Charlotte doulas, mothers and health advocates spent Black Doula Day sounding the alarm, calling on state and local leaders to move from talking points to action after fresh data laid out stark racial gaps in infant and maternal outcomes. They say the crisis is not just a matter of charts and trend lines, since Black families in Mecklenburg County continue to see higher rates of preterm birth, low birthweight and infant death. Doulas and midwives argued that support needs to follow families well past delivery, not stop in the hospital parking lot.
Iman Boykin of the National Black Doula Association told Spectrum News that doulas "empower these families to be heard" and help mothers "give birth without fear." Midwife Phebe Israel told the outlet that the disparity is so severe it "makes for conversation" and warned, "For us to be in America and supposedly a First World country, we have death rates of a Third World country." According to Spectrum, the Black Doula Day gathering functioned as an open forum where doulas, mental-health providers and mothers paired personal stories with pointed policy asks.
State data underscore problem
State health officials and the North Carolina Child Fatality Task Force say the picture is getting worse, not better. Recent figures place North Carolina among the states with higher infant-mortality rates, and Black and American Indian infants are hit hardest. The North Carolina Department of Health and Human Services reported that 2023 data showed Black infants dying at roughly three times the rate of White infants, a finding that spurred an updated perinatal health strategy (NCDHHS).
National context
Zoom out to the national level and the pattern looks disturbingly familiar. Federal analyses have found that Black people are more than three times as likely as White people to die from pregnancy-related causes. A KFF issue brief, using CDC data, reports pregnancy-related mortality rates of about 49.4 deaths per 100,000 for Black people compared with 14.9 per 100,000 for White people in 2023, and highlights social and structural forces as key drivers of the divide (KFF).
Local numbers point to preventable losses
Mecklenburg County’s own data show how that national story plays out on the ground. The county’s 2022 Community Health Assessment reports that the Black, non-Hispanic infant death rate between 2018 and 2020 was about 9.7 deaths per 1,000 live births, compared with 3.4 deaths per 1,000 for White infants. The assessment also notes that Black infants in the county face higher rates of preterm birth and low birthweight, both major contributors to infant mortality (Mecklenburg County Community Health Assessment).
Doulas' demands and policy options
Against that backdrop, Charlotte doulas used Black Doula Day to lay out a concrete wish list. They are pushing for Medicaid reimbursement for doula care, longer lasting postpartum supports and a formal seat at the policy table for community-based providers. Those demands mirror national organizers’ priorities and were reiterated locally, as organizers told Spectrum News that bringing community care into alignment with government decision makers is essential if the gap is ever going to shrink. State officials say they have updated the Perinatal Health Strategic Plan and made targeted investments, yet doulas argue that reimbursement policies and on-the-ground implementation are trailing far behind the announcements (NCDHHS).
What’s next
Organizers say the push will continue in clinics, community centers and the statehouse as advocates lobby for durable changes in payment and postpartum policy. The national Black Doula Day website offers a toolkit and events calendar tied to the global celebration next Saturday for anyone looking to plug into local efforts or learn more (Black Doula Day). Doulas and their allies maintain that sustained grassroots pressure, coupled with specific policy shifts, is the only realistic path to bringing the county’s infant health numbers closer to parity.
