Oklahoma Birth Equity Initiative details community doula, hospital work to address Black maternal and infant mortality in Tulsa

Amari Jemison, executive director of the Oklahoma Birth Equity Initiative (OK Bay), urged the Beyond Apology Commission on Thursday to support local efforts to reduce Black maternal and infant mortality by expanding community-based doula services, midwifery and hospital practices that center patient preference.

OK Bay provides no-cost, community-based doula support to people who identify as Black, Native/Indigenous, Latinx, teens, and people navigating the justice system or substance-use treatment. "We equip families to have healthy births with dignity," Jemison said in her presentation, describing OK Bay's work in Tulsa with doulas, hospital quality improvement and community programs.

Why it matters: In Oklahoma, Jemison said, Black women are about 3.2 times more likely to die from pregnancy-related causes than white women, and Native women about 2.8 times more likely. She and commissioners tied those disparities to treatment differences in clinical settings, limited local access to obstetric care and structural racism. Reducing maternal morbidity and improving birth outcomes is linked in the presentation to lower infant mortality.

Jemison described six cornerstone programs OK Bay runs or supports. The group's community-based doula model differs from paid private doulas: doulas are recruited from and matched to communities, provide intensive prenatal and postpartum contact (Jemison said OK Bay "touches" clients more than 30 times on average), and emphasize culturally congruent curricula OK Bay created called Blossoming Birth.

Locally, OK Bay has piloted TeamBirth, a hospital-centered practice that creates team huddles so the laboring person is included in care planning. Jemison said Tulsa hospitals have been trained in TeamBirth, and that the model has been used in clinic training and residency programs. She also noted Queens Village, a community model from Cincinnati designed to create safe community spaces for Black mothers, and said OK Bay is working toward a midwifery announcement in coming months.

Outcomes and policy: Jemison said preliminary Tulsa results show Black women supported by OK Bay had preterm-birth and low-birth-weight rates trending toward those for white women, and that participants had lower cesarean rates. She also noted state-level changes: Oklahoma expanded postpartum coverage about a year earlier and has begun doula reimbursement policies. Jemison criticized early implementation of doula reimbursement as treating doulas like medical billing entities and said OK Bay will begin managing billing for certified doulas to ease uptake, with a goal of starting July 1.

Commissioners asked about clinician buy-in and racial concordance of providers. Jemison said some physicians embrace TeamBirth while others resist; OK Bay's hospital work includes "lunch and learns" and policy work to make hospitals more receptive to doulas. She also described workforce barriers: national demand and higher salaries pull Black physicians to larger markets, and recent state laws have prompted clinicians to leave Oklahoma, compounding local access problems.

The presentation concluded with an appeal for the commission to encourage hospitals to accept doulas, to help publicize community options and to support training and workforce pipelines that increase providers who reflect the communities they serve.

Any next steps mentioned included upcoming hospital engagements and OK Bay's plans to help doulas with third-party billing; Jemison offered to provide data to commissioners who requested demographic breakdowns of program participants.