Doula program available to West Louisville patients

Black mothers can be more at risk to die from pregnancy-related causes. Norton Healthcare is piloting a doula program to help address the issue.

According to the Centers for Disease Control and Prevention (CDC), Black mothers are two to three times more likely to die from pregnancy-related causes than those who are white. While disparities around maternal mortality can be impacted by preexisting conditions that Black women are more likely to experience, such as hypertension, these disparities do not happen in a vacuum. Patients from Black communities can experience barriers to accessing and receiving quality care. Norton Healthcare is dedicated to addressing these health and racial inequities and has created a community-based doula program to provide doula services at no additional cost to patients with statistically poor maternal outcomes in Louisville.

Benefit of doulas for pregnant patients

Doulas are trained, nonmedical professionals who provide physical, emotional and informational support to a pregnant patient through all stages of childbirth in hopes of producing positive health outcomes. Using a doula has been shown to have many benefits for the patient, their labor and their postpartum experience. Doula-assisted pregnancies are shown to be four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving the mother or their baby and are significantly more likely to initiate breastfeeding. Additionally, patients who had support from a doula during labor were less likely to use pain medications, require Pitocin or have cesarean deliveries than patients who didn’t use a doula. The patients were more likely to experience shorter labor and have a vaginal birth without instruments. Patients who received support from a doula were more likely to be satisfied overall with their birth experience. Additionally, a statement from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine affirms that labor support from someone like a doula can help improve labor and delivery.

Barriers to doula use

Doulas can help improve the birthing experience by ensuring that women are supported and have an advocate who is sensitive to their culture and pregnancy care goals. However, a pregnant person contracts directly with a doula to provide services, and average costs for a birth doula can range anywhere between $800 and $2,500. Postpartum doula costs can be between $20 to $50 per hour, depending on services and time of day. According to the National Women’s Law Center, women are 35% more likely to live in poverty than men. Rates are even higher for women of color: 18% of Black women live in poverty, 18% of Native American women, 15% of Latinx women, and 8% of Asian women. Simply put, while doulas can provide many benefits, many people experiencing pregnancy can’t afford to contract with doulas.

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Norton Healthcare has developed the community-based doula program to help women with statistically poor maternal outcomes in Louisville have access to a doula and the benefits one offers. The program provides eligible pregnant patients with a doula at no cost to them. While doulas are welcome in many birthing hospitals, this is the first program in Kentucky that employs doulas as part of the care team.

“Traditionally, doulas employed by hospitals have served as birth coaches and postpartum support, but our new program will expand the role,” said Mary L. Schubert, DNP, MSN, system vice president, women’s services, Norton Healthcare. “Eligible patients will have someone who can help reduce the impacts of social determinants of health, as well as reduce the risks for pregnancy loss, health complications and even death.”

This new program will include several home visits throughout the patient’s pregnancy and the period after delivery. Eligible patients must live in the California, Portland or Russell neighborhood, and will receive additional prenatal care through Norton OB/GYN Associates and Norton Women’s Specialists downtown practices, with babies delivered at Norton Hospital. Initially, the program will employ three doulas. Providers at Norton Women’s Specialists and Norton OB/GYN Associates can refer patients to the community-based doula program.

The community-based doula program is made possible thanks to a $250,000 gift to the Norton Children’s Hospital Foundation from Aetna Better Health of Kentucky.

“By offering the support of a doula in addition to obstetric or midwifery care, we hope we can help women of color experience better outcomes and have the supportive, healthy pregnancy and delivery they deserve,” said Lecresha Sewell, APRN, a nurse practitioner with Norton Women’s Care and a member of the Louisville Coalition for Black Maternal Health. “And by following the patient after childbirth, a doula can help detect many complications that may occur in what we refer to as ‘the fourth trimester.’ Early detection is essential to improve health outcomes.”

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