Doulas can be a solution to the maternal health crisis but face barriers to providing care
Takeaways from Ashley Nguyen’s Instagram Live Interview with The Lily
By Rachel Ryan
Sixty percent of pregnancy-related deaths are preventable, yet the maternal mortality rates in the U.S. are unacceptably high, O’Brien Fellow and independent journalist Ashley Nguyen said in an Instagram live with The Lily on Friday.
Nguyen cites this Centers for Disease Control and Prevention statistic as one of the driving reasons for highlighting doulas in her four-part series in The Lily. About one third of these pregnancy-related deaths happen one month to a year after pregnancy, Nguyen said. Covid-19 isolation may be worsening some outcomes. People have said they’ve seen increases in postpartum mood disorders, Nguyen said.
“So many babies are being born in this soup of grief,” one doula told Nguyen.
Postpartum and birth doulas can be a part of the solution to these issues, providing critical emotional, physical and informational care for pregnant individuals. If a pregnant person is worried that something is wrong, they can turn to their doula for advice or to ask questions, Nguyen said.
Before Nguyen started researching doulas in her graduate program, she saw them as a “boutique” and “expensive service.” After delving into what they do and hearing from real doulas, she realized that lots of people use them and in fact, “everyone should have a doula if they want,” Nguyen said.
One of the biggest barriers doulas face is an unsustainable wage. In the series, Nguyen explored Oregon and Minnesota, two states that support Medicaid coverage of doulas services, but found that the rates being paid were low for the work required of a doula.
The situation faced by Rochelle Vincent, a doula in Minnesota, stuck out to Nguyen. Vincent was paid only $200 for spending more than 72 hours at a birth plus the other countless hours supporting the pregnant individual. As a Black doula, Vincent also described facing lots of racism in the healthcare system. Nguyen said Vincent had to balance this with also trying to look out for her client, who may also be experiencing racism.
Nguyen emphasized that it’s important to remember “there’s no one singular solution” to the maternal health crisis. Midwives and postpartum doulas can also provide crucial support, though they also face barriers to providing care.
“Doulas are not the first and I doubt they will be the last to deal with some of the issues that come with working in bureaucracy,” Nguyen said.
Moving forward, Nguyen said she hopes to focus on some of the other solutions to this crisis.
Ashley Nguyen’s ‘The State of Doula Care’ project is a part of the work she is doing through the O’Brien Fellowship in Public Service Journalism. O’Brien reporting interns Sarah Lipo and Rachel Ryan are assisting her with the series.
