Doulas could be an answer to Arizona’s maternal mortality crisis
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TEMPE – Leah Goldmann lounges on a sofa with her legs crisscrossed and a pillow cradled on her lap. She listens as Latisa Ratliff goes over birth plans, prenatal dietary considerations and how to know when it’s time to head to the hospital for labor.
Goldmann is pregnant with a girl, with an expected due date in January. It’s an exciting – and anxious – time for Goldmann, who at 33 years old will become a first-time mom.
But for Ratliff, the work is her bread and butter. As a birth doula, Ratliff’s job is to bring comfort and education to couples as they navigate the process of bringing a new life into the world – from the prenatal period to postpartum.
“One of our primary goals is to inform our clients and educate them with evidence-based information, so that they have the tools that they need in order to advocate for themselves in the hospital,” Ratliff said.
Doulas don’t deliver babies, but these nonmedical labor assistants can make a difference in maternal health outcomes. One recent study found that in three states with Medicaid-funded doula programs, women who received doula support were less likely to deliver via cesarean section or experience postpartum depression or anxiety than those who did not.
The U.S. has higher rates of maternal mortality than other developed countries, and those rates only worsened during the pandemic. Of 30 states where the maternal mortality rate is known, Arizona ranked ninth for these deaths from 2018 to 2020, according to the Kaiser Family Foundation.
Every year hundreds of people die during pregnancy or just after, and these tragedies are more common among individuals of color. A report from the Arizona Department of Health Services shows Native American and Black women are more likely to die from pregnancy-associated causes than white women. The same is true nationally.
Arizona is among states working to address the problem. One proposal on the table: Expand access to doulas.
Florida, Oregon and a handful of other states already cover doula services under Medicaid, and several more are in the implementation process. Advocates say Medicaid coverage would make these services more available to populations that need them.
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