Pregnant moms in Georgia are dying at the second highest rate

Healthcare advocates want Doulas to be included under insurance. They are trained professionals who provide support to women before, during and shortly after childbirth
Published: Feb. 21, 2023 at 12:28 PM EST|Updated: Feb. 23, 2023 at 1:47 PM EST
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ATLANTA, Ga. (Atlanta News First) - Georgia mothers are dying preventable deaths at the second highest rate in the country, according to national maternal death rates data.

As a result, healthcare advocates now want to see insurance coverage for doulas - who offer physical, mental health support and patient advocacy for pregnant women - guaranteed through state legislation.

According to, doulas are “trained professionals who provide continuous physical, emotional and informational support to their client before, during and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible.”

Dynalee Rael, 23, is among the 56% of Georgia women whose pregnancies are covered through Medicaid. During her recent pregnancy, Rael - who had a doula of her own - said she waited for hours, in active labor, for a local hospital to assign her a delivery room.

“From my own personal experience where I felt neglected and discriminated against, having my doula ... it was everything to me,” Rael said. Eventually, with her doula’s support, Rael left the hospital and went to another, where she delivered baby KJ.

The family’s doula was Zania Mathis, a provider with the Georgia Coalition of Healthy Mothers, Healthy Babies. Mathis’ role was to assist in creating a preferred birthing plan, help the family understand their medical rights, and use training techniques and massages for the mother’s physical discomfort, as well as emotional support during pregnancy and postpartum.

“That’s all doulas are trying to do: just make sure that families are taken care of,” Mathis said. “They’re seen, they’re heard, and their rights are listened to honestly.”

Mathis became a doula four years ago because of her own trauma during pregnancy. Data shows black expectant mothers like Mathis are four times as likely as white women to suffer PTSD.

The disparities with negative health outcomes don’t stop there. The Centers for Disease Control and Prevention found the rate of maternal mortality is four to five times greater for women of color.

A statewide study by Healthy Mothers, Healthy Babies, reveals contributing factors are not only pre-existing health conditions like asthma, diabetes, hypertension but also lack of access to quality care based on racial, economic inequities including systemic racism within healthcare.

Research by the Georgia Department of Public Health shows parts of the state have not made significant improvement in its prenatal care. Statistics show from 2016-2020 in Atlanta, roughly 20% of all births had inadequate prenatal care.

The percentage is based on the Kotelchuck Index, which measures sufficient prenatal care based on factors like the number of doctor visits or incomprehensive treatment.

That’s why Healthy Mothers, Healthy Babies, is among the organizations that believe Medicaid-insured doula coverage could be critical. Florida, Maryland, Minnesota, New Jersey, Nevada, Oregon, Rhode Island, Virginia, Washington D.C., and California already actively offer some form of doula insurance coverage.

A total of 175 pregnant women in Atlanta participated in the Healthy Mothers, Healthy Babies, doula Medicaid pilot program. They’re taking the results of the program to Georgia legislators in hopes of making doula insurance coverage a statewide standard.

“Having a doula is a necessity and not a luxury at all, especially if you are a Black or brown birthing person,” said Chanel Stryker-Boykin, development and education coordinator with Healthy Mothers, Healthy Babies, who oversaw the program. .“It’s not that doulas want to replace nurses, replace doctors, or want to be any of those things. It’s an addition, an integral piece to the whole echo system.”

A federal bill first introduced in 2021 calls for 12 new U.S. laws to improve maternal healthcare.

While historic data has been largely absent on doulas, new research by the National Institute of Health found expectant mothers matched with a doula saw better birth outcomes than mothers without.

“In the healthcare system it’s possible to feel pressured as if you don’t have any options, especially as a woman of color,” said Rael. “I’m grateful that she was there for me.”

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