According to the Centers for Disease Control and Prevention, Black mothers are twice to three times more likely than white mothers to die from pregnancy-related causes. These disparities in maternal mortality can be affected by preexisting conditions such as hypertension. Patients from Black communities may face barriers in accessing and receiving quality healthcare. Norton Healthcare is committed in addressing these health issues and racial inequalities. Norton Healthcare has established a community-based doula program that provides doula services at no additional cost for patients with statistically poor maternal outcomes.
Doulas can be a boon for pregnant women
Doulas are non-medical, trained professionals who support pregnant patients through every stage of childbirth. Their goal is to improve their health and help them achieve positive outcomes. A doula can be a great help for patients, their labor, and their postpartum experience. Doula-assisted pregnant women are four times less likely have a low baby weight (LBW), two times less likely experience a birth complication, and significantly more likely start breastfeeding. Additionally, patients who had support from a doula during labor were less likely to use pain medications, require Pitocin or have cesarean deliveries than patients who didn’t use a doula. Patients were more likely to have shorter labor and to have a vaginal delivery without instruments. Doula support was more common for patients who were satisfied with their birth experience. According to the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, doulas can provide labor support that can improve delivery and labor.
Barriers to doula-use
Doulas can make birthing easier by making sure women have support and a person who is sensitive and understanding of their culture and goals. A doula can be contracted directly by a pregnant person to provide services. On average, the cost of a birth doula ranges from $800 to $2,500. Postpartum doula fees can vary depending on services provided and the time of day. They can cost between $20 and $50 per hour. According to the National Women’s Law Center, women are 35% more likely to live in poverty than men. The rates are even higher for women of colour: 18% Black women live with poverty, 18% Native American women, 15% Latinx women, and just 8% for Asian women. Simply put, while doulas can provide many benefits, many people experiencing pregnancy can’t afford to contract with doulas.
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Norton Healthcare developed the community-based program for doulas to help women in Louisville with low maternal outcomes. The program provides pregnant patients with the opportunity to have a doula free of charge. Although doulas are welcomed in many Kentucky birthing hospitals, this program is the first to employ doulas as part the care team.
“Traditionally, doulas employed by hospitals have served as birth coaches and postpartum support, but our new program will expand the role,” said Mary L. Schubert, DNP, MSN, system vice president, women’s services, Norton Healthcare. “Eligible patients will have someone who can help reduce the impacts of social determinants of health, as well as reduce the risks for pregnancy loss, health complications and even death.”
This new program will include several home visits throughout the patient’s pregnancy and the period after delivery. Eligible patients must live in the California, Portland or Russell neighborhood, and will receive additional prenatal care through Norton OB/GYN Associates and Norton Women’s Specialists downtown practices, with babies delivered at Norton Hospital. Initially, three doulas are employed. Providers at Norton Women’s Specialists and Norton OB/GYN Associates can refer patients to the community-based doula program.
The community-based doula program is made possible thanks to a $250,000 gift to the Norton Children’s Hospital Foundation from Aetna Better Health of Kentucky.
“By offering the support of a doula in addition to obstetric or midwifery care, we hope we can help women of color experience better outcomes and have the supportive, healthy pregnancy and delivery they deserve,” said Lecresha Sewell, APRN, nurse practitioner with Norton Women’s Health and a member of the Louisville Coalition for Black Maternal Health. “And by following the patient after childbirth, a doula can help detect many complications that may occur in what we refer to as ‘the fourth trimester.’ Early detection is essential to improve health outcomes.”