Metro Nashville Health gains grant to train doulas
Jasmine Worles (right) discusses pregnancy concerns with her doula Miajenell Peake at Shelby Farms Park in Memphis, Tennessee January 2021. As a doula, Miajenell will support Jasmine with many aspects of her pregnancy and after delivery. (Karen Pulfer Focht)
The Metro Nashville Public Health Department will soon be seeking recruits for a federally-funded program aimed at creating additional support for expectant mothers in low-income areas.
On Tuesday, Metro Health announced they have received $125,000 from the U.S. Health Resources and Services Administration (HRSA) to fund a project aimed at recruiting and training doulas to assist families enrolled in the Nashville Strong Babies Project, which seeks to reduce infant-mortality rates in targeted zip codes.
Infant and maternal-mortality rates have decreased over the past few years but continue to be a problem, especially among communities of color.
State Rep. London Lamar, D-Memphis, spoke at Tuesday’s press conference on her pregnancy experience. Having had a cousin die during childbirth, Lamar, who is Black, was well aware that African-American women experience high mortality rates while pregnant. Often, she said, medical workers fail to take Black womens’ pain seriously during childbirth, leading to traumatic birth experiences.
But in 2019, Lamar nearly died during childbirth from underlying health conditions and gave birth to a still-born son.
“Why is it that Black women are dying? And when everyone found out about my story, my inbox was flooded with ‘Me toos’ and ‘It happened to me but I was too ashamed to say anything,’” said Lamar.
The Tennessee Maternal Mortality Review, headed by a multidisciplinary panel, publishes a yearly report on maternal deaths and found that while deaths decreased from 82 in 2018 to 62 in 2019, most of the deaths were considered to be preventable.
In 2019, the latest data available, research showed that about 74% of all maternal deaths were determined to be preventable and 34% of deaths had substance abuse as a contributing factor.
Infant mortality rates have also decreased from a rate of 7.4 per 1,000 births in 2018 to 7.0 per lived births in 2019. Despite this, infant mortality rates in Tennessee are still higher than the national average of 5.8.
Both maternal and infant-mortality rates are higher among Black women and babies. In Tennessee, Black women are three-times more likely to die from pregnancy complications than white women, and Black infants are dying at nearly twice the rates of white infants.
A variety of causes are to blame, including poor diets and health conditions such as preeclampsia. Studies have also found that areas with high maternal and infant mortality rates tended to be located far from healthcare providers, affordable housing and quality food resources.
In Black communities, women also blamed underlying racism and bias in the healthcare industry for their poor pregnancy outcomes.
Black communities have found that a solution to combating biases was having doulas working as advocates for patients and providing support for expectant mothers before, during and after childbirth.
Why is it that Black women are dying? And when everyone found out about my story, my inbox flooded with 'Me toos' and 'It happened to me but I was too ashamed to say anything. – State Rep. London Lamar, D-Memphis, on losing a baby
Why is it that Black women are dying? And when everyone found out about my story, my inbox flooded with 'Me toos' and 'It happened to me but I was too ashamed to say anything.
– State Rep. London Lamar, D-Memphis, on losing a baby
Finding low-cost doula services, however, is challenging. Doula rates depend on the person and can cost thousands of dollars, depending on the services provided. Prices are complicated by the fact that most insurance plans, including TennCare, do not consider doulas as vital healthcare workers.
To rectify this, Lamar sponsored a bill to have doula services covered under TennCare. The bill did not pass in the 2021 legislative session.
In the meantime, Nashville health officials are funding community-based doula care for families enrolled in the Nashville Strong Babies Project, which focuses on seven zip codes identified as low-income areas.
Over the next year, the program will recruit and certify community members who will provide care for pregnant mothers and their babies up until a year after birth. Supports include providing transportation, access to childcare, prenatal care and “any other service families need to thrive,” said Angela Williams, Nashville Strong Babies manager.
Community members interested in becoming doulas need only dedication and passion for their communities, said Williams.
“There are people that are interested in just supporting families through the birthing process and they come from all walks of life and disciplines,” she said.
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