“Black women are three to four times more likely to die or experience some sort of complication after childbirth or during their pregnancy.”
Rashana Keller, a registered nurse and educator in Women’s Clinical Education with Prisma Health-Upstate’s Clinical Education Department, knows those numbers by heart. But an innovative program is helping to move the needle, taking practical steps beyond the data to change those outcomes and improve the health and futures of Black mothers and their babies.
“The data has become so heavy,” Keller said. “The data is important, but what sort of intervention projects can we do to try to move us in the right direction in South Carolina, and hopefully at a national level as well? Which is kind of where the Black Doula Program comes in as an intervention project.”
An innovative program continues
Prisma Health’s Black Doula Program aims to make that difference. The program, aimed at enhancing maternal and birth outcomes for Black mothers, began as a pilot program in 2023 with a grant of $125,000 that served 100 mothers. It was recently renewed with an additional $200,000 in funding – both grants from TD Bank.
“When we think about addressing maternal outcomes and health disparities for women in South Carolina, we want to be a part of that positive change and essentially do the work,” Keller, who leads the program, said. “We received funding to start our program one year ago. And all of that funding goes directly back out to patients in the community who plan to deliver with us in the Prisma Health system, meaning that they could plan to give birth with us here in the Upstate or they can have plans to deliver in the Midlands.”
Black women who plan to deliver at a Prisma Health hospital can apply for up to $1,000 to offset the cost of doula services. Doulas provide essential non-medical support, including encouragement, advocacy and comfort measures before, during and after birth. This personalized support has been shown in national studies to lead to shorter labors, fewer complications, increased success with breastfeeding and overall positive birth experiences. The extension of this program is expected to serve an additional 100 women in each of its second and third years, during which staff members hope to explore if the use of a doula is associated with lower rates of postpartum depression.
Doulas offer support before, during and after birth
“Doulas do a number of different things. and it’s going to look different for every patient,” Keller said. “We leave that up to the patient to say, you tell us what you want to do with your money. Do you want a doula to support you during labor? Maybe they’ve had a previous birth, and that delivery didn’t go so well, maybe there’s some trauma that they’re still trying to heal from or move past – or maybe it’s postpartum services that a patient wants to utilize.”
Postpartum doula services can address a wide variety of needs, from dealing with the hormonal overwhelm that can follow birth to helping to prepare a meal or provide breastfeeding support.
“Mental health is a big, big, big issue that we try to hit on,” Keller said. “Just having patients apply for doula services postpartum is huge when you think about having someone to connect with, someone to talk to, to lower a patient’s chances or risk of getting postpartum depression.”
Prenatally, doulas can help educate expectant mothers as they prepare for birth and their labor and delivery experience. During the birth, they serve the mother’s needs.
“It’s important that mom feels both safe and loved and centered,” Arialle Kennedy Smith, a doula whose clients have received funding through the Black Doula Program, said. Smith owns Momma Magnolia and is a certified holistic doula.
Smith said her role is to help clients in whatever way serves them best, empowering them along the way. She said giving birth is like summiting a mountain.
“It’s nice to climb a mountain like that with someone who’s skilled,” she said. “When it comes to giving birth, I’m there to just skillfully guide both mom, partner and sometimes second support partner, whether it be mom or grandmother. I’m there to guide the family towards climbing the mountain of birth successfully.”
Learn more and apply for funding
The Black Doula Program supports Prisma Health patients by providing grants to offset the cost of doula services in the prenatal, delivery, and/or postpartum settings. Each patient chooses her own doula. Funds are distributed from Prisma Health directly to the doula of the patient’s choice and are distributed proportionally across all birthing hospitals to ensure Black women in all communities served by Prisma Health have an opportunity to participate.
Learn more about the program prismahealth.org/services/womens-health/maternity/black-doula-grant.