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Improving Health Disparities and Birth Outcomes: A Doula-Led Model That Saves Lives and Money

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A two-year North Carolina partnership shows birthwise led $2,000 in per-birth savings, an 88% vaginal delivery rate, and a 98% breastfeeding initiation rate, now expanding statewide.

CHARLOTTE, N.C. - TelAve -- A two-year maternal health partnership between Birthwise, the Charlotte-based practice founded by advocate Toni Curtis, and AmeriHealth Caritas has produced an estimated $2,000 in savings per person served, alongside meaningful improvements in birth outcomes for approximately 200 families across Mecklenburg, Union, Cabarrus, and Gaston counties. AmeriHealth Caritas is now expanding the program statewide across North Carolina as a value-added service for all members, positioning the partnership as a scalable framework for payers, health systems, and policy partners working to close the maternal health gap.

The findings arrive as more than a dozen states have moved to expand Medicaid doula coverage since 2023, and as North Carolina continues to report among the most challenging maternal and infant health outcomes in the United States, with the most pronounced disparities falling on Black birthing people regardless of income or education level, according to CDC maternal mortality data.

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The partnership tracked outcomes including hospital readmission, attendance at the first postpartum appointment, attendance at the first pediatric visit, birth weight, gestational age, live birth, cesarean delivery, and vaginal delivery. Across Curtis's nearly 30-year career in birth work, her broader practice maintains an 88% vaginal delivery rate, including VBAC, a 98% breastfeeding initiation rate, and a record of zero preventable maternal or infant losses. The per-person savings figure reflects reduced complications and shorter hospital stays.

"A good doula knows how to help you ask the questions you didn't even know to ask," said Toni Curtis, CD(DONA), founder of Birthwise. "This partnership proves that skilled doula support delivers better outcomes for families and measurable savings for the system. The evidence is built. The work now is to make it accessible. We stand to fight against disparities, but my expertise is for everyone."

The data underscores a point often missed in public coverage: Black women in the United States face the highest rates of pregnancy-related complications and maternal mortality, and the disparity persists even among highly educated, high-income mothers. The Birthwise model is built around the principle that skilled doula expertise belongs to every birthing family, not only those served through public coverage. Birthwise is proudly expanding its consulting, training, and education services across classroom and active education to meet this demand.

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Toni Curtis is available for interviews with health policy, women's health, and public health reporters. Learn more at https://birthwisedoulas.com/

About Toni Curtis

Toni Curtis, CD(DONA), LCCE, CLC, CVD(TVL), CHW, SpBCPE, SpBAP, GPBA, is a maternal health advocate with nearly three decades of experience in birth work, maternal health policy, and doula training. She is the founder and Director of Doula Services at Birthwise and serves as Director of Advocacy for DONA International, the oldest and largest doula certifying organization in the world, where she is also a director at the Black Mother and Baby subcommittee. Curtis is a UN Representative through the Africana Women Working Group (AWWG), a consultative body to ECOSOC, a Global Council Member at Forttuna, and a 2026 Forttuna Holistic Wellness Award nominee.  She is a featured voice at Embrace & Evolve, the Charlotte-based women's health leadership conference, on August 15, 2026.



Source: Birthwise Doulas
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