How Doulas Are Saving Black Women One Birth at a Time
By Tamika Rowe
Black women are magical, fierce, independent and are dying from one of the most natural acts-- giving birth. In the United States, Black mothers die at 3 to 4 times the rate of their White counterparts from childbirth. Additionally, they are 243% more likely to die from pregnancy or childbirth related conditions such as postpartum hemorrhage and eclampsia. These statistics transcend the boundaries of education and income, Black women of all education and income levels are affected by this national tragedy. Many Black women are not surviving childbirth, a health disparity that only recently began to receive national attention.
Stress from discrimination and prejudicial practices in the American health system is a major contributing factor in the increasing problem of Black maternal mortality. Dr. Airline T. Geronimus developed the “weathering” theory, which suggests that lifelong exposure to racism, political marginalization, social and economic disadvantages have caused early deterioration in the health of Black people. And Black women whom are considered a “double minority” experience higher levels of stress due to greater amounts of daily discrimination because of their gender and race. The unfortunate reality is, our health system is biased and often devalues Black women by ignoring our complaints, and by attributing conditions like hypertension to our racial identity instead of a possible underlying medical complication. Too often Black women’s cries are silenced, and our pain dismissed.
When Black women do survive childbirth they often describe negative birthing experiences and recall how poorly they were treated by medical providers. In a 2012 national study, 21% of Black mothers reported poor treatment from hospital staff due to their ethnicity, race, or cultural background, in comparison to 8% of White mothers and 19% of Hispanic mothers. This treatment extends into the postpartum period where Black mothers are not being screened and diagnosed effectively for mood and anxiety disorders. Although, 1 in 7 moms experience postpartum depression, new mothers of color are diagnosed at a rate of 38% for postpartum depression compared to the 13- 19% for all new mothers.
In addition to all of that, when women of color are diagnosed, up to 60% do not receive any mental health services due to social and economic barriers. Often issues like transportation, fear of losing their jobs, lack of paid time-leave, and being unable to make and keep appointments, prevent many Black women from accessing the help that they need. And due to lack of awareness many Black women do not recognize the signs and symptoms of mood disorders, and consequently are less likely to seek mental health care.
Many Black women are turning to doulas as an answer to the maternal mortality crisis and to help address the gaps in care they receive from healthcare providers. The word doula originates from a Greek term meaning “women who help”. They aren’t medical providers, but they can assist in making the birthing experience a positive one. Doulas are trained to support mothers emotionally, physically and provide pertinent information during labor and in the postpartum period. Their duties can range from accompanying expectant mothers to their medical visits, teaching mothers relaxation techniques, and helping mom understand various unfamiliar medical terms that are used by medical staff.
In a 2013 study, researchers found that doula assisted mothers have better health outcomes than pregnant woman who did not utilize their services. Doula assisted mothers were four times less likely to have a low birth weight baby, and two times less likely to develop a postpartum complication. The American Congress of Obstetrician and Gynecologists report that continual doula support can lead to the reduction of cesarean sections, less medical interventions, and overall improved outcomes for women in labor.
Postpartum doulas primarily assist new mothers after birth and are valuable in helping women make the transition from an expecting mother to a new mother with an infant. They visit the new mom and baby at home and can help address concerns with breastfeeding, sleep deprivation, and can encourage mothers to reach out to health providers if they are feeling unwell. Although many postpartum doulas are not certified in mental health, they can discuss the signs and symptoms of postpartum depression and mood disorders. In the Netherlands where follow up home visits are the norm, mothers have lower rates of postpartum mood disorders, higher rates of breastfeeding, and better maternal and infant health.
Legislators and state officials are beginning to take notice of the benefits doulas have to offer. Recently, Governor Cumo launched a pilot program expanding Medicaid coverage to include doula services in hopes of decreasing Black maternal mortality statistics the state of New York. According to a 2018 study, Black women are four times as likely to die in childbirth in New York state and 12 times as likely in New York City than White women. The governor has also created a taskforce to help address and study maternal mortality complications and deaths.
Doulas may be what many Black mothers need to turn the tide in the “war” for their lives. Studies and statistics show the overwhelming benefits their services have and how compassionate care can positively impact health outcomes. For Black women, their services can literally be life-saving and doulas can play an integral part in the birthing experiences by advocating on their behalf. Black women who are strong, resilient, magical, but still very much human, are dying and doulas are here to help this crisis one birth at a time.
Tamika Rowe is a public health practitioner that is passionate about maternal and child health, health inequity, and health access issues. Tamika is a freelance writer and holds a Master of Public Health degree specializing in healthcare and policy. Contact and correspondence information: firstname.lastname@example.org