Several counties across the country have begun providing low- or no-cost doula services to pregnant women, particularly women of color, in a bid to drive down disturbingly high maternal mortality rates. Capitalizing on research suggesting that the support and advocacy doulas provide through labor and delivery is associated with lower rates of Cesarean sections, decreased use of pain medications and epidurals, and increased satisfaction with the birthing process, some public health officials are pushing to improve access for the women most likely to need it: women of color and women living in poverty. The most recent area to embrace this effort is Los Angeles.
The Los Angeles County African American Infant and Maternal Mortality Initiative is a partnership between the Los Angeles Department of Public Health and First 5 LA, the state’s “largest funder of early childhood” according to its website, plus community partners. The initiative funds free doula care to pregnant black women in Antelope Valley, San Fernando Valley, San Gabriel Valley and South Los Angeles.
Pregnant Black women in Los Angeles County have maternal mortality rates four times higher than pregnant white women.
“Having a well-informed, articulate, supportive person by your side, who knows the health care system and can be a buffer and a bridge when you’re dealing with medical providers and so on,” Los Angeles County Department of Public Health’s Deputy Director Dr. Deborah Allen said. “[It] can really make the experience much more positive, much less stressful and, therefore, healthier for Black women.”
In the initiative’s first year alone, 363 women were served and 199 babies were born, and local health officials increasingly view the doula program as key to decreasing maternal mortality rates in their counties.
Some women of color living in the surrounding counties not covered by the initiative are still able to access low-cost or no-cost doula care, thanks to the Victoria Project. Project co-founder Janelle Green is a certified midwife, and she understood the uphill battle women — especially those living in poverty — face when it comes to financing doula or midwife care out of pocket. The Project covers “birth center midwifery care, doula care, acupuncture, home birth and chiropractic care, lactation support, and doula care for pregnancy loss and miscarriage” and even sometimes mental health therapy in the postpartum period. At some 200 clients, the Project is already almost at capacity less than a year since its September 2020 founding.
California’s legislature is currently considering SB 65, also known as the California Momnibus Act, in reference to federal Momnibus legislation. Besides increasing Medi-Cal coverage from just two months to a full year postpartum, the Act would fund four doula visits spanning the pregnancy and labor and delivery process, plus eight more visits during the vital ‘fourth trimester‘ postpartum period. Women suffering through miscarriage and stillbirth would also be eligible for doula care. But the bill incorrectly treats all pregnancy outcomes as equal, as doula coverage would additionally cover abortion.
Prenatal and postpartum doula services providing continuous emotional support are a reminder that pregnancy and motherhood are beautiful and natural, not pathological or burdensome. While the abortion industry financially profits from women’s emotional vulnerability during pregnancy, doula services support and enhance women’s natural strengths as they bring new life into the world.
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