Maria Silver Pyanov, CD, CPD, CCE

A Cochrane review of continuous labor support found a 39 percent lower C-section rate, fewer instrumental deliveries, shorter labors, and better satisfaction with birth experience. For Black birthing people, who face 3 times higher maternal mortality (CDC) and 36 percent national C-section rates, a doula functions as both emotional advocate and clinical translator during labor. Medicaid is now covering doula care in a growing number of states, including CA, NY, NJ, VA, MD, and others.

What birth doulas provide

• Prenatal meetings to build birth preferences
• Continuous support in labor: emotional, physical, informational
• Partner coaching
• Advocacy during interventions and decisions
• Immediate postpartum support
• One follow-up visit typically

Advocacy prompts

• What's your experience with the hospital I'm planning to birth at?
• Do you accept Medicaid or a sliding scale?
• What does your backup plan look like if you're unavailable?