A Georgia school trains doulas for rural areas that are losing maternity care

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Rural communities in the U.S. are losing access to maternity care. That raises the risk for pregnancy complications, especially for Black women, who face higher rates of maternal mortality. The Morehouse School of Medicine is trying to help by focusing on the southwest corner of Georgia, which has some of the highest maternal death rates in the state. It's training a cohort of rural community doulas, practitioners who offer patients extra support before, during and after childbirth. From WABE in Atlanta, Jess Mador reports.

JESS MADOR, BYLINE: In the small Georgia city of Albany, not far from the Florida and Alabama borders, it's graduation day for Morehouse School of Medicine's first class of rural community doulas.

NATALIE HERNANDEZ-GREEN: Thank you so much for being here. It just brings so much joy.

MADOR: Natalie Hernandez-Green opens the ceremony. She's the executive director of Morehouse School of Medicine Center for Maternal Health Equity. Lined up at the stage before their family and friends are the graduates, a dozen Black women all from this corner of southwest Georgia, where there's only one hospital operating in the Albany area. They've completed about 20 weeks of training to become what Morehouse calls perinatal patient navigators. They'll offer doula services and try to help with other needs like finding food assistance and transportation. Hernandez-Green.

HERNANDEZ-GREEN: We're developing a workforce that's going to be out there, providing the support that Black women and birthing people need.

MADOR: Black Georgians are more than twice as likely as white women to die from complications related to pregnancy.

HERNANDEZ-GREEN: And we're about to change that one person at a time.

(APPLAUSE)

MADOR: The American College of Obstetricians and Gynecologists says doula support can improve labor and delivery outcomes. But doula services can typically cost patients hundreds or thousands of dollars out of pocket. And in Georgia and many other states, Medicaid won't cover them. So the Morehouse Perinatal Patient Navigator program has to rely on grants to pay the salaries of five new doulas during their first year of work.

RACHEL HARDEMAN: It's not sustainable if you're chasing the next grant to fund it.

MADOR: Rachel Hardeman is professor of health and racial equity at the University of Minnesota. She studied what happens when Medicaid covers doula services. More than a dozen other states do it. Minnesota's Medicaid program has been doing it for around a decade.

HARDEMAN: And we found that there's a cost savings there.

MADOR: Hardeman and others have found that when Medicaid covers doula care, states save millions of dollars in health care costs. That's because doulas can help reduce the number of expensive medical interventions during and after birth. They can even reduce the likelihood of pre-term birth.

HARDEMAN: An infant that is born at a very, very early gestational age is going to require a great deal of resources and interventions to ensure that they survive and then, you know, continue to thrive.

MADOR: Advocates pushing for Georgia's Medicaid program to cover doulas say it could save the state a lot of money and reduce racial disparities in maternal mortality at the same time. The advocates acknowledge doulas alone can't fix the problem, and the state needs to do more to bring OBGYNs to communities across Georgia. In the meantime, Morehouse program graduate Joan Anderson (ph) says she's excited to get to work supporting patients, especially from rural areas around southwest Georgia.

JOAN ANDERSON: I feel like I'm equipped to go out and be that voice, be that person that our community needs so bad.

MADOR: And someday, she wants to open a facility to offer a type of maternity care patients here can't get.

ANDERSON: A birthing center because we do not have one here in southwest Georgia at all.

MADOR: For NPR News, I'm Jess Mador in Atlanta. Transcript provided by NPR, Copyright NPR.

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