Say their name.

It’s been a theme of this year’s Black Maternal Health Week in the Pennsylvania capitol.

The CDC reports that black women are 3 times more likely to die from pregnancy-related causes than white women in the United States. 

In 2020, 107 Pennsylvania women died from pregnancy related or associated causes, according to a recent report from the state’s Maternal Mortality Review Committee. The same report says that 51% of those deaths took place postpartum (after birth), and 92% of them were preventable.

Lawmakers and advocates this week remembered women who have died in childbirth, while also pursuing policy they believe can bring change. The Black Maternal health Caucus recently introduced a ‘Momnibus’ of 8 bills that address maternal health.

One of their solutions? Doulas.

 

Advocates For the Process

“I felt like it was a very sterile environment, didn’t feel listened to, my partner didn’t feel listened to, and I just felt very alone."

Alexia Doumbouya was in labor for 36 hours when giving birth to her daughter. After her pregnancy;

“I really could not process how I could have done something so beautiful by bringing this life into the world, but I could not make the genuine connection and feel like I could serve her in the best way."

A friend helped Doumbouya identify her experience as postpartum depression—a year after giving birth.

“What I always say from that journey is I decided to become what I did not have."

That was a decade ago. Now, Doumbouya is a certified doula and president of CocoLife.Black- connecting and training others in the profession.

A doula gives women emotional and educational support during and after their birth. The National Doula Certification Board lays out basic standards for the profession. A person educates themselves on all the options that surround giving birth- at a hospital, or at home? Does a mother want to be induced? How can they prepare for a birth? Will they breastfeed after?

Aware of the spectrum of choices a mother has to make, a doula can give education on the options and help create a birthing plan. They then stay engaged with the mother, creating relationship that helps them advocate before, during, and after the birth.

“They are that voice for that birthing person through out the birthing process,” said Rep. Morgan Cephas (D-192). She is co-chair of the Black Maternal Health Caucus, and is sponsoring several bills related to doulas.

Pennsylvania’s Maternal Mortality Review Committee said that 45% of pregnancy-related deaths in 2020 were linked to mental health. National data shows doulas can reverse negative pregnancy outcomes.

Notably, doulas do not act as a medical professional; they don’t give medical advice or perform medical tasks. But their holistic knowledge lets them refer a mother to the help she needs for more specific assistance.

 

Expanding Access in Pennsylvania

The Pennsylvania Black Maternal Health Caucus is working on several policies related to doulas.

“Right now doulas, we want to make sure they are being paid an equitable wage, but also being able to be directly reimbursed through private insurance as well as medicaid,” said Cephas. Her H.B. 1602 accomplishes the medicaid portion of that goal, and passed out of the House Health Committee today.

While national certification is an option, each state chooses how it will regulate professions. Cephas is also looking to create an advisory board, which will help legitimize the profession for insurance purposes.

Doumbouya noted that structure in the profession is good. She also wants future regulations to remember the doula is not a medical profession, and to ensure the profession stays rooted in the communities being served.

“We just want to know the path that is taken to make sure you are prepared to serve in those spaces,” said Doumbouya.