April is known as National Minority Health Month with April 11-17 focusing on Black Maternal Health Week.  Black Maternal Health Week’s campaign and events aim to elevate the voices of black mothers while putting the principles and practices of the birth justice and reproductive rights movements front and center. 


Pregnant Woman” by alyssasieb/ CC0 1.0

Black Maternal Health Week serves as a reminder of the suffering, mistreatment, and loss that so many families endure during what ought to be one of the happiest periods in their lives. In America, black women are three times more likely than white women to have pregnancy related complications, with increased rates of morbidity and mortality.  


Why Black Maternal Health Week?

It is imperative that a light be shed on  institutional racism’s role in the high rates of maternal mortality within the African American community. Due to internal biases and prejudice amongst health care workers, black women are frequently neglected or dismissed in hospitals and other healthcare facilities. 

Pregnant couple” by __dahc/ CC0 1.0

Outside of the medical system, several of these mothers deal with socioeconomic disparities including lack of access to quality health care, housing insecurity, and income inequality.  Chronic stressors, sexism, lack of support for pre and postpartum depression, are also factors which increase a black woman from having a poor outcome during and after her pregnancy.  


For Black families and communities, doulas—trained specialists who offer physical, emotional and informational support to women and those giving birth—hold historical significance. Black birth attendants like doulas and midwives, offer a comprehensive style of care that benefits both the mother and baby.


Despite the fact that doulas don’t offer clinical treatment during births, the patient-centered and holistic care they offer has been linked to a decrease in cesarean rates and a decrease in obstetric complications. Particularly for individuals most at risk of unfavorable outcomes, community-based doulas can provide assistance tailored to their cultural values.

Baby” by NappyStock/ CC0 1.0

3 Benefits of Doulas

Enables Better Health Outcomes

Studies have shown that women who receive support from a doula during labor and childbirth are more likely to give birth instantaneously, have shorter labor, and be comfortable with their birthing experience. They are also less likely to need a cesarean birth and have decreased use of pain medication.

pregnant woman” by courtneyoung/ CC0 1.0

Doulas offer assistance to expectant families, empowering them to make more knowledgeable pregnancy-related healthcare decisions. They can assist couples in gaining access to services like housing, transportation, reduced cost food, and even childcare. 


They also provide emotional support, helping ease anxieties and fears around the birthing process. 


Advocacy

As part of the birthing team, community-based doulas can be a voice for the woman who is in a vulnerable position as she prepares to bring forth life. They can be advocates for these women especially within the healthcare system where the women may be too afraid, tired, or in pain to speak up for herself. Even if she does speak up for herself and is not heard, the doula can be the second voice necessary for the mother to be heard.

Lowers Perinatal Costs

By lowering the necessity of medical interventions such as cesareans, instrument-assisted deliveries, and pain medication, doula care results in significant cost savings.  Pregnancies with doulas as part of the birthing team have also been shown to have reduced rates of premature birth and NICU stays,thereby reducing medical costs.

Mothers who use doula services are more likely to breastfeed, and for longer periods which helps with infant immunity and likely to decrease illness, doctor visits, and hospital stays. 

So Why Aren’t Doulas Being Used?

Baby Crib” by Freestocks.org/ CC0 1.0

Unfortunately many private insurances do not cover the cost of doulas as they have no billable codes associated with their services. 

Doula services are covered by Medicaid in only a few states, and the doulas must be registered with Medicaid and agree to their reimbursement plan (which may be a barrier due to low pay scales”.)

Some HSA/FSA accounts can be used towards the cost of a doula and therefore all receipts of services should be kept as proof. 

Fortunately the government has recognized the benefit of doulas and doula services was added to President Biden’s 2022 Maternal Health Budget. 

Black and white macro of baby“/ CC0 1.0

“through the President’s FY 2023 Budget, HHS will grow and diversify the doula workforce by providing grants to community-based organizations to develop and/or expand programs to recruit doula candidates, support their training and certification, and then employ them as doulas to support improved birth outcomes in the community.”

This initiative and several private organizations are working to increase education and access to doulas. With time these services will hopefully be accessed by future parents of all incomes and socioeconomic status.

Doulas are just one piece of the puzzle when it comes to improving black maternal morbidity and mortality in the USA. We must take into account issues such  as implicit bias and racism if we are to see more improvement in the health and well being of black mothers and babies. 

What more information and ways to support?

Check out these websites

Black Mamas Matter

Black Doula Network

Black Doula Directory