WUOT’s Carole Myers: The overall rate of maternal mortality in the United States is the worst among similar high income countries. And black women in the US are three times, yes, three times more likely to die during pregnancy than white women. Furthermore, according to the Centers for Disease Control, 80% of pregnancy related deaths are preventable. Doulas have been shown to improve birth outcomes among black women and address underlying disparities that contribute to poor birth outcomes. My guest today, Alexis Alsop is the founder of empowered doula services. She is a birth doula and currently a student midwife. Welcome to Health Connections, Alexis,
Alexis Alsop: Thank you for having me.
Well, let's dig deeper, Alexis, into the issue of poor birth outcomes among black women. What are some of the contributing factors, and more importantly, what are the implications for the affected women, their families and communities?
Yeah, so we know the statistics that black women are more times likely to have complications or passed away for childbirth, and it's due to the worst health outcomes due to racism, we have implicit bias in the healthcare system as well that exists and economic challenges as well.
How does a doula improve birth outcomes among black women and address underlying disparities?
I doula and I show up to families and meet them where their support needs to be at. Doulas are trained professionals who give emotional and informational support, physical support at birth. We support them during the whole pregnancy, show up at birth and postpartum, so we're following up, making sure they're still good, babies still well, and we also interla the fathers in the role too. That's been a very important thing that I do as a doula, and I show up for families and where they need me to show up. So for example, if I have a family that I'm supporting and they need diapers or they need clothing or anything, I'm going to make sure that I can get those donated to me to give to them. Mom needs me to come to a doctor's appointment. I go up to doctor's appointments too, because sometimes they need advocacy there as well. It looks different for everybody, and every family, too. Support looks different.
But surely, support isn't all that's part of addressing this problem of maternal mortality. So what is it that you do when you talk about things like implicit bias, system problems? How do you advocate or change what the birthing process is about.
So, I do that by educating activism, pushing policy like I did this past year on a maternal health bill that went in effect this year of July. 1, I really make sure that my clients and families are educated so that way they can make informed decisions. Informed decision making is important that way they have evidence based information for them decide what's best for their family.
Am I correct to say that you're looking to make system changes at the same time you're making changes in the process?
Yes
What policy or other changes are needed to facilitate the work of doulas improve accessibility and utilization for the goal of improving birth outcomes.
Support new systems in place, right? New standard of care. Make doulas more accessible in standard of care. So that's where the first one supporting, you know, policies that come in place to where we can all collaborate, because we all want the same thing.
Okay, so what might some of the specific system changes be? I mean, it sounds like you just have to get doulas to be allowed to be present
Yes, be present. And also offering innovative payment methods, making sure that doula care can be covered on insurance, right, and not just Medicaid, but, you know, really expanding that, and then also providing and paying for doula trainings.
Can you talk a little bit about the evidence about doulas to support these system changes you're talking about?
Yeah, studies have shown that a doula that's been present can reduce cesarean rates up to 39% also shorten labor by an average of 41 minutes, and then decrease the need for pain relief by 10%
This transcript has been lightly edited for content.
