Connecticut looks to expand doula services to improve childbirth outcomes
Lucinda Canty is a researcher who focuses on maternal mortality. As part of her Ph.D. program at UConn, she interviewed several women who had severe complications in childbirth.
And while the specific details of their stories varied, they all pointed to a similar conclusion.
“With pregnancy, women are so vulnerable, and then you add labor on top of that, you need someone to be there to advocate and encourage you,” Canty said, “and we have a health care system that, even myself as an educated women, I still feel intimidated by it.”
Improving childbirth outcomes is becoming a priority in health care discussions as maternal and infant mortality rates remain high, particularly for women of color. In Connecticut, advocates are figuring out how doulas — or birth aids — may help lower the number of pregnancy-related deaths.
Canty, who is also a certified nurse midwife and an assistant professor at the University of Saint Joseph, is a member of a new state task force dedicated to expanding doula services. These professionals provide emotional, physical and informational support and coaching to women before, during and after pregnancy.
The task force is made up of community leaders, researchers, public health experts and working professionals — it convened for the first time last week in Hartford.
“Just hearing horror stories of women—black women in particular—of all different socioeconomic statuses is just horrifying,” said Eva Haldane, a research consultant and aspiring doula. “And so, I’m really trying to be part of the solution.”
National reports show there are 10.5 maternal deaths for every 100,000 births in Connecticut. That rate is about three times higher for black, Latino and Native American women.
Studies have shown that pregnancies involving doulas have better outcomes. Erin Jones, of the March of Dimes organization, said providing greater access to doulas is just one part of the puzzle.
“It’s not going to be a silver bullet, it’s not going to change everything for everyone, but I think it’s an attempt and a try to addressing the issues,” Jones said.
Tekisha Everette, executive director at Health Equity Solutions, said racial disparities in birthing outcomes are getting more attention as public figures like Beyoncé and Serena Williams talk about their own issues with childbirth, but everyday people with fewer resources and support have had the same poor experiences.
“There are women every single day in Connecticut who are not famous, who do not have millions of dollars, who do not have access to the greatest care every possible in Connecticut who are struggling,” Everette said.
Task force members hope doulas can improve pregnancy experiences for women of all races, but the profession faces obstacles. There’s currently no statewide, uniform certification program for doulas, so practice techniques vary. Doulas also can’t get reimbursed for their services from Medicaid like other reproductive health care providers because of how they’re categorized as non-medical professionals in federal guidelines.
Earlier this year, lawmakers failed to pass legislation that would have helped create a certification program and a payment structure for doulas.
According to a legislative fiscal note in April by the state Office of Fiscal Analysis, Connecticut could bring in about $17,500 from regulating and certifying doulas in the first year of a licensing program, but it could cost up to $75,000 to reimburse doulas for their services.
Task force members said they’re looking at ways to regulate and bolster the profession so that they don’t deter people from becoming doulas, as well as figure out how to pay them.
“We also need to have this be a working wage so that doulas can actually perform the jobs that they need to do and be able to survive themselves as a profession,” Everette said.
Jones said they hope to hear from more practicing doulas, obstetrician and gynecology providers, and women with childbirth experiences. The task force plans to make recommendations to lawmakers in time for the next legislative session.
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