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The U.S. faces a severe maternal health crisis with devastating impacts on the health and well-being of birthing parents across the country. Compared to other high-income countries, women in the United States are more likely to die from complications related to pregnancy or childbirth. A driving factor behind the high mortality rate is the disproportionate number of Black and Indigenous women who experience pregnancy-related complications and death. What’s more, the CDC estimates that 84% of maternal deaths in the U.S. are preventable.
Doula care is gaining prominence in the mainstream as an effective way to combat some of the inequities experienced by birthing parents in the United States—and globally. Doulas have been a source of birthing care for pregnant people for centuries, but only in the past few decades have doulas seen broader recognition among the healthcare industry and government.
“When families are supported by doulas from their home communities, they are able to receive culturally humble care within a medical system that largely doesn’t enable that type of care,” says Maven Doula CE Durfee, MSN, CNM, ARNP, CLC, CD(DONA).
As employers and health plans look for avenues to reduce the insidious effects that inequities have on the health of parents-to-be and new parents, increasing access to doula care should be a key component of any strategy. Here’s what HR and health plan leaders need to know about doulas and health equity.
Understanding the role doulas play in pregnancy, birth, and postpartum
A doula is a trained professional who provides emotional and physical support to birthing parents during childbirth and the postpartum period. Doulas are not medical professionals and do not provide medical care; rather, they offer information and advocacy to help pregnant people navigate the healthcare system, make informed decisions about their care, and understand their options throughout pregnancy. While third-party certifications for doula care exist, many doulas working today do not seek certification.
“Doulas are so important because we help educate birthing parents,” says Blue Andrew, Maven Care Advocate and Doula at Brooklyn Birth. “We normalize advocating for yourself and having ownership and autonomy over one’s body, which many people don’t experience as part of their birthing process. Doulas are there to carry and support parents through one of the most vulnerable times of their lives.”
Doulas are there to carry and support parents through one of the most vulnerable times of their lives.
Through their emotional support and advocacy, doulas help drive better outcomes for birthing parents in clinical settings. A study by the University of Washington found that birthing parents supported by doulas are less likely to have a C-section, have a low birth weight infant, and give birth to a newborn that requires medical attention immediately after birth. Birthing parents who receive doula care also report increased engagement in their health and higher satisfaction with care.
“Doula care gives families confidence and support,” says Qef Johnson, Maven Birth & Postpartum Doula. “We help parents make an informed decision and encourage them to become an engaged part of their care team instead of being completely reliant on their medical professional to lead their care. And this advocacy can be incredibly important because providers may make decisions that are unconsciously driven by racism, classism, or sexism that don’t result in the best care.”
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