The Citywide Doula Initiative, spearheaded by the NYC Department of Health and Mental Hygiene, improved the maternal health outcomes for Black and Hispanic mothers and babies, an audit from the city Comptroller found.
The initiative was created to address racial disparities in maternal health by offering free, professional doula support to eligible pregnant individuals, particularly those living in neighborhoods disproportionately impacted by systemic health inequities and the COVID-19 pandemic.
Birth outcomes for those enrolled in the program outperformed citywide averages, with lower rates of cesarean sections, preterm births and low-birth-weight babies, according to the audit. No pregnancy-related deaths were reported during the audit period, and participant satisfaction was high.
“By providing doula services at no-to-low costs, the city is making progress toward closing the racial gap in maternal health outcomes and on its way to eliminating maternal mortality," Comptroller Brad Lander said. "Providing equitable care access for all is the first step toward building a thriving and healthier city to start and raise a family.”
According to DOHMH, Black non-Hispanic women and birth givers accounted for 17.7% of all live births in the city, but a staggering 39.7% of all pregnancy-associated deaths. Black and Hispanic women and birthgivers made up over three out of four deaths, despite accounting for less than half of all live births across the five boroughs.
The initiative is a frontline defense and what true care looks like, said Chanel Porchia-Albert, CD, CLC, CHHC, founder and chief executive officer of Ancient Song Doula Services.
"As federal funding for comprehensive reproductive healthcare is rescinded and Medicaid faces mounting threats, the New York Citywide Doula Initiative remains a lifeline for our communities," she said. "It has built a powerful workforce, delivered critical care, and offered unwavering support to birthing people, especially in the often-overlooked postpartum period."
Despite its successes, the audit also identified areas for improvement, including the need to ensure equitable access across all boroughs. Plans are underway to expand training programs for culturally competent doulas and to increase partnerships with hospitals and shelters. The health department also pledged to enhance data collection methods to measure not just the quantity of supported births, but also the quality and impact of the support provided.
