There are lots of reasons why black babies born in the United States statistically experience higher mortality rates and poorer health outcomes overall than their white counterparts, and none of them have to do with fundamental biological differences between the two groups. In fact, black babies die at higher rates largely because they're oftentimes coming from a lower socioeconomic background and the related barriers in access to care as the result of systemic racism, Newsweek reported over the summer. So, to combat this, some cities are training doulas to help improve black infant health outcomes — and it certainly seems as though they may be onto something.
Midwives are childbirth experts who are equipped to deal with all the medical aspects of having a baby; doulas are non-medical professionals who can take care of a clients' emotional and physical needs. So, while a midwife gets down to the business of actually monitoring moms' and babies' health, doulas may offer massages to moms in labor or help them to find the most comfortable positions. Doulas guide moms through the process before, during, and after birth, often decoding doctors' recommendations. They could even perform services to help calms mom's fears such as co-writing a labor pep talk with them.
According to a report by Stateline, a Pew Charitable Trusts initiative, cities all around the United States — such as New York City, Chicago, and Tampa — have invested in doula training programs for this very reason. Baltimore is in the process of mobilizing a program, and Denver, San Antonio, and San Francisco have reached out to the doula training company MaternityWise Institute about getting started.
That all sounds great, but how does it help women and babies who typically don't get the medical care they need? Well, working as independent contractors in Baltimore, for example, the trained doulas will complete the traditional tasks of helping women navigate their pregnancies and baby care — services that have been shown to reduce the risk of unnecessary C-sections, for instance. Moms who have doulas also experience fewer complications and are less likely to have babies with low birth weights.
But the seemingly ancillary services doulas will provide for women in Baltimore (and beyond) could have just as much of a positive effect on women and their babies, as Stateline reported: helping them to access housing, transportation, nutrition, and employment services.
The sad fact that many black mothers unfortunately don't have access to basic advantages like reliable transportation and basic nutirtion helps to explain when black infants die at about twice the rate that white ones do here in the United States, according to Newsweek. And poverty certainly plays a role in this. Take, for example, how a soon-to-be mom's lack of access to adequate preventive care can sabotage her pregnancy down the road. If she has a chronic health condition such as diabetes or high blood pressure, it could go untreated if she isn't seeing a doctor regularly. So, when she gets pregnant, her own health problem can then portend a preventable bad health outcome for her baby.
What's more, women of color and those who are poor all too often have bad experiences in medical institutions, Baltimore doula trainee Keyona Hough told Stateline. Having a doula by their side can help to ensure that these experiences don't repeat themselves:
Like me, a lot of these moms have been subjected to violence and trauma. That's why I want to help them understand what their rights are, so they can move through that system without being re-traumatized.
Clearly, doulas can customize their services for each client according to her background, concerns, and needs, and that can make all the difference.