Expanding Equitable Access to Doulas for Patient-Centered Maternity Care
Empowering Health Care Consumers
December 9, 2022
Most maternal deaths and complications are preventable, but they stem from a complex mix of individual, health system, and societal factors, including implicit bias and structural racism.
Although there is no silver bullet solution to the maternity crisis, doulas are emerging as a cutting-edge strategy. Doulas are trained nonclinical childbirth professionals who provide physical, emotional, and informational support during and after pregnancy and are associated with better maternal and infant health outcomes. However, people of color and people with low incomes are less likely to use doula services because of cost, access, lack of cultural sensitivity, and provider resistance. This past year, New York City Mayor Adams increased funding for maternal and infant health initiatives to $30 million per year, including the new Citywide Doula Initiative (CDI) to expand access to no-cost doula services. Simultaneously, Icahn School of Medicine at Mount Sinai (ISMMS) is piloting a doula initiative in Queens, filling a gap in the citywide initiative. In 2022, NYHealth awarded ISMMS a grant to leverage the initiative to provide people with low incomes and people of color with better access to doulas.
Under this grant, ISMMS will design trainings and other educational resources to facilitate positive doula-clinician interactions, including simulations to practice skills for patient-centered communication and shared decision-making. ISMMS will also develop best-practice materials on doula integration that can be disseminated throughout NYC Health + Hospitals and peer birthing hospitals. Both the City and ISMMS will capture data on service delivery, patient satisfaction, and cost and health outcomes. They will share their findings with partners across the State and use the data to make the case for government, hospital, and, ultimately, private insurance funding.
NYHealth is also supporting a complementary initiative with a grant to the Fund for Public Health in New York.