NYC aims to reduce racial inequities in maternal health care by offering free access to doulas

By Zoe Sottile, CNN

New York City is to offer free access to doulas for families in the city’s most vulnerable neighborhoods.

Mayor Eric Adams announced the expansion of the program, known as the Citywide Doula Initiative, on Wednesday. The project aims to provide access to doulas for 500 families by the end of June, according to Adams‘ statement.

A doula is a “professional labor assistant who provides physical and emotional support” during pregnancy and childbirth, according to the Mayo Clinic. Doulas are not required to have any professional health care experience. Nurse midwives, by contrast, are “advanced-practice providers” and are able to provide medical care, like by prescribing medications.

Families benefiting from the program will receive three prenatal home visits from a trained doula, support during labor and delivery, and four postpartum visits. The city will also expand the doula workforce by training 50 doulas by the end of June and certifying 70 others, according to the statement.

In addition to expanding the doula initiative, Adams also announced the expansion of the citywide Midwifery Initiative, which will allow the New York City Department of Health and Mental Hygiene to gather data on births and care with midwives — and the expansion of the Maternity Hospital Quality Improvement Network to all 38 birthing facilities in the city.

The doula initiative is part of a larger project to reduce racial inequities in maternal health, said Adams.

“The root causes of racial disparities in maternal health are real, so it’s time we do right by every mother and every baby, no matter the color of their skin or the language they speak,” said the mayor. “By expanding and investing in both doulas and midwives, we are taking the steps necessary to begin to address the disparities in maternal deaths, life-threatening complications from childbirth, and infant mortality.”

Racial disparities in maternal health outcomes are stark. Black women are three times as likely to die from a pregnancy-related cause than white women, according to the US Centers for Disease Control and Prevention. In New York City, these differences are even more dramatic: Black women in the city are nine times more likely to die from a pregnancy-related cause than White women, according to the mayor’s office, and their infants are three times as likely to die under the age of 1.

Doulas, some argue, are a key tool in combating those disparities and improving outcomes for mothers and babies. Studies have linked the services of doulas and midwives to health benefits for the mother and baby — such as lower rates of birth complications, lower rates of low birth weight for babies, and increased rates of breastfeeding.

“Expanding the role of these two crucial initiatives is essential to recovering from COVID and addressing the inequities that already existed in maternal health, especially in communities of color,” said New York City Council Member Lynn Schulman, according to the press statement.

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