Addressing the American maternal health crisis
The United States is the most dangerous wealthy country to give birth in. The maternal mortality rate in the United States is the highest among wealthy countries, according to a report from The Commonwealth Fund. In 2018, the maternal mortality rate in the United States was twice as high as in France, with the second highest maternal mortality, and more than ten times as high as in New Zealand, with the lowest maternal mortality. Since 2018, maternal mortality rates have increased, reaching 23.8 per 100,000 live births in 2020, and for Black mothers, the rate was 55.3, according to a report from the Centers for Disease Control. The maternal mortality rate has been increasing since 2000, and an estimated ⅔ of maternal deaths are preventable.
Even for births with favorable outcomes for the mother/pregnant person and baby, the American hospital birth experience can be traumatic and disempowering, and medical coercion and unnecessary interventions are common. New York Hospital infamously told pregnant people not to prepare birth plans.
Our solution: Doulas, non-medical support people that advocate for the pregnant person and provide emotional support during childbirth and postpartum.
Doulas are especially important for marginalized pregnant people, including queer people, disabled people, low-income people, and people of color, who are especially vulnerable to medical mistreatment and abuse. Doulas are increasingly recognized as important parts of a pregnant person’s birth team. New York City recently created an initiative to provide low-income pregnant people with doulas. According to the Citywide Doula Collective, pregnant people who use birth doulas are less likely to have an instrumental vaginal birth or cesarean section, have their labor induced, or receive pain medications, and more likely to have a shorter labor, initiate breastfeeding earlier and breastfeed for longer, have positive feelings about their birth experience, have better mother-baby bonding. In addition, the city recognizes community-based doulas as important to addressing racial inequality. New York City even passed legislation that requires pregnant incarcerated people to have twice weekly access to doula services.