When Bristeria Clark When she went into labor together with her son in 2015, her contractions were regular at first. Then they stopped. Her cervix stopped opening. After a couple of hours, the doctors reported Phoebe Putney Memorial Hospital in Albany, Georgia, Clark prepared for an emergency cesarean section.
It was not the vaginal birth that Clark had hoped for during her pregnancy.
“I freaked out. This was my first child. You don't plan something like that, of course,” she said. “I just remember the gas getting in my face and I eventually fell asleep.”
She remembers feeling a fantastic sense of relief when she woke up and saw that her little boy was healthy.
Clark, a 33-year-old nursing student who also works full-time in county government, had one other cesarean section when she gave birth to her second child in 2020. This time, the cesarean section was planned.
Clark said she is grateful that the doctors and nurses who delivered her two babies were kind and caring during labor and delivery. Looking back, nonetheless, she wishes she had had a doula to offer personal care while pregnant, delivery and afterward. Now she wants to offer other women the chance she didn't have.
Clark is a member of the Morehouse School of Medicine’s first-class of rural doulas, called Perinatal patient navigators.
The program recently graduated a dozen participants, all black women from southwest Georgia. They accomplished greater than five months of coaching and are scheduled to start working with pregnant and postpartum patients this 12 months.
“We are developing a workforce that provides black women and mothers with the support they need,” Natalie Hernandez-Greenassociate professor of obstetrics and gynecology at Morehouse School of Medicine, said on the Doula Graduation Ceremony in Albany, Georgia.
Albany is the second site of Morehouse School of Medicine's Perinatal Patient Navigator program. The first site has been in operation in Atlanta since training began in fall 2022.
Georgia has certainly one of the very best maternal mortality rates within the country, in line with a Analysis by KFFa nonprofit health information organization that features KFF Health News. And black Georgians are greater than twice as likely than white Georgians die from pregnancy-related causes.
“It doesn’t matter if you are rich or poor. Black women are dying [an] alarming rate of pregnancy-related complications,” said Hernandez-Green, who can be executive director of Center for Maternal Health Equity on the Morehouse School of Medicine. “And we're going to change that person by person.”
The presence of a doula and regular care are related to improved labor and delivery outcomesless stress and better patient satisfaction, in line with the American College of Obstetricians and Gynecologists.
Several studies also link doulas with inexpensive birth interventionsincluding caesarean sections.
Doulas will not be medical professionals. They are trained to teach patients about pregnancy and the postpartum period, guide them through the health care system, and supply emotional and physical support before, during, and after birth.
The Morehouse School of Medicine program is certainly one of a growing number of comparable Efforts initiated across the country as increasingly more communities turn to doulas to assist Maternal mortality and poor maternal health, particularly amongst black women and other women of color.
After graduating, Clark is looking forward to helping other women in her community as a doula. “I want to be the person who is there for my clients and treats them like a sister or mother, in the sense of respect,” she says. “The ultimate goal is for them to feel comfortable and know that I am there for them.” Her training has inspired her to Become an advocate for maternal health in southwest Georgia.
The Morehouse School of Medicine Doula Program is funded by grants and costs $350,000 annually. Graduates receive a $2,000 training stipend, and this system places five graduates with health care providers in southwest Georgia. The grants also pay the doulas' salaries for one 12 months.
“It is not sustainable to chase the next grant to finance it,” said Rachel HardmanProfessor of Health and Racial Equity on the University of Minnesota School of Public Health.
According to Georgetown University's Center for Children and Families, 13 states cover the price of doulas through Medicaid.
Hardeman and others have found that when Medicaid programs cover doula care, States save thousands and thousands of dollars in health care costs. “We were able to calculate the return on investment if Medicaid decided to reimburse doulas for pregnant individuals who are Medicaid recipients,” she said.
Doulas may also help reduce the number of pricy medical interventions during and after birth and improve birth outcomes, equivalent to reducing the variety of cesarean sections.
Doulas may even Probability of premature birth.
“An infant born at a very, very early gestational age requires a lot of resources and interventions to ensure that he or she survives and continues to thrive,” Hardeman said.
There is a growing demand for doula services in Georgia, said Fowzio JamaResearch Director for Healthy Mothers, Healthy Babies Coalition in GeorgiaHer group recently accomplished a Pilot study that offered doula services to about 170 Georgians covered by Medicaid. “We had a waiting list of over 200 clients and wanted to give them the support they needed, but that just wasn't possible with the resources we had,” Jama said.
The services of a doula can cost a whole bunch or 1000’s of dollars out of pocket, making them too expensive for a lot of low-income people, rural communities and communities of color, a lot of whom suffer from an absence of birth care, in line with the March of Dimes.
The Healthy Mothers, Healthy Babies study found that matching high-risk patients with doulas—particularly doulas of comparable racial and ethnic backgrounds—had positive patient outcomes.
“The use of Pitocin to induce labor has been reduced. We have seen fewer requests for pain medication. And only 6% of our infants had low birth weight,” Jama said.
Nevertheless, she and others acknowledge that doulas alone cannot solve the issue of high maternal mortality and morbidity.
States like Georgia must do more to offer comprehensive obstetric care to communities that need more options, Hardeman said.
“I think it's important to understand that doulas are not going to save us, and we shouldn't put that expectation on them. Doulas are a tool,” she said. “They're a piece of the puzzle that helps solve a really, really complex problem.”
Meanwhile, Joan Anderson, 55, said she is looking forward to the work that can see her assist patients, especially those from rural areas around Albany.
“I feel equipped to go out and be that voice, that person that our community so desperately needs,” said Anderson, a graduate of Morehouse School of Medicine's doula program. “It gives me courage to know that I'm going to join this mission, this fight for us as far as maternal health is concerned.”
Anderson said she would really like to at some point open a birthing center to supply prenatal care. “Here in southwest Georgia, we don't have one at all,” Anderson said.
In addition to providing support during and after birth, Anderson and her graduates are trained to evaluate their patients' needs and connect them with services equivalent to food assistance, mental health care, transportation to prenatal care and breastfeeding assistance.
Her work is more likely to make waves in a largely rural area of Georgia, said Sherrell Byrd, Co-founder and director of SOWEGA promotiona nonprofit organization in southwest Georgia.
“Many of the graduates are part of church networks, they're part of community organizations, some of them are our government employees. They're very well connected,” Byrd said. “And I think that connectedness will help them be successful in the future.”
Originally published:
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