SC doula program designed to address racial health disparities for Black mothers

GREENVILLE — In a state with one of the worst maternal mortality rates in the country, Black mothers face even higher rates of pregnancy-related deaths than White women.

One hospital system’s program aims to change that by connecting Black mothers with doulas.

Doulas act to advocate, encourage and provide comfort measures for expectant mothers throughout the pregnancy process and after birth. Such support has been shown to lead to shorter labors, fewer complications, increased success with breastfeeding and overall positive birth experiences.

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Prisma Health, one of the largest health systems in South Carolina, financially supports doulas for Black mothers in areas it serves from the Midlands to the Upstate.

The program, which launched as a pilot in 2023, provides small grants to offset the expenses of doula services for 100 expectant Black mothers each year. This year, program leaders hope to explore the effects on postpartum depression.

The state ranks eighth highest in maternal mortality rate of all U.S. states, according to the South Carolina Maternal Morbidity and Mortality Review Committee’s 2024 Legislative Brief. A pregnant person’s health is often tied with their child’s, as seen in the wide racial disparities in infant and maternal mortality that permeate the South.

In South Carolina, Black women were 4.2 times more likely to die from a pregnancy-related complication than White women in 2020, the most recent year the committee surveyed. Regional disparities for such deaths persist, and there’s a much higher mortality rate for rural residents versus urban residents.

Discrimination, which can appear as differences in care, clinical communication and shared decision-making, was found to be a contributing factor in more than 36.4 percent of the deaths reviewed.

Black women — even some high-profile celebrities like tennis great Serena Williams, who nearly died after giving birth — have cited not feeling believed with their health concerns as a reason for not receiving adequate pregnancy-related care.

One participant in the Prisma Health program, Jernae Webb, said she would have loved to have a doula with her first baby.

“I didn’t know any other new mothers at the time, and I was going through a lot of unfamiliar feelings that I didn’t feel comfortable sharing on follow-up doctor visits,” Webb said in a news release.

Webb’s doula helped her through an especially painful period of breastfeeding, cooked meals and cared for the baby. That let Webb spend time with her other two children while her husband took care of other household needs.

“Everyone wants to hold the baby, but who holds the mother? That’s what doulas do — provide unconditional support and advocacy for the mother,” Webb said. “As a Black woman, I really appreciated being able to work with someone who has a shared cultural understanding.”

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