Monroe began studying midwifery as a teenager, after learning about the high infant mortality rate in her hometown of Boston, Massachusetts. Although born in the northeast, she recognizes her Alabama roots and practices healing using the laying on of hands for pregnant and postpartum women, newborns, and families. From 1978-1990 she provided homebirth services to her community and ran a midwife school, graduating five midwives. 

In 1991, Monroe moved to Portland, OR, at seven months pregnant. Unable to find a Black midwife for her home birth, she founded the International Center for Childbearing (ICTC), the first national non-profit to increase Black midwives, honor the legacy of twentieth-century African American midwives, and empower families to improve birth outcomes. She also began to bring midwives together with the International Black Midwives and Healers Conference, which has to date been held fourteen times across the nation. 

In 2002, Monroe created the ICTC Full Circle Doula Birth Companion Training Program, today known as SMC Full Circle Doula Birth Companion Training, the first Black doula training program in the nation. Offering a dual certification for the labor and postpartum doula, the program includes the midwifery model of care and how to become a midwife for interested doulas. Since its inception, Monroe has trained over 5,000 doulas, 85% of whom are Black, helping to diversify birth and postpartum care. 

Today, Monroe also consults with healthcare professionals and doulas to help them achieve cultural competency, increase clients, and improve perinatal outcomes. She mentors hundreds of people to claim their power as healers, midwives, doulas, and leaders. 

In 2016 Madame Noir named her “Queen Mother of a Midwife Movement “because of her pioneering work of introducing midwifery and homebirth services to Boston, MA in the 1970s. Her Boston work is also profiled in the books “Granny Midwives and Black Woman Authors,” and “Wings of Gauze: Women of Color and the Experience of Health and Illness.” 

Monroe’s work has been recognized by numerous awards, including four Lifetime Achievement Awards. In 2022 Scientific American included her in their “People Making History in Health Cathe Lifetime in 2019 she received the Dr. Hildrus A. Poindexter Lifetime Achievement Award from the Black Caucus of Health Workers (BCHW), the oldest caucus of the American Public Health Association (APHA) and the Midwives Alliance of North America Lifetime Achievement Award; in 2016, she received the Lifetime Achievement Award by Maternal Child Health Champion Awards Ceremony Human Rights in Childbirth US Summit; Maternal-Child Health Champion; and in 2014 she was celebrated in Portland’s We Are Health Movement. She is on the mural “Women Making History in Portland, in Portland, Oregon.