Cumberland County is again funding doula services to help address disparities in pregnancy outcomes and maternal mortality rates.
Piloted last year, the county grant program offers up to $75,000 to two organizations to help provide uninsured and underinsured pregnant residents with a doula’s non-clinical pregnancy, delivery and postpartum services. Those services can include childbirth planning, advocacy during labor and postpartum childcare.
“We believe every mother and every baby deserves a healthy start,” Dr. Kinglsey Momodu, chair of the Cumberland County Board of Health, said in a press release. “Funding for doula services will help address the unacceptable disparities in maternal and infant health, ensuring that all families have access to the care and support they need to thrive, regardless of race or income.”
Doula services are associated with improved outcomes for people in labor, according to the American College of Obstetricians and Gynecologists. Pregnant women in Greensboro who used doula services were two times less likely to have birth complications, according to a 2013 study published in The Journal of Perinatal Education. Doulas have also been associated with shorter labor, decreased caesarean (C-section) births and improved feelings about childbirth, according to a review of 26 trials involving over 15,580 women globally.
The pilot grant, which was distributed in February, is already making an impact. Central Carolina Doulas was one of two organizations to participate in the pilot, and has already seen better birth outcomes in 17 clients served by the funding, said founder and owner Aida Algarin.
The clients are racially diverse, though most are Black, Indigenous or other people of color — those most at risk of birth complications and pregnancy-related deaths, according to an analysis by KFF. Some are part of the LGBTQ+ community. None could afford Central Carolina Doulas’ services without the county grant.
The free doula services have led to fewer C-sections and babies needing to stay in neonatal intensive care units (NICUs) among at-risk clients, Algarin said. She also said clients are reporting feeling safer, thanks to their doula’s advocacy during health appointments and labor.
“Everyone deserves support when they’re pregnant,” Algarin said. “I am so proud to be a resident of Cumberland County and right now being part of a solution to help the marginalized.”
However, the rate of preterm births among clients has been a difficult issue for Central Carolina Doulas to tackle. Preterm birth occurs when a baby is born before 37 weeks of pregnancy, while an average pregnancy is around 40 weeks. About one in every nine pregnancies in Cumberland County resulted in a preterm birth in 2023, according to data from the North Carolina Department of Health and Human Services.
Chronic health conditions like hypertension and diabetes increase the likelihood of preterm birth. Pregnant people with lower incomes are also more likely to give birth preterm, according to the Centers for Disease Control.
Central Carolina Doulas’ grant clients face these conditions and others like domestic violence, substance use disorders and homelessness, leading the organization to connecting clients with other programs. Doulas help clients sign up for WIC, or Women, Infant and Children, the federal food benefit and nutrition education program for low-income pregnant people. They also make free health appointments at the Cumberland County Department of Public Health and offer at-home birth classes when clients can’t access transportation.
“We are not reinventing the wheel,” Algarin said. “What we are is the spoke connecting the clients to the resources in the community. What this grant does is really morph our role of professional doulas to be more community doulas that are community health workers as well.”
The funding is also providing families with car seats for newborns and every child in the family who needs one, something critical to Algarin after seeing clients with expired seats because they were the only affordable option.
This year’s funding
Funding for this year’s doula grant was appropriated from the county’s fiscal year 2026 budget by Cumberland County Board of Commissioners. The funds can only go towards care for county residents.
“With the inclusion of funding for doula services in the budget, we are making a tangible investment in the well-being of our community,” Kirk deViere, chair of the county board of commissioners, said in the grant press release.
To be eligible for the funding, the organization must support at least 30 clients annually and hire or contact at least two certified birth doulas. Those doulas must use evidence-based practices to provide doula care during pregnancy, at least two days after birth and again within six weeks after birth.
Organizations interested in learning more about the grant can attend one of two online webinars — one on Thursday, Aug. 7 at 10 a.m. and the other Monday, Aug. 11 at 10 a.m. — hosted by the county. Webinar access is provided in the grant’s press release.
Any questions not answered by the webinars must be sent to Sophia Murnahan, purchasing manager with the county, by email by Aug. 15 at 2 p.m. Applications must be submitted by Sept. 5 at 2 p.m.
Algarin said Central Carolina Doulas will be submitting an application.
“We want to continue to build on the foundation that we’’ve started,” she said. “It can only get stronger.”
CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the News Foundation of Greater Fayetteville.