National WIC Association

Black Maternity Mortality and How Doulas Can Help

April 13, 2023

By LaKora White

Black women are three times more likely to die from a pregnancy-related cause than white women. Multiple factors contribute to these disparities, such as variations in quality healthcare, underlying chronic conditions, structural racism, and implicit bias.

Recent data from the Centers for Disease Control and Prevention continues to tell the same bleak story we’ve been hearing for years: Black women suffer far worse maternal health outcomes than their white counterparts. The new figures released in a February 2022 report revealed that outcomes aren’t improving, despite growing public awareness of the issues Black mothers face. 

According to the report, the maternal mortality rate for Black women in 2020 was 55.3 deaths per 100,000 live births—nearly three times higher than the rate for white women.

A proven way to improve maternal health outcomes for Black women is by investing in doulas—professionals who offer support before, during, and after birth. I am a full-spectrum doula. LCE (Lactation Counselor Educator), and Breastfeeding Peer Counselor with the Detroit Health Department WIC. At the start of 2023, Michigan Medicaid began reimbursing doula services provided to individuals covered by or eligible for Medicaid Insurance.

Helping families have a safe, healthy, and positive birth experience is a priority. By hiring a doula, families receive valuable support during childbirth, resulting in improved birth outcomes and cost-effectiveness, making it a safe and worthwhile investment. Doula services have been shown to positively impact the social determinants of health, support birth equity, and decrease existing health and racial disparities.

Women with doula care have a 22% lower risk of preterm birth, according to a 2016 study from the University of Minnesota School of Public Health. The researchers theorized that “doula support during pregnancy may influence this constellation of risks for preterm birth by reducing stress, improving nutrition, improving health literacy, providing referrals and connections to resources, and improving emotional well-being.”

Because birth is such a vulnerable moment in a woman's life, families should be better protected.

Of course, this isn’t to say that doulas can single-handedly fix everything, and they shouldn’t be tasked with trying to. We still need to hold medical institutions accountable for their role in the current state of outcomes. To achieve lasting change, it is essential that we thoroughly scrutinize every aspect of our healthcare and medical procedures that may impact a pregnant individual, both inside and outside of the delivery room. This includes evaluating the roles played by clinicians, ranging from the individual's dermatologist to their primary care physician, to identify and eliminate any biases or stereotypes that may be present during routine visits, both before and after childbirth. It will require implicit bias training, more patient feedback surveys and bedside data, early screenings for treatable health conditions, and extended postpartum coverage to a full year, to name a few.


Working Together to Reduce Black Maternal Mortality

If you’re pregnant, here are steps you can take to protect your health:

  • Find an obstetrics and gynecology provider that fits your family’s needs.

  • Talk to a healthcare provider if anything doesn’t feel right or is concerning.
  • Know and seek immediate care if experiencing any of the urgent maternal warning signs, including severe headache, extreme swelling of hands or face, trouble breathing, heavy vaginal bleeding or discharge, overwhelming tiredness, and more. These symptoms could indicate a potentially life-threatening complication.
  • Share recent pregnancy history during each medical care visit for up to one year after delivery.
  • Connect with healthcare, birth workers (doulas), and social support systems before, during, and after pregnancy.

Health Affairs: Prioritize Doulas in Black and Brown Communities 

CDC: Working Together to Reduce Black Maternal Mortality

LaKora is a Full Spectrum Doula, LCE (Lactation Counselor Educator), and Breastfeeding Peer Counselor with the Detroit Health Department WIC program.