Supporting Black and African American Families With Doula Services | Blue Shield of California

For Black families and those who identify as African American, pregnancy should be a time of joy – but too often, it is overshadowed by fear. Despite medical advancements, Black and African American people in the United States are three times more likely to die from pregnancy-related complications than white mothers, according to the Centers for Disease Control and Prevention (CDC). Contributing factors such as inadequate prenatal care, systematic bias in health care, and a lack of support during labor and postpartum recovery continue to put Black mothers and their babies at risk.

California is facing a maternal health crisis. Every five days, a Californian loses their life to pregnancy-related complications, according to the CDC. In 2023, non-Hispanic Black or African American women experienced a maternal mortality rate of 50.3 deaths per 100,000 live births, significantly higher than white women, according to the CDC. Furthermore, Blacks and African American women over the age of 40 face a maternal mortality rate nearly five times higher than those under 25. These figures underscore the need for more comprehensive and culturally congruent care.

Doulas make a difference

Across the country, maternal health advocates are embracing new solutions to improve maternal health – and doula care is making a significant impact. Doulas are non-clinical professionals who are trained to provide non-medical support, including emotional, physical and informational care before, during and after birth. They also guide families through pregnancy loss, miscarriage and the postpartum period with compassion and expertise. They are passionate about supporting families during the pregnancy journeys and their child’s first year of life.

People with doula support are more likely to have a healthier pregnancy, fewer birth complications and better birth outcomes, according to the National Library of Medicine. With Black and African American mothers facing disproportionate risks, doulas play a crucial role in improving maternal health outcomes by providing personalized continuous care.

Studies show that doula care leads to better health outcomes for both mothers and babies. Research has linked doula support to lower rates of C-sections, reduced epidural labor times, and fewer low-birthweight and premature deliveries, according to the Patient Centered Outcomes Research Institute.

“Black and African American mothers often face unique challenges in the healthcare system,” said Nicole Evans, senior manager, Maternal, Infant and Child Health Equity at Blue Shield Promise. “Having a doula can make a critical difference in ensuring that Black and African American families receive the respectful, empathetic, nonjudgemental and intentional support they deserve during their birthing experience, contributing to a positive birth outcome.”

The emotional support provided by doulas also helps ease emotional strain during labor, while increasing the feeling of empowerment and satisfaction with the birthing process. Mothers with doula support are also more likely to have successful and longer breastfeeding experiences.

Gestation period: During pregnancy, Black and African American expecting families often face challenges in receiving the respectful and attentive care they deserve. In some cases, this can lead to delayed care, and a higher risk of complications. Doulas help mitigate these challenges by offering emotional support. They educate mothers about their birthing options and encourage regular prenatal care, ensuring that they make informed decisions and reduce the likelihood of complications throughout their pregnancy. With a doula’s support, Black and African American expectant families feel more confident and empowered to advocate for themselves and their babies, ensuring their voices are heard and respected in medical settings.

Labor and delivery: Doulas continue to provide invaluable support during labor and delivery. They offer both emotional and physical assistance, reducing stress and anxiety, which can lead to smoother deliveries. Studies have shown (Sobczak et al., 2023) that with a doula present, mothers are more likely to experience better labor outcomes, including a reduction in the need for medical interventions. Their continuous presence reassures mothers, helping them remain calm and in control. Doulas also ensure that mothers are fully informed about their options during labor, empowering them to make decisions that align with their birth plan.

Postpartum and infant care: After birth, doulas remain a critical source of support. They help new moms navigate the challenges of breastfeeding and monitor signs of postpartum depression, which disproportionately affects Black and African American families. Doulas can connect families with additional resources, ensuring they have the support they need during this crucial period. Mothers who receive doula support then experience lower rates of postpartum depression and are more likely to successfully breastfeed, improving both maternal and infant health outcomes.

Building on this success and recognizing the urgent need to support Black and African American families, Blue Shield Promise is working to expand access to doula care. The program, currently available for Medi-Cal mothers, is designed to provide equitable maternal health care by:

• Increasing training for all doulas and recruiting more Black and African American doulas to better serve their communities
• Providing Medi-Cal covered doula services for all eligible mothers
• Raising awareness about the life-saving role doulas play in Black and African American maternal health
• Partnering with local organizations to improve healthcare accessibility in underserved areas

To learn more or find a doula near you, please visit: Maternity Program | Blue Shield of CA Promise Health Plan.