Maternal Health Disparities and the Medicaid Doula Benefit

In the Grassroots Advocacy skills seminar, I created a Community Action Plan to begin to address the problem for the Baltimore City community. During this class I learned how to connect with the community affected, plan for addressing needs, partner with stakeholders, create a messaging campaign, and evaluate the success of the plan. The issue that I identified is the maternal health disparity that low income black women in Baltimore face. 

In Maryland, Black women are 2.75 times more likely to die of pregnancy-related causes than their White counterparts (MMHIP, 2021). Low income Black mothers who are Medicaid eligible are at an ever higher risk for negative birth and postpartum outcomes. In the U.S. in 2019, Medicaid covered 65% of black women’s births compared to 40% of White women’s births. Doula services could be part of the solution to the maternal health crisis.  Women who are supported by doulas have improved birth outcomes, including shorter labors and lower cesarean section rates. 

Doula support has a personal connection for me. I was a trained birth and postpartum doula from 2012 to 2019 during which I attended 50 births and supported multiple families during the postpartum period. I witnessed first hand the benefits of continuous labor support and birth advocacy services provide. Therefore, I truly believe that every woman deserves a doula. Unfortunately, for the families who need it most, hiring a doula is usually cost prohibitive. On February 21, 2022, Maryland Medicaid declared that it would provide coverage for doula/birth worker services to Medicaid beneficiaries. The objective of my work and partnerships  is to begin to close the maternal health disparity gap by increasing access and opportunity of low income black women to doula care through the new Medicaid doula benefit and by connecting culturally congruent doulas and mothers through grassroots efforts. Maternal health parity is a necessary component of reproductive justice.