LA County

L.A. County Seeks to Expand Doula Services for Pregnant Women of Color

"Well-educated, well-resourced black women have significantly worse birth outcomes than white women who live in absolute poverty and haven't graduated from high school," the public health director said.

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Hoping to improve infant and maternal mortality rates among low-income women of color, the Los Angeles County Board of Supervisors today asked staffers to identify funding to expand doula services for pregnant women.

Supervisors Hilda Solis and Mark Ridley-Thomas co-authored the motion.

"Access to high-quality health care should not depend on a woman's income or socioeconomic status, and I am committed to erasing these disparities in medical care by expanding doula care services," Solis said. "Doulas empower women to communicate their needs to their medical providers, which leads to healthier families."

Public Health Director Barbara Ferrer said there are "stark inequities" in outcomes for low-income women of color. The maternal mortality rate for black women is almost six times higher than all other women, even ignoring issues of income and education, she said.

"Well-educated, well-resourced black women have significantly worse birth outcomes than white women who live in absolute poverty and haven't graduated from high school," Ferrer said.

"Emerging science really suggests that the unique stress -- some of which is associated with racism and discrimination -- that's experienced by black women in our society explains a lot of the gap."

More than 41% of pregnancy-related maternal deaths are preventable, according to a 2018 review by the California Department of Public Health.

Doulas are professionals who offer social and emotional support, education and coaching during pregnancy and often assist during birth and postpartum recovery. Proponents say that culturally-responsive and patient- centered care from doulas can reduce Cesarean births, low birth weight and preterm births, as well as the impact of postpartum depression. Doulas are also credited with increasing rates of breastfeeding and satisfaction with the birth experience.

"I believe that increasing the quantity of certified, high-quality doulas and making their services affordable to those who need them most will lead to a reduction in these unnecessary and preventable fatalities," Ridley- Thomas said.

The board asked staffers to consider services for women who are Medi- Cal recipients, jailed or members of an at-risk population not eligible for Medi-Cal.

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