Rootead’s birth doula program aims to reduce Kalamazoo’s racial disparity in infant mortality
KALAMAZOO, MI – The racial disparity in infant mortality rates in Kalamazoo is being addressed, in part, by expanding access to birth doulas in the community.
Last February, Cradle Kalamazoo, the community initiative focused on reducing child mortality, presented in its annual findings that the the infant mortality rate was falling, but a racial divide was widening.
Cradle Kalamazoo and the county health department are now focusing on providing childbirth doulas for black and Latin mothers, for increased support. A doula is a non-clinical support person who helps during times of transition, such as birth or death.
The Rootead Enrichment Center offers doula training through Red Birth Green to advocate for mothers during the birth process and continue to support them in the postpartum period.
Unlike midwives, doulas cannot perform medical procedures or make medical decisions. However, the two professions often work in tandem to provide options and education, said Erica Guthaus, birth recovery conjurer and director of Red Birth Green.
Birth doulas also have more time with the mother, Guthaus said. The heart of a doula’s job is to build a relationship of trust. Doulas are available 24 hours a day, every day of the week, she said.
Having a trusted advocate and sounding board has been particularly relevant in the digital age, Guthaus said.
“If you get news that is not what you expected, you panic, you have questions, go to your doula first,” she said. “Let your doula filter it, because we will often have the information you need and we can give it to you as part of this trusting relationship, which will be much better received than getting off the Dr. Google train.”
Red Birth Green continually checks in with mothers for a year after their baby is born. Sometimes it looks like mental health exams, and other times it’s personal recommendations for pediatricians, Guthaus said.
Michigan ranks in the top ten among states with a high number of infant deaths. The state falls closer to the middle when ranked by infant mortality rate. In 2018, the state’s infant mortality rate was 6.2 per 1,000 live births, according to the Centers for Disease Control and Prevention.
There is no doubt that a significant disparity remains between infant mortality rates among white and black residents.
Between 2006 and 2018, the white infant mortality rate declined slightly, while the black rate declined by 25% due to a reduction in infant deaths since 2005, according to the Michigan Department of Health & Human Services. The decline in the infant mortality rate in Michigan is largely due to a reduction in black infant mortality.
While the numbers overall are decreasing, the racial gap is not decreasing. The MDHHS described it as a “persistent racial disparity” in which black mothers suffered three times the risk of infant death compared to white mothers.
Cradle Kalamazoo data from 2017 shows white infant mortality at a rate of 4.7, compared to black infant mortality at 15.3 per 1,000 live births.
“It has nothing to do with the socio-economic status or the level of education of the mother,” Guthaus said. “These are really social factors. Systemic racism is one of those, and it really is a widespread point of contact in medical care. “
The role of birth doulas in minimizing this racial disparity is to be another pair of eyes trained to look for risk factors before and after the baby is born, Guthaus said.
“When you have a knowledgeable and trusted person out there to watch things tend to get a lot better,” she said.
In the delivery room, doulas can offer a simple reminder of the options available or slow down to make the family feel less rushed. Other times, doulas can provide tools for mothers or birthing partners to defend themselves if they feel they are being pushed into decisions, Guthaus said.
“It really comes down to keeping the human space,” she said. “It’s not meant to be sterile. The birth that we see theatrically is chaotic. It doesn’t have to be. Often times, especially if a doula is part of this equation, it is not; it’s the contrary. This is very quiet.
The Red Birth Green program is currently training a birth doula cohort. Once training is complete, they will have eight doulas on their staff and plan to overtake that squad next year, Guthaus said.
Developing a network of doulas is part of Rootead’s overall mission to ‘reclaim the village’. The uncertainty and isolation of 2020 has already caused people to seek refuge in the community, which Guthaus says is a good boost for their work.
“It starts with breaking out of that individualized mindset that has become second nature to us as American citizens,” she said. “We have to get back into the collective if we really want to move forward. “
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