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Title V Technical Assistance Meeting

 Doula Care and Health Equity

How does doula support decrease health disparities and improve birth outcomes for women of color/minorities?

Rachel Abramson, RN, MS, IBCLC
Executive Director, HealthConnect One

The powerful impact doulas have on birth outcomes for both mother and baby has been well-documented in recent years, making this a pivotal moment for doulas and those of us who work with doulas. For doula support to decrease health disparities, however, special attention must be paid to who doulas are serving, where doulas are working, how they are building relationships with their clients and how their impact is sustained in communities of color.

While doulas are experienced women who support other women during childbirth, community-based doulas are experienced women who support other women specifically in their own communities throughout pregnancy, birth, breastfeeding and early parenting. Community-based doula programs have successfully served birthing families in communities of color and low-income communities around the country for over two decades. How these programs function and the transformative effect these doulas have was detailed in a federally funded study in 2014, which describes high breastfeeding rates (87 percent at 6 weeks vs. 61 percent of a similar sample), low C-section rates (24 percent vs. 30 percent ​of a similar sample) and increased access to maternity and pediatric care. Additionally, community-based doula programs have demonstrated lower rates of prematurity and low birth weight, increased birth spacing and more responsive parenting. Because these programs rely on peer-to-peer support, women from the communities being served are recruited, trained and hired – thus providing community and workforce development as well as improved birth outcomes. 

HealthConnect One is the national leader in advancing respectful, community-based, peer-to-peer support for pregnancy, birth, breastfeeding and early parenting.

Naima Black, Doula, CLC
Coordinator, North Philadelphia Breastfeeding & Community Doula Program

It's all about relationships. For many decades, women of color have been underrepresented in the world of birth workers. Thankfully this trend is changing with a growing community of midwives and doulas of color who are supporting their sisters with culturally and linguistically connected perinatal education, and support during pregnancy, childbirth, and the postpartum period. Community doulas offer non-judgmental mentoring to families about their options in childbirth and infant feeding choices. They nurture mothers so mothers can nurture their babies. This movement is having positive impact in Philadelphia communities that face significant poverty and race-based barriers to equitable health care. Women are having fewer cesarean sections and breastfeeding rates are on the rise. Women are encouraged to become active participants in the health and wellness of their families. And many women who were supported by a community doula are now becoming trained themselves. Each one teach one!