Thursday, September 17, 2020

9/15: Do Doulas Keep Moms Alive?

 9/15/2020 

Preventing maternal death is something of a holy grail for physicians treating patients of color.

About 700 women die each year in the U.S. from complications during pregnancy (31%), at delivery (36%), and up to a year afterward (33%), the CDC says.

Disproportionately, the 700 women who die each year are Black women or other women of color. Black moms are three to four times more likely to die from pregnancy or childbirth-related causes than white mothers.
One strategy for dialing back these numbers is to pair pregnant Black women with Black doulas, who assist women throughout pregnancy, childbirth, and post-delivery issues.
Doula care makes for happier moms, according to Katy Backes Kozhimannil, a professor at the University of Minnesota School of Public Health. Doulas lead to shorter labors, more vaginal births, fewer preterm births or epidurals, higher rates of breastfeeding, and "higher maternal confidence and satisfaction." Confidence matters because Black and indigenous women often face racial discrimination in medical treatment.
Even so, there's no evidence that shows that doulas prevent maternal death, Kozhimannil says. With the benefits she cites, it's hard to imagine why. But the good professor says that it's not something that we can lean on doulas to fix.
'We cannot put the maternal mortality crisis at the feet of doulas and tell them to solve it when they're the least paid member of any care team," Kozhimannil says.

That is, so far, there are no cheap fixes to this ongoing public-health problem.

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