Date of Graduation

Fall 2025

Document Type

Dissertation

Degree Name

Doctor of Public Administration (DPA)

Department

Public Policy and Administration

Committee Chairperson

Angela Kline, PhD

Committee Member

Stacie Metz, PhD

Committee Member

Sharon DeJoy, PhD

Abstract

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” (Hoyert, 2023a)

The mistrust Black Americans hold towards the healthcare system is rooted in centuries of systematic racism and medical exploitation. This study consists of in-depth interviews with Doulas with varied experiences and their perceptions of their impact on Black maternal mortality. Currently, expectant mothers who meet the income guidelines are eligible for Doula services under Medicaid expansion. Forty-six states provide or are in the process of delivering Doula services. Of the 43 states, 15 provide Doula services under Medicaid expansion. (Cuello, 2025). This study underscores the urgent need to integrate Doula care as a standard of care for Black expectant mothers, which can impact practice and policy, guided by the voices closest to the work. Through strategic and sustainable policies, there is potential to reshape outcomes and restore trust within Black maternal health.

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