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Illinois Gov. Pritzker pitches plan to reduce Black maternal deaths in latest budget

Kayla O’Neal, 28, holds Caine, her 2-week-old baby, on Friday, Jan. 27, 2023, at her home in St. Peters, Mo.
Brian Munoz
St. Louis Public Radio
Kayla O’Neal, 28, holds Caine, her 2-week-old baby, in January 2023 at her home in St. Peters. Illinois Gov. J.B. Pritzker wants to use part of the state's budget to support doulas and other community birth workers.

Illinois Gov. JB Pritzker wants to spend more than $20 million of his proposed $53 billion budget to help decrease the numbers of Black women who die during pregnancy or shortly after giving birth.

Pritzker, a Democrat, presented the plan Wednesday as part of his budget plan for the fiscal year that begins in July. The budget includes $4.4 million to study the state’s maternal mortality rate and create a plan to help pregnant women and new mothers.

It also includes $1 million to help midwives and other community-based providers open practices and gain Medicaid certification and $5 million to bolster the state’s home-health visiting program for low-income and young families.

Between 2018 and 2020, an average of 90 people each year died while pregnant or within one year of giving birth, according to a report the state’s health department released last year.

Black women were twice as likely to die from any pregnancy-related condition and three times as likely to die from pregnancy-related medical conditions as white women, the report found.

The state legislature will need to sign off on any spending.

Community-based care is necessary to reduce the state’s racial disparities in maternal mortality, Pritzker said.

Doulas (who offer coaching, information and emotional support during and after pregnancy) and midwives (who are medical practitioners who help with pregnancy and birthing) are examples of community-based providers that often can offer more personalized and extensive care than what is found in more traditional medical settings, said Chastity Mays, an independent doula who works in southern Illinois.

“Birth workers are ‘boots on the ground,’ is what I call it,” said Mays, who operates Hathor Doulas in Carbondale. “We're actually doing the work. We're serving the clients. We're helping these families prepare for birth. We are educating, we're teaching them to advocate for themselves.”

While many people may want to become birth workers, the cost of licensing and opening up an independent practice can keep potential professionals away, Mays said.

“Removing the barriers for Black women who are doulas, midwives, lactation consultants, is just going to open up the doors for them to serve the clientele that we need to reach,” she said.

Pritzker’s plan would create a grant program allowing such workers to defray the administrative and capital costs associated with private practice.

For example, it would help doulas get licensed to receive Medicaid payments. In 2021, the Illinois legislature passed a law that allows birth workers to be reimbursed for care they provide through the government-funded health insurance program.

More workers of all types are needed to care for pregnant people, said Belleville-based doula Charity Bean, particularly as maternity wards close down in rural areas and there aren’t enough providers to care for pregnant people.

“In the Southern Illinois area here, we're in the maternal health desert,” she said. “We don't have very many providers … to even choose from, let alone midwives.”

Bean, who operates a pregnancy resource center called the Doula Lab, is happy Illinois politicians are beginning to pay more attention to pregnancy workers who aren’t associated with major medical systems or clinics.

“[We] who want to serve our population who needs us the most, we can't afford to serve them,” she said. “By providing grants and Medicaid coverage ... that creates jobs, it creates financial stability for us to continue to do this work and be able to improve those outcomes.”

Sarah Fentem is the health reporter at St. Louis Public Radio.