A Kansas City nonprofit is stepping into a widening void left by Missouri hospitals that keep shutting down their labor and delivery units, sending doulas, community health workers and sometimes midwives directly to pregnant people who otherwise have nowhere nearby to turn. Altruism Inc. has already supported more than 200 families and handed out more than 38,000 diapers since its Maternal and Infant Health Center opened, according to its own figures. The need keeps growing as more of the state goes without basic obstetric care.
Altruism Inc. works to connect pregnant people and new families with support before, during and after childbirth, according to KSHB 41 Kansas City. The organization partners with Samuel Rodgers Health Center to reach families who face barriers to quality care, and it deploys doulas, community health workers and sometimes midwives to those struggling to access services. Tonia Wright, identified by the station as founder and CEO of Altruism Inc. — though the organization's own website lists her as founder and chief operating officer — has pushed the model as a direct answer to a crumbling system.
Wright said evidence-based doula benefits can greatly decrease Black maternal mortality and save lives, per the station's reporting. She also said doula support can improve maternal health outcomes, particularly for Black families, pointing to persistent disparities that women of color face in maternal and infant health. Wright told KSHB that March of Dimes gave Missouri a D+ for preterm birth, and she cited a Black infant mortality rate above 11% in the state.
What a Doula Actually Does
Doulas offer nonmedical support and guidance throughout the birthing process, working alongside — not instead of — medical providers. At Altruism Inc., that support follows a defined rhythm: three visits before birth, attendance at the birth itself, and three postpartum visits, according to the nonprofit's own description of its model relayed to the station. Sa'Myah Williams, a full-spectrum doula with Altruism Inc., is among those providing that ongoing care through pregnancy and the postpartum period.
Beyond the doula visits, Altruism Inc. connects families with food assistance, mental health services and pediatric care, rounding out a wraparound approach meant to catch people who fall through the cracks of a thinning health care system. Per Altruism Inc.'s own materials, its Maternal and Infant Health Center operates from two locations — one in Lexington and one at Sam Rodgers in Kansas City — and the services are free to those who qualify, including people covered by Medicaid and those who are uninsured.
Missouri's Shrinking Map of Maternity Care
The nonprofit's work lands against a backdrop of steady contraction in Missouri's obstetric infrastructure. Nearly a dozen hospitals in the state have closed their labor and delivery units since 2010, according to a March of Dimes report cited by KSHB. More than half of Missouri's counties now have no local labor and delivery services or obstetric clinicians at all, according to KCUR.
The scale of that gap shows up in the numbers. Nearly 140,000 Missouri women ages 15 to 44 live in counties with no labor and delivery unit and no obstetric doctor, the same outlet has reported, and more than 120,000 live more than 30 minutes from a hospital that offers labor and delivery. Nine Missouri counties lost hospital-based obstetric services between 2010 and 2024, and recent closures have added roughly 25 minutes to the average drive for families nearby. Researchers have also found that in the year after a rural county loses hospital-based obstetrics, the risks of preterm birth and out-of-hospital birth both rise.
A Hospital Sale, Then a Sudden Cut
That pattern recently played out in Marshall, where Fitzgibbon Hospital delivered 252 babies in 2025. Just nine days after a sale of the hospital closed in early September, the new operator announced labor and delivery services would end by the close of the month, KCUR reported. Missouri Valley Regional Medical Center plans to keep emergency-delivery equipment on hand and staff its emergency room with on-call midwives and OB-trained nurses once the unit closes. Nationally, researchers have found that rural hospitals acquired by other organizations were 11% less likely to still offer obstetric care five years after the sale.
Deaths, Disparities and a State Response
The stakes behind these closures are measured in lives. Missouri's pregnancy-related mortality ratio stood at 32.3 deaths per 100,000 live births from 2018 through 2022, well above the national rate of 22.3, according to the Missouri Perinatal Quality Collaborative. Black women in Missouri were 2.5 times more likely than white women to die from pregnancy-related causes during that same period, and mental health conditions, including substance use disorders, were the leading cause of those deaths, accounting for one in three cases. The group also found that 82% of pregnancy-related deaths occurred within a year postpartum, with 43% occurring after the six-week mark — a window when routine postpartum checkups often end but risk remains.
Sources differ on just how many of those deaths could have been prevented. Sam Rodgers Health Center materials describing its partnership with Altruism Inc. put the figure at more than 70%, while the Missouri Perinatal Quality Collaborative's own review panel determined that 80% of pregnancy-related deaths were preventable. Missouri has recently expanded the number of doula visits Medicaid patients can access, according to KCUR, a shift that could widen the reach of programs like Altruism Inc.'s.
What the Research Says About Doula Support
Early evidence suggests that model can move the needle. A study of 722 Medicaid-enrollee pairs found that those with doula support were 46% more likely to attend a postpartum visit, had 47% fewer cesarean deliveries and experienced 29% fewer preterm births, according to accessHealth News. A separate randomized controlled trial found that while overall outcomes were similar between study groups, Black birthing people saw improved cesarean and breastfeeding rates with community doula support, and researchers called for larger studies to confirm the findings, per PubMed Central.
For now, Altruism Inc.'s model remains a small but growing counterweight to a statewide trend running in the opposite direction. As more Missouri counties lose their last labor and delivery units, organizations built around doulas, community health workers and wraparound services are increasingly filling a gap that hospitals once covered on their own.
