Healthy mothers, stronger communities: Why Arkansas needs more doulas

Arkansas is at a crossroads when it comes to maternal health. With some of the highest maternal and infant mortality rates in the nation, bold and innovative action is required to address this crisis. As the founding executive director of the Doula Alliance of Arkansas, I have seen firsthand the profound impact doulas can have on improving outcomes for mothers and babies. Through collaboration, training and expanding access, doulas are poised to play a transformative role in tackling our maternal health crisis.

For those who don’t quite understand the role of doulas, they are trained birth coaches who provide emotional support, advocacy and practical assistance during pregnancy, labor and postpartum. They are not a replacement for medical care, but they are a crucial part of the solution. Research shows that the presence of a doula leads to fewer cesarean births, higher birth weights, increased breastfeeding success rates, and lower rates of postpartum anxiety and depression.

The work of doulas spans all stages of the birthing journey. During the prenatal period, doulas provide education about childbirth, help mothers create birth plans, and offer emotional and physical preparation for labor. During birth, they offer continuous physical and emotional support, assisting mothers in managing pain, advocating for their wishes, and facilitating communication with medical staff. In the postpartum period, doulas assist with breastfeeding, provide guidance on newborn care and support maternal mental health, ensuring a smoother transition to parenthood. This comprehensive approach enhances the birth experience and leads to better outcomes for mothers and babies.

Doulas also play a critical role in addressing systemic inequities. Arkansas’ maternal health crisis disproportionately affects Black and Hispanic women, who experience higher rates of complications and mortality. By advocating for culturally sensitive care and ensuring that mothers feel heard and respected, doulas help bridge the trust gap between these communities and the health care system.

Despite these documented benefits, Arkansas faces a significant shortage of doulas, with fewer than 100 trained practitioners serving the entire state. The urgency of this shortage is underscored by the recent UAMS study that highlights the need for more doulas, especially in migrant communities and among non-English-speaking populations. The study revealed that doulas not only provide critical support during childbirth but also act as cultural liaisons, ensuring mothers feel safe and included in health care settings.

The Doula Alliance of Arkansas, formed in August, has been working to address these challenges. Our partnership with UAMS has been a game-changer. Together, we launched a comprehensive training program to expand the doula workforce in all 75 counties, with an emphasis on recruiting individuals from diverse cultural and geographical backgrounds to serve in their communities. This initiative aligns with findings from UAMS’ research, which stresses the importance of community-based doulas who understand and can navigate their clients’ unique cultural and social needs.

Our efforts have been further bolstered by the Healthy Moms, Healthy Babies Act and the recent announcement of the $17 million Transforming Maternal Health (TMaH) grant awarded to Arkansas. This funding will support maternal health initiatives, including efforts to increase access to doula services. Medicaid reimbursement for doulas is a key priority, as affordability remains a significant barrier for many families. This approach aligns with the Arkansas Center for Health Improvement’s recommendations, which endorsed expanded access to doulas to address maternal and infant health disparities.

As someone with an extensive background in health care, I understand the skepticism some may have about integrating doulas into traditional medical teams. However, the personal stories I’ve heard from doulas and patients across the state illustrate their profound impact.

One doula shared how she helped a Spanish-speaking mother navigate a high-risk pregnancy, advocating for her wishes in the delivery room and connecting her with resources for postpartum support.

Another described the emotional toll of back-to-back births, highlighting the need for more trained doulas to share the workload and provide consistent, quality care.

A mother who used a doula told me, “It was like having a really knowledgeable professional, a friend, and a sister all in one,” and believes she received better medical care because of the confidence and insight the doula provided. She added, “I never felt alone because I had my doula.”

While doulas are not a replacement for medical care, they are absolutely an enhancement. By fostering collaboration between doulas and health care providers and increasing access points for more women, we can create a supportive environment that prioritizes the needs and voices of mothers.

Our work is far from done. The Doula Alliance of Arkansas is actively raising awareness of the importance of doulas, building partnerships to expand training programs and recruiting doulas in every corner of the state. But we cannot do it alone. We need the support of health care providers, policymakers and the community to ensure every mother in Arkansas has access to the care she deserves.

Investing in doulas is not just an investment in maternal health; it’s an investment in the future of Arkansas. Healthy mothers lead to healthy families and stronger communities. By recognizing the value of doulas and committing to expanding access, we can ensure that every mother in Arkansas — regardless of her income, background or ZIP code — has the support she and her baby need to thrive.

Editor’s note: Lori Ross is the executive director of the Doula Alliance of Arkansas. The opinions expressed are those of the author.