4:08
- wellness
- April 11, 2022
Black women turn to doulas amid maternal crisis
Black women in the U.S. are more likely to die in childbirth than other races.
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Dr. Ashanda Saint Jean, a board-certified OBGYN and chair of OBGYN for the Health Alliance Hospitals and Westchester Center Medical Health Network in New York, notes that doulas are a source of non-medical support for pregnant women before, during and after childbirth.
\"A doula is a support person who has been trained and educated in labor and delivery,\" said Saint Jean. \"I've had a number of Black patients feel that having a doula is an extra layer of support where they're able to more ask questions about their birthing experience and explore all measures to ensure a healthy outcome.\"
In Naomi's experience, she and her doula created a birthing plan so that Naomi's doctors and partner would know what she wanted, and the doula made sure the plan was executed during labor.
\"With a doula, I can relax and focus on labor,\" said Naomi. \"She can even tell my partner things like, 'Rub her back right here.'\"
Dr. Jacquelyn McMillian-Bohler, a certified nurse-midwife and assistant professor in Duke University's school of nursing, describes doulas as bridging the communication gap between health care providers and Black female patients.
\"Our health literacy is poor across the board, and then when you add racism on top of that, it just creates another layer,\" she said. \"That's what we're doing with the doula, we're trying to attack that health literacy piece that really affects outcomes.\"
![\"PHOTO:](\"http://a.abcnews.com/images/GMA/2-graphic-abc-rc-201211_1607701625386_hpEmbed_16x9_384.jpg\")
Studies show that continued support like doulas for pregnant women can help reduce the rate of C-sections, which are higher among Black women.
The postpartum care offered by doulas also helps to increase the rates of breastfeeding, which improves health outcomes for new moms and babies, and decreases the rates of postpartum complications, like blood clotting and blood hemorrhaging, both of which impact Black postpartum women, data shows.
Stephanie Devane-Johnson, Ph.D., associate professor at Vanderbilt University's school of nursing, said she sees doulas as filling a lifesaving role in the birthing process for Black women.
\"It takes a village not only to raise a child, but also to give birth,\" said Devane-Johnson. \"What we're trying to accomplish here is to create the village to support Black mothers.\"
Devane-Johnson and McMillian-Bohler are among the health experts leading the fight to get more Black doulas trained to meet the need of expectant Black women.
They and other experts point to the issue of racial bias in medicine and say it is critical to have doulas who understand and share the same lived experiences as their clients.
\"It's very important that we have health care providers that look like the community we serve and birth workers that look like the community that we serve,\" said Devane-Johnson. \"I still actively practice at Vanderbilt University and it's amazing how Black patients, whenever I walk into a room they're like, 'Where did you come from?'\"
\"It gives them a sense of comfort,\" she said.
Venus Standard, assistant clinical professor in the University of North Carolina-Chapel Hill's School of Medicine's department of family medicine, recently received a $75,000 grant to train Black doulas, a program she is working on alongside Devane-Johnson and McMillian-Bohler.
The funding will allow the trio to recruit and train 20 Black women to earn doula certification -- which can cost hundreds of dollars and is often a barrier to entry for Black women -- and also provide business and marketing seminars to \"help the newly-trained doulas establish viable businesses,\" according to UNC.
\"There's a lack of trust in within the Black community toward the medical community,\" said Standard. \"There is a better trust value when [a Black pregnant woman] knows that you're going to give them accurate information and information that's needed for them and their particular situation, especially if her provider team does not look like her.\"
McMillian-Bohler pointed out the trust factor between doulas and patients is especially important because the birthing process is so personal.
\"You think about someone being in your intimate space, being with you in your home and potentially coming to the hospital and and sitting in a room with you for 20 hours,\" she said. \"It can be a hard sell so that's why this grant is so important and projects like this are important, so that not only do people know doulas are out there, but that we're growing the body of doulas that look like the people we are caring for.\"
Health care providers who are on the front lines of helping Black pregnant women describe a heartbreaking situation of watching women live in fear during what it supposed to be a joyous time.
\"I cannot have another Black patient come to me and say, 'I'm scared I'm going to die having this baby,'\" said Saint Jean, the OBGYN in New York. \"It breaks my heart that in 2021 we still have women in the United States afraid that they will die in childbirth.\"
And while having a doula is helpful for Black mothers, it is not a cure-all for the maternal mortality crisis in the U.S., experts say.
For one, doulas can cost upwards of $1,000 per birth. While there are efforts to have doulas funded by Medicaid and more insurance plans and there are initiatives like the Black Parent Initiative (BPI) in Oregon that offers doulas free of charge, the access is not equal, according to BPI's Bryant-Daaka.
![\"PHOTO:](\"http://a.abcnews.com/images/GMA/BlackDoulas_v02_DG_1617982532202_hpMain_4x3t_384.jpg\")
\"Everyone should be able to have a doula, no matter what the cost is,\" she said. \"If we know that these services are helpful and are going to save lives and reduce cost on the backend, why would you not want them offered to women who are giving birth?\"
Having doulas present is also not going to eliminate all of the underlying issues that put Black pregnant women in more danger, according to McMillian-Bohler.
\"Black doulas are not going to fix the oppression and discrimination and those things that are still happening,\" she said. \"Because what you hear [from Black women] that's very consistent is, 'I don't feel heard, 'I'm not listened to;' 'I don't feel comfortable explaining how I'm feeling because I'm not taken as seriously as someone else.'\"
\"We have example after example after example of where that has happened, and until we get to that issue, it's not going to go away,\" she said.
ABC News' Dr. Adjoa Smalls-Mantey, Dr. Alexis E. Carrington and Danielle Genet contributed to this report.
Editor's note: This story was originally published on April 13, 2021.
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