After losing twins, Long Beach resident Cassandra Carter approached the birth of her daughter, Nyomi, last November with anxiety. She wanted support for herself and her husband, Adewole, that extended beyond routine medical care.\u00a0\n<\/p>\n
\u201cGetting pregnant as a Black woman, I wanted a team around me that made me feel safe,\u201d she said. \u201cI know all about the mishaps that Black women experience.\u201d\u00a0\u00a0\n<\/p>\n
Carter, a therapist and self-described hippie, hired Yvette Perry, a doula and co-founder of Divine Birthing Services LLC<\/a> in Lancaster. Perry helped Cassandra craft a detailed birth plan.\u00a0\n<\/p>\n \u201cI was worried about postpartum depression. Mrs. Yvette knows a lot about how postpartum affects men as well,\u201d Carter explained.\u00a0\n<\/p>\n Perry was present the day Nyomi was born. She held the baby when Carter or her husband needed a moment and even set up candles in the birthing suite.\u00a0\u00a0\n<\/p>\n \u201cWhatever I needed for my comfort, she was there,\u201d Carter said of Perry. \u201cShe was there as an advocate and voice. I had a really serene birthing experience because I had someone extra who wasn\u2019t tied to me as my family.\u201d\u00a0\u00a0\n<\/p>\n Perry, a doula for nearly six years, said preexisting conditions, poor communication and dismissive hospital care heighten health risks for Black mothers.\u00a0\n<\/p>\n \u201cSometimes, Black mommies are not being heard. They don\u2019t know they have rights. They don\u2019t know they can say, \u2018no,\u2019\u201d Perry explained. \u201cDoulas empower them. We are there to educate them.\u201d\u00a0\n<\/p>\n Perry\u2019s concerns reflect a broader public health crisis. According to the Centers for Disease Control and Prevention\u2019s 2024 maternal mortality report, non-Hispanic Black women in the U.S. died from pregnancy-related causes at a rate of 44.8 deaths per 100,000 live births.\u00a0\n<\/p>\n In California, Black women experience the highest pregnancy-related mortality rate \u2014 about four times greater than other women, according to statistics. From 2021 to 2023, the leading causes of pregnancy-related deaths included cardiovascular disease, COVID-19, hemorrhage, sepsis, amniotic fluid embolism, and pulmonary embolism.\u00a0\n<\/p>\n The Centering Black Mothers in California report<\/a> found that structural racism \u2014 including barriers to high-quality health care, and chronic stress\u2014 disproportionately harms Black women.\u00a0\n<\/p>\n In a statement to California Black Media (CBM), the California Department of Public Health (CDPH) said maternal mortality disparities stem from multiple factors. The department said addressing structural racism, listening to Black women\u2019s experiences and reducing provider bias are key to closing the gap.\u00a0\n<\/p>\n California began covering doula care as a Medi-Cal benefit in 2023, providing eligible patients with support during pregnancy, childbirth and the postpartum period, according to CDPH.\u00a0\u00a0\n<\/p>\n Whitney Dotson of Inglewood wanted an expert on pregnancy, labor, and delivery to guide her and her husband, Anthony, through the birth of their son, Anthony III. So, she hired Perry for doula support.\u00a0\n<\/p>\n \u201cIt\u2019s always more comfortable when you can have a second opinion,\u201d she said. \u201cKnowing she was better versed in what the options were, made me more comfortable.\u201d\u00a0\n<\/p>\n Dotson, 39, had a healthy pregnancy but faced recommendations common for expectant mothers over 35. Her doctor advised inducing labor at 39 weeks, but she hoped to carry to full term.\u00a0\n<\/p>\n \u201cI wasn\u2019t comfortable with that,\u201d she admitted.\u00a0\n<\/p>\n Perry provided Dotson with information about induction guidelines and alternatives, helping her understand her options and communicate her preferences.\u00a0\u00a0\n<\/p>\n Then, Dotson returned to her doctor.\u00a0\n<\/p>\n \u201cI said, \u2018I don\u2019t want to \u2014 and this is why,\u2019\u201d she recalled. \u201cHe agreed and pushed the induction date back a week.\u201d\u00a0\n<\/p>\n Perry also advised Anthony on how he could support his wife during and after the pregnancy and during Anthony III\u2019s birth. She also reminded Dotson to change birthing positions \u2014 from her back to her hands and knees.\u00a0\u00a0\n<\/p>\n Before Saveneh Martinez became a doula with Fierce Advocates in Contra Costa County<\/a>, she was a new mom, uneducated on aspects of birth, which led to her first child, Colton, being placed in a Neonatal Intensive Care Unit.\u00a0\n<\/p>\n \u201cI didn\u2019t know my choices,\u201d she said.\u00a0\u00a0\u00a0\n<\/p>\n Martinez called it \u201clifesaving\u201d for expecting moms to have a doula.\u00a0\u00a0\n<\/p>\n \u201cIt should be a medical right,\u201d she said.\u00a0\u00a0\n<\/p>\n California Perinatal Quality Care Collaborative<\/a> (CPQCC) Senior Associate Medical Director Kimberly D. Gregory said research suggests that doulas decrease the pre-term birth rate and the likelihood of a C-section.\u00a0\u00a0\n<\/p>\n \u201cHaving a doula is a proactive thing to do,\u201d she said.\u00a0\u00a0\n<\/p>\n Efforts are being made across the state to reduce maternal deaths.\u00a0\u00a0\n<\/p>\n CDPH\u2019s Title V Action Plan<\/a> aims to reduce pregnancy-related deaths among Black birthing mothers from 49.7 to 42.3 per 100,000 live births by 2030 through improvements in patient-centered care, expanding community-based perinatal teams, and addressing the social factors that contribute to poor maternal health outcomes.\u00a0\n<\/p>\n CDPH\u2019s Black Infant Health (BIH) Program and Perinatal Equity Initiative (PEI) have already begun to make headway.\u00a0\u00a0\n<\/p>\n \u201cBIH\u2019s prenatal group model improves key intermediate outcomes for participants, including increased social support and empowerment, better stress management, reduced depressive symptoms and gains in health knowledge and behaviors such as safe sleep practices and reduced smoking,\u201d the CDPH told CBM.\u00a0\u00a0\n<\/p>\n \u201cPEI\u2019s early implementation results show progress across several participant-reported areas, such as improved birth experiences, breastfeeding initiation, and coparenting skills among fathers and partners,\u201d the CDPH statement continued.\u00a0\u00a0\n<\/p>\n