Studies show that community doulas are increasingly more common and available to pregnant moms. They also may be the key to reducing racial disparities in birth and in solving our country’s maternal health crisis. Communities where the number of doulas is increasing are seeing decreased deaths and harms among laboring and birthing women. What is it about doula care that leads to improved outcomes for birthing people and their babies? Doula’s speak out with their thoughts.

What are Doulas?

Doulas are non-clinical birth workers who provide physical, emotional, and educational support to people during pregnancy, labor, birth, and postbirth (postpartum) recovery. While they don’t do health assessments or provide health care, their work definitely improves health. Research shows that support from a doula results in healthier babies, shorter labors, fewer caesarean surgeries, and more birthing people beginning and sustaining breastfeeding with their newborn. In fact, having a doula during labor and birth may even help you feel more satisfied with your birth experience!

Doulas as Advocates

Doulas help pregnant people navigate the healthcare system. Experts suggest that doulas can stop negative experiences in hospitals as they empower birthing people to advocate for themselves. This includes protecting them from the harmful effects of implicit bias and discrimination that many Black, Indigenous and People of Color (BIPOC) people experience during pregnancy, labor, and birth.

Doulas Speak Out

Naima Black, Director of Community Doulas and Lactation Services at the Maternity Care Coalition (MCC) in Philadelphia, PA, is a full-spectrum doula and has been doing this work, as well as the work of activism and advocacy in maternal child health, for more than 20 years. She summarizes her work as a doula: “Helping women reclaim their power, trust in their body, and understand their body and the profound experience of bringing life into the world and how life changing that can be…honoring people for who they are and what they bring, has been really remarkable to me,” said Black. “One of the most rewarding, memorable and transformational moments for me was creating the perinatal community doula program and training model.”

Doulas Break Barriers to Better Care

Most doulas agree that the greatest barrier to doula services is cost. Typically, doula support has only been available to birthing people with the private financial means to hire them. As a result, doula care in many communities has become a privilege reserved only for those who can afford to pay for those services. Low-income people, including those in Black and Brown communities, tell experts that they want access to doula support during labor birth, but simply can’t afford it. As a result, some hospital healthcare systems are starting to add doulas to their staff. Community doula services in urban settings, like MCC’s Perinatal Community Doula Program, are addressing these barriers head on and offering doula services in underserved communities for free.

Making a Difference One Birth at a Time

Iyonia Guinyard became a certified perinatal community doula in July of 2020 through the doula certifying body called Uzazi Village. She was part of one of the first graduating classes of community doulas in New Jersey. Guinyard is now an alumni member of Community Doulas of South Jersey, which was born from a grant awarded to the Southern New Jersey Perinatal Cooperative (SNJPC) in 2019. Guinyard continues to serve Black and Brown families in the Camden and Atlantic City area. As a full spectrum doula, Guinyard also created her own private doula practice called Kind Comforting Births that serves those in Burlington and Mercer County, New Jersey. A mover and a shaker in the New Jersey community, Guinyard says doula work is her passion and her calling: “Educating our Black and Brown mamas is so important and teaching them that it’s not a privilege to have a doula, it’s their right.” New Jersey was the first US state to offer Medicaid reimbursement

for doulas. As a result, doulas can accept Medicaid, which increases the number of people who can train to become doulas and earn a living wage supporting laboring people. Medicaid reimbursement for doulas has transformed access to doula services—and outcomes—in underserved communities. When asked how doulas can advocate to decrease the high infant and maternal mortality rate among Black and Brown moms and babies, Guinyard says: “There is still a lot of work to do when it comes to improving maternal child health in Black and Brown communities. But by encouraging pregnant and birthing people and their families to advocate for themselves and reclaim their power before, during, and after birth, community doulas may just be the answer to bridging the gap between the medical profession and family-centered care. Community doulas are changing—and saving lives!”

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Essence Williams, MSN, BSN, RNC-MNN, CCB, LCCE, is a maternal child health nurse who manages the clinical nursing component of a high-risk perinatal program affiliated with the Southern NJ Perinatal Cooperative. She also works in collaboration with Cooper University Hospital, Osborn Family Health Center and CAMCare in Camden City, NJ.

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