North Carolina’s Fight to Reduce Black Maternal Deaths Stalls Amid Funding Cuts and Policy Hurdles
North Carolina has long struggled with a stark disparity in maternal mortality rates: Black women are nearly twice as likely to die from pregnancy-related causes as white women, according to the North Carolina Maternal Mortality Review Committee. Nearly 80% of these deaths are preventable, yet progress toward reducing them is now threatened by funding cuts, legislative gridlock, and ongoing gaps in access to critical care—including doula services—that have proven effective in improving outcomes.
Doula Care: A Proven but Underfunded Solution
Research consistently shows that doula care—non-medical support before, during, and after childbirth—significantly improves maternal and infant health outcomes. Studies indicate that low-income mothers who receive doula care are four times less likely to have low-weight babies and twice as less likely to experience birth complications, according to findings cited by NC Newsline. Despite these benefits, private insurance rarely covers doula services, and Medicaid reimbursement remains inconsistent.
Organizations like MAAME (Mobilizing African American Mothers through Empowerment), based in Durham, have stepped in to fill this gap. MAAME, which provides culturally competent doula care, has seen firsthand how these services reduce anxiety and improve birth experiences. Laura Gonzalez Dutor, a Durham mother who received doula care, shared,
She gave me a sense of peace, in a way, given that she was very knowledgeable about everything. I knew that there was always going to be someone, in addition to my partner, that would be able to advocate for me and just help me make informed decisions.Laura Gonzalez Dutor, Durham mother
Still, MAAME’s ability to expand its services has been severely hindered by funding challenges. Last year, the organization lost $10,000 in sponsorships that were meant to help it reach a $15,000 fundraising goal, according to NC Newsline. These cuts forced MAAME to reduce local services, leaving many North Carolinians without access to this life-saving support. The organization’s survival now hinges on American Rescue Plan funds from Durham County, which have kept it afloat for another year—but further funding reductions could spell disaster.
Statewide Perinatal Care Collaborative on the Brink of Collapse
Beyond doula care, North Carolina’s broader maternal health infrastructure is as well at risk. The Perinatal Quality Collaborative of North Carolina (PQC-NC), a statewide network that has worked since 2009 to improve maternal and infant health, faces imminent closure due to a $905,000 annual budget cut. This funding, tied to Medicaid, was slashed as part of a larger $33 million underfunding of the Medicaid Oversight Fund by the North Carolina General Assembly, as reported by NC Health News.
The PQC-NC has achieved measurable success, including reducing infant mortality and improving care for mothers with substance use disorders. For example, its initiatives have saved $4.5 million annually by shifting treatment protocols for newborns with withdrawal symptoms, according to NC Health News. Yet, without funding, the collaborative will be the only statewide program of its kind in the U.S. To shut down, leaving North Carolina’s maternal health system critically weakened.
Legislators, including Rep. Grant Campbell (R-Kannapolis) and Sen. Jim Burgin (R-Angier), have publicly advocated for restoring the funding. The Child Fatality Task Force voted unanimously to support reinstating the collaborative’s budget, but political divisions between the Republican-led legislature and Democratic Gov. Josh Stein have stalled progress.
Legislative Efforts Fall Short Amid Partisan Divides
Despite these challenges, lawmakers have introduced bills aimed at addressing maternal health disparities. The MOMnibus Act (Senate Bill 571/House Bill 725), sponsored by Sen. Natalie Murdock (D-Chatham), proposes several key measures, including:
- Grants for community-based organizations providing doula and lactation support.
- Implicit bias training for maternal care professionals.
- Funding for lactation consultant training programs at historically Black colleges.
- Perinatal education grants to improve access in underserved areas.
The bill has faced significant hurdles, however. In previous iterations, it failed to advance in committee, and this year’s version—introduced for the fourth time—lacks Republican support, despite controlling both chambers of the legislature. Dr. Michelle Benoit-Wilson, an OB-GYN in North Carolina, emphasized the urgency of the issue:
We need to stop using politics as a bouncing ball, as opposed to recognizing the core problem, which is that women are dying, and they shouldn’t be.Dr. Michelle Benoit-Wilson, OB-GYN
Advocates like Charity Watkins, an assistant professor of social function at North Carolina Central University, highlight the personal stakes. Watkins, who nearly died from pregnancy-related heart failure, recounted being dismissed by medical staff despite her advocacy for herself.
I’m highly educated and I am able to advocate for myself. Yet, I was dismissed, and my symptoms could have easily resulted in me losing my life.Charity Watkins, NC Central University
Moving Forward: What Can Be Done?
The path forward requires immediate action on multiple fronts:
1. Restore Funding for Critical Programs
Legislators must prioritize restoring the $905,000 annual budget for the Perinatal Quality Collaborative and ensure consistent funding for organizations like MAAME. Advocates are urging the General Assembly to address the $33 million Medicaid underfunding that jeopardizes these life-saving initiatives.
2. Expand Access to Doula Care
Medicaid and private insurers must expand coverage for doula services, particularly in communities with the highest maternal mortality rates. Policy changes should also incentivize hospitals to partner with doula organizations, as seen in successful models across the country.
3. Pass the MOMnibus Act
While the current legislative session may not spot the MOMnibus Act passed, building public and political momentum is essential. Advocates are calling for grassroots campaigns, media engagement, and partnerships with community leaders to ensure these measures gain traction in future sessions.
4. Address Systemic Racism in Healthcare
Implicit bias training for medical professionals, as proposed in the MOMnibus Act, is a critical step. Policies must be enacted to ensure equitable access to prenatal and postpartum care, including transportation, childcare, and culturally competent providers.
Key Takeaways
- Disparity in Maternal Mortality: Black women in North Carolina are nearly twice as likely to die from pregnancy-related causes as white women, with nearly 80% of these deaths being preventable.
- Doula Care Works: Research shows doula services reduce complications and improve birth outcomes, yet funding and access remain limited.
- Funding Cuts Threaten Progress: The Perinatal Quality Collaborative’s shutdown would leave North Carolina without a statewide perinatal care network, worsening maternal and infant health outcomes.
- Legislative Action Needed: The MOMnibus Act, though stalled, offers critical solutions, including grants for doula services, implicit bias training, and expanded lactation support.
- Systemic Change Required: Addressing racism in healthcare and ensuring equitable access to care are essential to reducing maternal mortality disparities.
FAQ: Addressing Common Questions About Black Maternal Health in North Carolina
Q: Why are Black women in North Carolina at higher risk of maternal death?
A: Multiple factors contribute to this disparity, including systemic racism in healthcare, implicit bias among providers, limited access to quality prenatal and postpartum care, and socioeconomic barriers. Studies also highlight how racial bias can lead to misdiagnoses or delayed treatment, as seen in cases like Charity Watkins’ near-fatal experience.
Q: What is a doula, and how does doula care improve outcomes?
A: A doula is a trained professional who provides non-medical emotional, physical, and informational support during pregnancy, birth, and postpartum. Research shows doula care reduces the likelihood of Cesarean sections, lowers rates of low-weight babies, and decreases birth complications—particularly for marginalized communities.
Q: Are there any states that have successfully reduced Black maternal mortality rates?
A: Yes. States like Maryland and California have implemented comprehensive strategies, including expanding doula services, funding perinatal care collaboratives, and addressing implicit bias in healthcare. Maryland, for example, saw a 30% reduction in maternal mortality among Black women between 2015 and 2020 through targeted interventions.
Q: What can individuals do to support maternal health equity?
A: Individuals can advocate for policy changes, donate to organizations like MAAME, volunteer as doulas (if trained), and support legislation like the MOMnibus Act. Raising awareness about maternal health disparities in local communities can drive systemic change.
A Call to Action
North Carolina stands at a crossroads. The data is clear: Black maternal deaths are preventable, and solutions exist. Yet without immediate action—restoring funding, passing critical legislation, and addressing systemic barriers—the state risks backsliding on years of progress. The time to act is now.