Intervention helps lower the incidence of prematurity and maternal and infant morbidity and mortality
Kaylin Carter is a 21-year-old African American woman living in St. Louis, Missouri and enrolled in the Parents as Teachers’ Show Me Strong Families program and a committed user of doula support to her pregnancy process. Kaylin is a pre-school teacher who was once homeless, but through the support of Parents as Teachers, transitioned her life into a public educator.
When Kaylin became pregnant with her first and only child, she knew then that she wanted to take an unconventional path toward prenatal care and delivery of her child. So, the 21-year-old African American mother-to-be enlisted the services of a doula.
After a brief stint in a homeless shelter where she was referred to Parents as Teachers (PAT), an international non-profit organization that specializes in early childhood development and parenting education through personal visits, a pregnant Kaylin met doula Robin Lloyd, a lead parent educator at Parents as Teachers, during a counseling session.
Headquartered in St. Louis, Missouri, Kaylin’s hometown, PAT has the most replicated home visiting model in the nation. The 37-year-old organization has 1,301 affiliate partners across the world that implement its home visiting program. As part of its comprehensive package of services, its St. Louis-based affiliate called Show Me Strong Families (SMSF) has five certified doulas who specialize in assisting mostly Black expectant clients.
Positive Impact of Doulas
What is a doula? A doula is a trained professional who provides emotional, physical, and educational support to an expectant mother during pregnancy, labor, and in the weeks following the birth. Non-clinical support to the mom, they work to improve health outcomes.
SMSF’s doulas help moms design a birth plan and advocate for themselves during pregnancy and the birthing process and have supported 26 families to date. Kaylin says involving a doula in her pregnancy process was the best thing she could’ve done for herself and her baby.
“I learned about the program during a prenatal visit at the homeless shelter and that’s where I met Ms. Robin. She was the best thing that could’ve happened to me during my pregnancy,” said Kaylin, mother to now one-year-old daughter Harmony Wims. “Although my daughter’s dad, Brenyn, was present during her birth, Ms. Robin made me feel peaceful and brought a lot of peace to my heart.
“In fact, she stayed with me the entire time I was in labor, for 14 hours, and I don’t recall her ever leaving to eat or anything. She didn’t leave until my baby was delivered and for that, I am most grateful,” Kaylin added.
Doulas Address Health Disparities in Black Women
Doulas play a significant role in helping prevent deaths during pregnancy. According to the Centers for Disease Control and Prevention (CDC), Black women are dying from complications related to giving birth at roughly three times the rate of white women. That statistic gets more ominous with age, as Black women over age 30 are four to five times more likely to die in childbirth than white women.
Those shocking numbers are what prompted Lloyd, who is also African American and a mother, to become a certified doula in 2019. Lloyd has worked for PAT for the past 20 years. She and her team are trying to combat this statistical outrage by getting involved in the early stages of Black women’s pregnancy.
“Black women of all backgrounds are facing life or death challenges when pregnant,” said Lloyd. “The lack of safety in birth affects every Black mother and making doula care readily available may help improve Black maternal health in pregnancy and delivery.”
Doulas as Parent Educators
SMSF’s doulas are cross-trained as parent educators and can provide an extra level of education to families they already know and support during pregnancy. SMSF’s five certified doulas, who are African American and PAT parent educators, provide culturally competent, comprehensive doula care through pregnancy, birth, and postpartum, as well as social, physical, and emotional wellness support so families can thrive.
PAT President and CEO Constance Gully said PAT has developed a model for training parent educators who visit families, in person or virtually, during pregnancy and with children from birth through age 5. These trained professionals, she said, help new parents build their confidence in their role as the first and most important teacher in their child’s life.
“Parent educators serve as mentors who offer friendly, reassuring support and expert guidance to new parents,” said Gully, who herself was a PAT mom during her son’s birth almost three decades ago. “They provide parents with information and resources to help them gain a deeper understanding of the emotional, behavioral, and physical developmental stages of their young children. They also help promote parental resilience and connect families to resources if needed.”
Many might assume the disparity in maternal deaths among Black and white women is primarily an economic issue. That’s not true. According to the CDC, Black mothers with a college degree are 5.2 times more likely to die in childbirth than their white counterparts. This has been attributed, in part, to the trauma of historic racism, referred to as ‘weathering.’
Black women are also 36 percent more likely to have a C-section than women of any other race. Prenatal doula care gives women additional prenatal support, provides a delivery room advocate, and has been shown to reduce C-section rates.
Being Black appears to be the only commonality that decreases a birthing person’s chance at a healthy pregnancy and delivery. Facts surrounding Black maternal health including racism, sexism, income inequality, and lack of access to resources unquestionably influence a mother’s birthing experience. If she’s Black and birthing, she may be in the fight of her life.
African American babies are two times more likely to die before their first birthday than white babies. That’s why every year, SMSF in collaboration with FLOURISH, a St. Louis-based group that works to lower the incidence of prematurity and maternal and infant morbidity and mortality in the area, hosts an event to celebrate the first birthday of Black children enrolled in the PAT program.
Donna Givens, PAT’s manager of Community Partnerships and Groups, said too many babies are dying before their first birthday. Some St. Louis neighborhoods have rates three times the national average.
“Every year, we host a first birthday party for our families to celebrate them and to educate and encourage them to follow safe sleep recommendations for their infants,” Givens said. “The kids play games, have their likeness created by a cartoonist, receive Sesame Street themed gifts bags with pajamas, enjoy refreshments, and have their pictures taken. Their parents also receive gifts and kudos for their successful parenting.”
Show Me Strong Families Serves All Communities
SMSF’s black doulas offer their services to a wide demographic of clients enrolled in PAT programs and services. Last fall, they provided service to a mother who gave birth to a baby boy born on National Parents as Teachers Day. His name is Jace. Baby Jace was born on Nov. 8 and weighed in at 4lbs and 10 oz. He has two older brothers ages 3 and 6. The family has participated in SMSF since July of 2020. Mom received prenatal and postpartum visits from her doula.
Like Jace’s parents, Kaylin and Brenyn are still very involved with PAT. They attend group connections to learn new parenting skills and collaborate with other young parents.
“I love Parents as Teachers and I’m calling Ms. Robin the next time I get pregnant. She is so nurturing,” said Kaylin, who now works as a pre-school teacher in nearby University City, MO. “I would definitely recommend the program to my family and friends and anyone thinking about having a baby. It’s the best.”