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."

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.

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.

"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."

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.

"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."

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.

"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."

"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.

"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."