According to the Centers for Disease Control, in the United States, childbirth mortality rates for Black pregnant persons are 3-4 times greater than their white counterparts, no matter their socioeconomic or education status. Given this alarming disparity, Family Medicine assistant professor Venus Standard, MSN, CNM, founded the Alliance for Black Doulas for Black Mamas (ABDBM), which recently was awarded a $525,000 grant from The Duke Endowment.
The program, led and entirely staffed by Black women, will continue its recruitment, support, and funding for Black doula training to decrease maternal mortality rates. Its unique strength is a holistic approach to addressing perinatal morbidity and mortality in the Black community. Families who receive care from a doula have been shown to have fewer medical interventions, infants with higher birth weights, fewer birth complications, and are more likely to breastfeed, all leading to decreased maternal and infant mortality and morbidity rates.
Given persistent racial and ethnic disparities in birth outcomes, workforce diversity is particularly urgent in the context of supportive care during pregnancy and childbirth. Lack of recruitment, high fees, and limited availability of culturally appropriate training has made it very difficult for Black women to receive certification from DONA International, the largest and leading doula certifying organization. In response, the program is partnering with DONA to provide learners guidance to the required instructional elements and certification for successful graduates. In addition, ABDBM is enhancing the traditional DONA labor support doula training by designing a curriculum from the Black perspective, including considering cultural needs, institutional racism, and lack of trust in the healthcare system. Augmenting the primary doula curriculum with topics such as the Black Birthing Bill of Rights, medical mistrust, and social determinants of health weaves in the mind, body, and spirit connections essential to this work.
With initial support from UNC C. Felix Harvey Award to Advance Institutional Priorities, ABDBM graduated its first class of nine Black doulas in July and eleven in September 2021. The 3-year grant from The Duke Endowment will support the training of 120 new Black doulas from Alamance, Durham, Granville, Guilford, Orange, and Wake counties and has a goal of 2,000 total mothers and families served by the end of the grant period. Training these new doulas will increase access to doula services for Black pregnant persons by 300 to 600 families per month moving forward.
The long-term vision of these efforts is to establish a diverse maternity care workforce pipeline. This includes developing or partnering with existing programs to provide additional training to Black doulas to be certified as postpartum doulas or CNA/CMA training or both, providing enhanced care. This advanced training will allow graduates an opportunity for more involved support of patients and increased income possibilities. Equally important, data collected related to birth outcomes and patient satisfaction will help drive policy changes related to insurance coverage for doula care. As insurance companies and payers begin to reimburse doula services, certified doulas completing this program are equipped to be compensated for services, sustaining their doula practices.