Right to Informed Consent, Right to a Doula: An Evidence-Based Solution to the Black Maternal Mortality Crisis in the United States

Abstract

This Note seeks to build on existing research about how to improve childbirth in the United States for women, particularly for Black women, given the United States’ extremely high maternal mortality rate. Through examining the history and characteristics of American and Western childbirth, it seeks to explore how the current birth framework contributes to maternal mortality. To fight this ongoing harm, I suggest increasing access to doulas— nonmedical support workers who provide “continuous support” to the birthing person. Through this Note I seek to build on the research of others by identifying the ways medicalized birth practices fail women, particularly Black women, and possible solutions to this crisis. To that end, I examine the pathologization of childbirth, paternalism in medicine, and how the history of early gynecologists’ experimentation on enslaved Black women reverberates in the context of birth today, as both a cause of ongoing medical racism and paternalism, and as a symptom of misogyny, misogynoir, and racism. Furthermore, this Note builds on existing work in this field by suggesting a solution that has become more popular in recent years: the use of doulas to improve labor and childbirth. I identify why doulas are such an excellent tool to combat the current issues that plague women’s pregnancy and births in this country, specifically against a backdrop of how medical paternalism, racism, and the law have hamstrung women’s ability to safely birth. Finally, I suggest a workable solution to increase the usage of doulas by women who most need support: adding doulas to the “maternity and newborn care” essential health benefit, one of ten essential health benefits private insurers are required to cover under the ACA.