A nonprofit publication of the Kentucky Center for Public Service Journalism

Doulas provide practical support, guidance during birth, and their care can reduce maternal mortality


By Mariann H. Hutti
University of Kentucky Healthcare

The Centers for Disease Control and Prevention recently released statistics on maternal mortality in the United States. These statistics show maternal deaths rose at an alarming rate, and large disparities continue when deaths in Black and white pregnant women are compared. Overall maternal mortality in the USA rose by 14% between 2019 and 2020 but increased by 26% among Black women. Mortality was three times higher when Black women were compared to white women.

It is clear that Black families bear a disproportionate burden of devastating pregnancy outcomes. Currently, Black infants are more than twice as likely to die than white infants. In addition, more than 45,000 stillbirths or newborn deaths in the first week of life are reported each year, with Black women experiencing twice as many of these losses as white women. These statistics do not consider the hundreds of thousands of miscarriages that also occur in the USA each year but are not officially reported.

Kentucky also shares in this healthcare crisis. A recent Kentucky public health report found 78% of maternal mortality cases were considered preventable.

A doula is a lay (non-medical) birth support person who is trained in meeting the emotional and physical needs of the family during pregnancy, childbirth, and/or the postpartum period. Doulas offer practical, non-judgmental support, guidance and education.

Doula care is associated with these pregnancy benefits:

• Shorter laboring
• Less likely to need a C-section or have preterm birth
• Less likely to use an epidural or other pain medication during labor
• Fewer uterine ruptures
• Fewer hysterectomies after uterine rupture
• Fewer maternal deaths

Last week Blue Shield of California launched a new program to combat maternal mortality in Black women. The Maternal Child Health Equity Program is intended to support childbearing women in underserved communities. It will train doulas and make supplies, emergency funds and family-based services available to pregnant women.

Doula support programs have been in existence for many years. Research indicates doula support programs are well-accepted by high-risk women from underserved communities. Pregnancy, postpartum and labor support by doulas is a cost-effective approach to providing better care to pregnant women and their babies in Kentucky.

Mariann H. Hutti, Ph.D., WHNP-BC, is a Women’s Health Nurse Practitioner and professor of nursing at the University of Kentucky.


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