Adverse Maternal Health Outcomes in Tennessee and Expanded Access to Doula Care

Abstract

Tennessee experiences the highest maternal mortality rate in the United States.  Yet most adverse maternal health outcomes are preventable, highlighting gaps in support and healthcare access.  Expanding access to doula care provides an evidence-informed strategy to address this issue, as research links doula support with lower rates of medical interventions, reduced preterm births, improved maternal health, and cost savings.  This paper uses ecological systems theory and a reproductive justice framework to examine how doula care can mitigate systemic failures, enhance agency for birthing individuals, and address racial and social disparities in Tennessee.  Based on these findings, the paper recommends implementing TennCare coverage for doula services, investing in workforce development, and establishing community-based programs to promote equitable and culturally responsive maternal healthcare.