Black women in the United States are facing a maternal health crisis that continues to claim lives at alarming rates.
In 2021, the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births—nearly three times that of white women. Even more alarming: over 80% of these deaths are considered preventable, according to the CDC.
This isn’t just a healthcare issue—it’s a racial justice issue. Structural racism, medical bias, chronic stress, and limited access to culturally competent care have created a deadly gap in outcomes.
One of the most effective ways to close that gap? Black doulas.
What Is a Doula?
A doula is a trained, non-medical professional who provides emotional, physical, and informational support during pregnancy, childbirth, and postpartum. Unlike doctors or midwives, doulas don’t deliver babies—they deliver advocacy, reassurance, and presence during one of the most vulnerable moments in a person’s life.
When doulas are involved, outcomes improve: labors are shorter, cesarean sections are less common, pain medication is used less frequently, and satisfaction with the birth experience increases. In other words, doulas help create safer, more supported births.
Why Black Doulas Are Critical
The presence of Black doulas is especially powerful in addressing the gap in care that Black mothers often face. Studies consistently show that Black women are more likely to be ignored or misdiagnosed during pregnancy and childbirth, regardless of income or education level. A doula who shares their cultural background can serve as both a trusted advocate and a source of comfort in medical environments that often feel unsafe or unwelcoming.
But the impact goes beyond emotional support. Black doulas can also help reduce the effects of chronic stress caused by racism, which is a proven contributor to poor birth outcomes.
When someone experiences racism—whether in the form of medical bias, daily microaggressions, or systemic barriers—the body responds with heightened stress levels. Over time, this persistent stress triggers inflammation, disrupts hormone regulation, and puts strain on the cardiovascular and immune systems. These physical changes have been linked to pregnancy complications such as:
Preeclampsia (dangerously high blood pressure)
Gestational diabetes
Preterm labor
Low birth weight
Postpartum depression
Research published in journals like Obstetrics & Gynecology and The American Journal of Public Health confirms what many Black families have long known: racism doesn’t just affect how people are treated—it affects how their bodies respond to pregnancy and birth.
That’s why having a doula who understands these lived experiences and actively works to reduce stress and advocate for respectful care is so powerful. Doulas offer steady, informed support that helps Black birthing people feel safer and more in control—and that can lead to healthier outcomes for both parent and baby.
Access Remains a Barrier
Despite the clear benefits, doulas are still out of reach for many families. The average cost for doula services ranges from $800 to $2,500 per birth, and most insurance plans don’t offer coverage. While a handful of states have started to reimburse doula care through Medicaid, and some employers are adding doula services as a covered benefit, access remains inconsistent and inequitable.
This gap is especially troubling in the same communities that would benefit the most from culturally aligned, continuous care.
Community-Based Solutions and the Future of Doula Care
Across the country, Black-led doula collectives and community birth programs are working to close this gap. These doulas are not only trained professionals—they are returning to a long-standing tradition of communal care, wisdom, and support that has existed in Black communities for generations.
As awareness grows, so does the opportunity to amplify and support this work. Increasing visibility for Black doulas, highlighting their impact, and making it easier for families to find them are all key parts of the solution. Platforms that feature and connect culturally competent providers can play an essential role in bridging access and trust.
What Needs to Change
To close the gap in maternal health outcomes, we must go beyond raising awareness and commit to systemic change. That includes:
Expanding Medicaid and private insurance coverage for doula care
Investing in Black-led doula training and certification programs
Integrating doulas into hospital care teams and birth planning
Educating families about their options and rights in the birth process
The maternal health crisis facing Black women is urgent—but it is also solvable. Black doulas are already making a difference. Now it’s time to ensure they are recognized, supported, and accessible to every family that needs them.
