doula and lactation specialist based in Southwest Michigan, speaks on advocating for birthing parents—and their babies—in her rural community and beyond.

Bianca Nash-Miot, aka “The Milk Queen,” has had some interesting experiences since she started working in maternal health care in 2019. 

“One of my favorite—and least favorite—experiences that I’ve been through was actually with my sister,” said Nash-Miot. 

In 2023, Nash-Miot drove from her home in South Haven to Chicago, IL, to be with her sister, Ayla Nash, as she prepared to give birth to her first child. 

After arriving at the hospital, Nash-Miot noticed communication issues between her sister and her doctors that raised several red flags.

During a cervical exam to see how far dilated her sister was, hospital staff felt that the baby needed to be repositioned. While it is common to sometimes reposition a baby during the birthing process, it is often done with a patient’s consent—something Nash-Miot said her sister didn’t receive. 

“They just started repositioning the baby, which she didn’t know was happening, and it was quite painful for her,” said Nash-Miot, a licensed doula and lactation counselor. She spoke up to the doctors on her sister’s behalf when she realized what was happening.

“How can she consent to something she doesn’t know she isn’t consenting to? Informed consent isn’t retroactive. I told them, ‘You’re eroding her ability to have informed consent because you didn’t give her the information—this is inappropriate.’”

Nash-Miot says that, after that conversation, things “started to get a little bit testy” as her sister began to show signs of having preeclampsia, a form of high blood pressure that can lead to deadly outcomes for a pregnant mother and fetus.

“I knew something was going on. She had high blood pressure, and her diagnosis was continuously upgraded. Every time that she would have a contraction, [the baby’s] heart rate would decline,” said Nash-Miot.

Despite her sister’s blood pressure continuing to rise, Nash-Miot said hospital staff kept her sister in the dark as to what was truly happening to her and her baby, prompting Nash-Miot to advocate even harder for her sister. 

“We had to have a conversation about transparency, and I was open and honest with them. I said, ‘I feel like you guys aren’t being transparent with her. She doesn’t know that her baby’s in danger,’” said Nash-Miot. 

After spending 12 hours in labor, Nash underwent an emergency C-section, but that wasn’t the end of the rollercoaster ride she was on. The doctors rushed the newborn to the hospital’s neonatal intensive care unit (NICU) and kept him in observation overnight.

The next day, once Nash-Miot returned to the hospital after a restless night with little sleep, she learned that her nephew was still in the NICU and that her sister hadn’t seen her baby—or even received an update on how he was doing—since giving birth the night before.

“I swear I could have turned over every table at that hospital,” said Nash-Miot. 

After another conversation with hospital staff, Nash-Miot reunited her sister and baby. Both sisters were overcome with joy to see that the newborn was breathing on his own and that his vitals were stable. 

“It was a very tearful moment, but it showed me that the system has become so disassociated and disconnected from the people,” said Nash-Miot. 

Fired up

Nash-Miot said that helping her sister navigate the turbulent delivery of her nephew refueled her fire to do even more in her community. 

“I found that there was not much access to support for families, especially since I lived in a small rural community,” she said. 

Situated along Lake Michigan’s coastline and only minutes from some of the best state parks, South Haven is easily one of the Mitten’s more popular spots for tourists.

However, the area lacks essential maternal health resources for residents who live there year-round. In Van Buren County, where South Haven is located, residents travel an average of 24 miles to get to the nearest birthing hospital.

“I think there’s always this assumption that when we’re thinking of these rural places, it’s all in the UP or Northern Michigan, but those gaps are everywhere,” said Nash-Miot. 

With vast maternity care deserts across Michigan, doulas serve an especially critical role in combating maternal mortality rates. Studies have shown that expectant mothers who receive doula support are four times less likely to have a baby with a low birth weight, two times less likely to experience a birth complication involving themselves or their baby, and are more likely to initiate breastfeeding. 

To combat Michigan’s maternal health deserts and connect doulas with folks needing their services, Gov. Gretchen Whitmer launched a program in 2022 to expand Medicaid to ensure new moms and babies had health insurance for a full 12 months after giving birth. Then, in 2023, Whitmer included doula services for Medicaid recipients as part of her “Healthy Moms, Healthy Babies” initiative. 

The expansion included creating the Doula Initiative, a program that partners with the Michigan Department of Health and Human Services (MDHHS) to connect pregnant Michiganders with a statewide network of birth doulas.

Since January 2023, nearly 450 doulas have joined the registry, about 60% of whom are covered by Medicaid, including Nash-Miot and her organization, Birth Queens and Milk Queens.

“It was important for me to fill the shoes that I did not see filled in my community,” said Nash-Miot.

In addition to providing in-home and virtual lactation consultations, Birth Queens and Milk Queens host multiple free weekly support groups virtually and in-person at the HOPE Parent Resource Center in Van Buren County. Nash-Miot also travels across Michigan to speak with other organizations and prospective doulas.

Related: Medicaid-covered doulas are bridging the gaps for Black mothers in Michigan

“These folks who are going through these situations are queens,” said Nash-Miot.

“Motherhood, maternal care…that is a very sacred thing.”

Read more: Doulas are helping birthing families in Michigan more than ever