Earlier this year, Missouri hosted the state’s first Black Maternal Health Summit in Columbia. The summit’s keynote speaker, Commonsense Childbirth founder Jennie Joseph, was one of Time’s “Women of the Year” in 2022 for her tireless efforts to address the Black maternal mortality crisis—a particularly pressing issue.
In fact, Missouri ranks 44th among states for pregnancy-related mortality. Black women face three times the ratio of pregnancy-related deaths compared to white women, while women in rural areas have a 24 percent elevated risk.
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Some area health care providers are turning to doula care as one solution. Doulas can help pregnant and laboring patients remain comfortable and provide vital support. “Research finds that community-based doula services are an effective strategy,” says Dr. Carolyn J. Pryor, medical director of maternal services for SSM Health St. Louis and medical director of the DePaul and St. Joseph–St. Charles OB Care Centers. “Our goal is not only to provide additional support for our patients but to improve healthy birth outcomes.”
Pryor reports that doulas can help reduce rates of preterm birth, low birth weight, and NICU admissions, as well as increase prenatal visits and breastfeeding initiation. Pryor says doulas can also address social needs and connect patients to resources outside of the clinical care.
SSM Health is partnering with the doula collective On Up to offer care for expecting mothers at SSM Health DePaul Hospital and SSM Health St. Mary’s Hospital. With a grant from the St. Louis Department of Health, SSM will be able to make doula support available to 200 patients.
BJC HealthCare is also taking steps to provide new and expectant mothers with support. “We understand that one of the major barriers to accessing doulas is financial support,” says Doneisha Bohannon, director of community health partnerships and collaboration for BJC HealthCare’s Community Health Improvement. “We also know that another barrier is around awareness.”
According to Bohannon, BJC is ensuring that its facilities are doula-friendly. It’s also hosting meet-the-doula nights and offering doula training for clinical team members. The health care system is now educating nursing students, residents, and fellows about the doula model of care.
Bohannon explains that BJC is also advocating at the state level for policies that improve access to and compensation for doulas. One important aspect of their work is tracking data—documenting whether patients have a doula and how it affects outcomes. In Missouri, insurance typically does not reimburse for doula services, but some state lawmakers are trying to change that. Legislators have proposed bills that would allow for doula services to be covered by Medicaid and other insurers in the hope of reducing maternal mortality and the lack of access to care in some parts of the state.
“Data is going to be key in a lot of decision-making around doula support and doula care,” Bohannon says. “We’re happy to be able to contribute to the conversation holistically.”
At Barnes-Jewish Hospital, health care providers are working with community organizations such as Jamaa Birth Village to broaden the integration of doulas in clinical settings and ensure that doulas are accessible.
Jamaa founder/CEO Okunsola Amadou, a practicing midwife and doula, knows the importance of doula care. “Not only do they know a patient’s birth plan, as well as their traumas and triggers, but they can advocate for patients by asking the right questions if plans change,” she says. “A doula will be there the whole time.”
