Doula Diaries
CHC’s Doula Diaries Celebrate Unsung Maternal Health Heroes During Black History Month
Unsung Heroes
Women in the United States face a maternal mortality rate more than double that of most high-income countries. This maternal health crisis is especially felt in Black communities. Black women are 3 times as likely as other women to die from pregnancy related causes in the U.S. Black women also are about 50% more likely to deliver a premature baby.
Historically midwives supported by doulas were the leading maternal care providers in Black communities to fill care gaps. However, as more births moved into hospitals over the past century, the number of doulas, midwives and birth advocates declined— reducing the opportunity for pregnant people to receive the individualized care that midwives and doulas provide.
Doulas are key to addressing the maternal health crisis. That’s why CHC: Creating Healthier Communities is partnering with communities to fill the gaps and address unmet needs through the Black Birthing Initiative. In recognition of Black History Month, we’re highlighting the importance of these unsung heroes and the continuum of care that they provide Black families.
Healthier Communities
Early midwives were important to enslaved communities, as these women were often allowed to travel and maintain community connections in a way that was unusual for enslaved individuals. “Granny Midwives” were Black women who continued this tradition post emancipation, working in underserved communities in the Southern United States. As obstetrics became a medical specialty, the mostly male physicians sought to exclude the traditional female role. Prior to a greater understanding about asepsis, this trend caused thousands of maternal deaths due to infection. This period was also marked by an increase in unnecessary medical interventions for low-risk pregnancies and a loss of choice for women in the childbirth process. Unfortunately, the marks from this history persist today.
A recent study reported that one in six women preparing for childbirth reported medical mistreatment, including being shouted at or scolded and having medical concerns ignored. Reported rates for mistreatment were higher for Black women across socioeconomic groups. Having a Black partner is also associated with higher reported rates of mistreatment for women of all races.
Many Black women, including famous individuals such as tennis star Serena Williams, find that their concerns are dismissed due to variations in quality of healthcare, implicit bias and structural racism. Doulas, who are not authorized to make medical decisions, but instead work as a companion and advocate in the birth process, can help bridge that gap. As reported by the World Health Organization, “When a woman has access to trusted emotional, psychological and practical support during labor and childbirth, evidence shows that both her experience of childbirth and her health outcomes can improve.”
CHC is committed to implementing responsive strategies that are equity-centered, evidence-informed, and community-led. CHC’s approaches address the social drivers of health, incorporating community perspectives and the lived experiences, needs, and concerns of affected communities.
Doulas are underfunded, particularly in Black communities. One unique element of CHC’s Black Birthing Initiative is that we partner locally to ensure that doulas are supported and receive full-time salaries, allowing them to focus on Black mothers and families.