Black women are more likely to die during pregnancy. A local doula program aims to change that.


Launched in October 2021, the program is funded by the health system’s United Against Racism initiative, which seeks to address issues related to medical racism. His four mass hospitals—Massachusetts General Hospital, Brigham and Women’s Hospital, Salem Hospital, and Newton Wellesley Hospital—his Brigham Hospitals will use the funds to contract doulas from local agencies. Patient’s cultural and linguistic background.

“The program helps us understand how the process works and how to prepare,” said Cadet, 27, who lives in Randolph. “When you can’t even talk, there’s someone there to talk for you.”

According to the Centers for Disease Control, black women are about three times more likely than white women to die from pregnancy-related causes and are more likely to have a caesarean section. According to the Massachusetts Department of Public Health, in Massachusetts, black non-Hispanic women are almost twice as likely to die during pregnancy or within the first year of childbirth as white non-Hispanic women.

Research also shows a gap in breastfeeding rates. Black, Latino, and Indigenous mothers are less than half as likely to leave the hospital exclusively breastfeeding as white women, a potentially serious health hazard for both mother and child.

doulas offering Nonclinical physical, emotional, and informational support for families during and after pregnancy can play a role in addressing these health disparities. Trained in labor and birth anatomy and physiology, they can help women make medical decisions and serve as a bridge between the patient and the medical team.

“For those of you who have never done this before and don’t understand the process very well, we break down the process to help you make decisions so that it is part of the process rather than the process being done. Make it feel like a department,” says Mari-Elena. Reckel, founder of Boston Bath Associates, which offers doula support and childbirth education classes.

Working with a doula has been associated with improving the health of the mother as well as the infant. A 2022 report from the Massachusetts Special Commission on Racial Injustice in Maternal Health found that doula use contributed to his 39% reduction in caesarean sections, a decrease in painkiller use, and an increase in breastfeeding rates. be connected.

However, doula care, which can cost upwards of $2,000 per birth In the Boston area, it is often inaccessible to those most likely to benefit because it is not typically covered by health insurance. We’re investigating, so that may change soon.

Despite evidence that doula care leads to improved health outcomes, according to Dr. Ashanda San Jean, associate professor of obstetrics and gynecology at New York Medical College and director of obstetrics and gynecology at the Health Alliance, Hospital initiatives to provide doula services are still fairly rare. New York hospital.

“What’s happening in Boston is truly revolutionary and should be applauded and replicated across the country,” said Saint-Jean.

Another barrier to doula care for women of color is the overwhelmingly white workforce. That can make it harder to find a doula with a similar racial and linguistic background, according to her senior medical director, Dr. Allison Bryant, at Mass General Brigham’s Health Equity.

To address this, the Birth Partners program is funding doula training scholarships to diversify the Massachusetts workforce.

Bryant, who is also an obstetrics maternal and child medicine specialist, said: Gynecology, Massachusetts General.

Brigham and Women’s patients who qualify for the Doula Program enter the lottery later in their pregnancy. If selected, you will be paired with a doula who can attend two prenatal visits, birth, and two subsequent home visits.

Cadet first heard about the program seven months into her pregnancy from doctors who were concerned that lupus could put her at risk for complications. Autoimmune diseases are three times more likely to affect black women than white women in the United States, according to the CDC, and can increase the risk of birth complications such as pre-eclampsia and premature birth.

Yessia Lee is a birth doula at Brigham and Women’s Hospital. Susanne Kreiter/Glovestaff

The cadet said working with Lee greatly reduced her anxiety, especially during labor. Supported.

Lee, 48, became a doula 28 years ago and helped advocate for her mother in a way she felt no one helped her during her pregnancy. Her main job, she said, is to “help them feel like they have a voice” both at the hospital and in her family.

The program aims to improve the overall maternal health of participating patients, but its two main goals are to reduce caesarean section rates and increase exclusive breastfeeding.

Dr. Nicole Smith, a cadet physician and specialist in maternal-fetal medicine at Brigham Hospital, believes that the 23.6% national rate set by Healthy People 2030, the U.S. Department of Health and Human Services’ Department of Women and Health and Human Services, We hope to see a reduction in caesarean sections consistent with our goals. Commitment to children’s health. Massachusetts has the highest rate of caesarean births, ranking her 19th in the nation, nearly a third, according to CDC data.

Dr. Nicole Smith is a maternal-fetal medicine specialist at Brigham and Women’s Hospital.Susanne Kreiter/Glovestaff

This is not the first hospital program to offer free doula services in the area. Boston Medical Center developed the Birth Sisters Program in 1999 in response to high infant mortality rates and a widening birth gap between blacks and whites. The program is currently focused on addressing maternal morbidity and mortality, providing multicultural doula services to pregnant women in greatest need, including women with no or low social support.

“BMC decided to apply for a grant to reduce the discrepancies that were happening at the time, and offered a program that brought in doulas from communities where pregnant people actually came,” said one of the certified nurses. Donna Rodriguez said midwife, director of the Birth Sisters Program, and clinical assistant professor of obstetrics and gynecology at Boston University’s Chobanian & Avedisian School of Medicine. Unlike doulas, midwives are medically trained to provide prenatal, birth and postnatal care.

According to Ebere Oparaeke, BMC program coordinator, doula support can help reduce disparities among mothers, but is a temporary solution to the larger problem of systemic racism that underlies these disparities. should not be used as

“Adding tools to the system doesn’t make a difference,” she said. “It comes from challenging, dismantling and uprooting what has been embedded for so long.”


Zeina Mohammed can be reached at zeina.mohammed@globe.com. follow her on her twitter @_Zeina Mohammed.





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