What is a Doula?
If you aren’t familiar already, you may have started to hear the term “doula” in the world of healthcare and pregnancy. Doulas are a major talking point as one way to help protect pregnant people and babies. But who are they? What do they do? And why are they important?
Doulas are nonclinical professionals who provide continuous physical, emotional, and informative support to childbearing people before, during, and after childbirth. Professional “doulas” emerged in the 1960s in the United States - the term originating from ancient Greek, meaning “a woman who serves.” While not labeled “doulas” historically, this role has been critical to the birthing experience across all cultures for centuries, but this role is unsupported in the current American healthcare system.
Modern doulas do not replace licensed medical staff such as doctors and midwives. Instead, they work alongside them to ensure pregnant folks are advocated for, comforted, and respected. Doulas provide many invaluable benefits by increasing agency and comfort to birthing people. For example, a doula may work with a family to create a birth plan, teach breathwork exercises, offer massages during labor, or provide breastfeeding support. Doulas also act as a communication link between patients and clinicians to ensure patient concerns are being addressed.
Doula services are now becoming more popular because they are a well-researched and proven way to save on healthcare costs and reduce birth complications. This is significant because the United States is in a maternal mortality crisis.
Maternal Mortality in the United States
Maternal mortality is defined as the death of a woman during her pregnancy, childbirth, or 12-month postpartum period. Women in the U.S. face a maternal mortality rate 10 times higher than that of other industrialized nations. This can be attributed to a lack of social and economic supports during a woman’s pregnancy, delivery, and postpartum period. Without this support, women in the U.S. are deprived of the quality of care they need to survive pregnancy and childbirth.
This crisis is felt even more acutely by Black and Native women, who are respectively three and two times more likely to die during childbirth than white women. While factors such as educational attainment or income usually correlate to better health outcomes, they do not overcome racial disparities in maternal health outcomes. The rate of death for a Black woman with a college degree is still 1.6 times higher than a white woman without a high school diploma.
Moving Towards a Safer Future
As maternal mortality rates stay high, governments are calling for change. In 2022, the White House released its Blueprint for Addressing the Maternal Health Crisis. The Blueprint specifically named doulas as one way to address this crisis for their proven benefits to maternal health outcomes. Most states now have active Medicaid coverage for doula services or are exploring this possibility. Tennessee is one of the states considering this option. Other immediate policy choices that Tennessee can pursue to address this crisis is paid leave and Medicaid expansion.
We cannot turn back time and prevent these pregnancy related deaths. We cannot take away the trauma their families are now left with. But we can strive for a better future. We can become a state where Tennesseans feel safe and are safe to give birth. Covering doula services is one place to start.