(NEW YORK) — A major spring storm hits the western U.S. Monday with snow, high winds and blizzard conditions.
The storm will move into the central U.S. on Tuesday and Wednesday, bringing a multi-day severe weather outbreak to millions.
Another storm system in the mid-South will bring the first round of severe weather Monday night, before the more widespread severe weather moves in.
Residents located in areas from Texas to southern Illinois, including major cities like Dallas, Little Rock and Memphis, can expect to see damaging winds, scattered hail and a few tornadoes Monday. Little Rock has the highest chance for very large hail and a strong tornado or two.
By Tuesday night major cities such as Dallas, Kansas City and Des Moines can expect to see strong tornadoes and huge hail.
The highest threat for tornadoes on Tuesday will likely be areas north of Kansas City and across much of Iowa.
On Wednesday, a severe threat will move east, heading into the Great Lakes, Ohio, Tennessee Valleys and the Gulf Coast.
Major cities such as Chicago, Indianapolis, St. Louis, Nashville, Little Rock and Jackson will be in the bull’s-eye for strong tornadoes, huge hail and damaging winds.
Severe weather will extend all the way to the Gulf Coast, including New Orleans, through Wednesday night.
After a weekend of heat waves in the West, a new storm is expected to bring in heavy snow and strong winds. Some areas throughout the West could see more than 2 feet of snow and wind gusts up to 80 mph. In addition, blizzard warnings extend from Montana to the Dakotas this week.
(NEW YORK) — As COVID-19 cases continue to tick up in the United States, the Northeast appears to be fueling the increase.
Four of the five states with the highest seven-day case rates per 100,000 are in the Northeast. In the 10 states with the highest seven-day rates, seven are Northeastern, according to data from the Centers for Disease Control and Prevention.
Rhode Island currently has the highest seven-day case rate at 172.4 cases per 100,000 people. This is nearly three times higher than the national rate of 59.4 cases per 100,000 people.
As of Friday, the Ocean State has also seen its average daily number of cases increase 53% over a two-week period from 170 per day to 260 per day, CDC data shows.
Other Northeastern states seeing increases include Vermont, New York, New Jersey, Maine and Connecticut.
In particular, New York and New Jersey have seen their average daily cases increase by 64%, the CDC data shows.
Experts said one of the reasons for the rise in cases is the spread of BA.2, a subvariant of the original omicron variant that is more transmissible.
In the Northeast, BA.2 accounts for more than 84% of COVID-19 cases that have undergone genomic sequencing, more than any other region in the country, according to the CDC.
Dr. Ali Mokdad, an epidemiologist with the University of Washington’s Institute for Health Metrics and Evaluation, told ABC News that early evidence suggests people who were infected with the original omicron variant during the previous wave may now have some immunity against BA.2.
He suggested states that were able to have better control of cases earlier may currently be more vulnerable to infections.
“States that did a good job controlling infections with mandates, most in the Northeast and West, are more susceptible now with BA.2,” he said.
Mokdad compared Maine and Florida using data from the institute, which projects COVID-19 cases around the country.
“We estimate that 54% of people in Maine have been infected at least once as of April 4,” he said. “So, we estimate that 60% are immune. We estimate that 87% of people in Florida have been infected at least once as of April 4. We estimate that 80% are immune.”
Another reason Northeastern states may be seeing case increases is due to the lifting of mask and vaccine requirements, the experts said.
“Not only is BA.2 extraordinarily transmissible, but now, consistent with CDC guidelines, many people are going to crowded indoor events and outdoor events without wearing a mask and not social distancing,” Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University in Nashville, Tennessee, told ABC News. “In anticipation of summer … people are eager to see family and friends and engage in near-normal activities again.”
However, the experts warned the true number of cases could be even higher as some states shift their COVID-19 testing strategy.
In late February, the Rhode Island Department of Health announced that — starting March 7 — state-run testing sites would not accept asymptomatic patients unless they had been in close contact with a person who tested positive for the virus.
“Focusing testing efforts at Rhode Island’s state-run testing sites on people who are symptomatic and people who are close contacts will ensure that people who are positive and eligible for treatment can be quickly connected to treatment,” the department said in a news release.
Schaffner said he expects that the rise of cases in the Northeast will be followed in the next few weeks by increases in the Midwest, the South and the West.
“This is reminiscent of the very beginning of COVID here in the United States,” he said. “The Northeast led the rest of the country; they had the most infections for quite a period of time before the COVID virus spread to the rest of the county. So perhaps this is a little bit of history repeating itself.”
However, the doctors reiterated that unvaccinated people are at the highest risk of severe illness and death from BA.2 and stressed the importance of getting vaccinated and boosted.
(NEW YORK) — Many parents across the country are scrambling to find baby formula amid a nationwide shortage.
Nearly 30% of popular formula brands may be sold out at stores across the U.S., according to a firm that tracks what’s stocked on the shelves, and that has led some stores to limit the amount of formula products customers can buy.
The shortage is the result of multiple factors, including inflation, supply chain issues and a formula recall.
As for when parents can begin to see stocked shelves again, ABC News’ Eva Pilgrim says some companies have ramped up production “but it’s going to take a few weeks before we really see that shortage ease.”
Ukrainian forces fire GRAD rockets toward Russian positions in Donbas, Ukraine on April 10, 2022 – Wolfgang Schwan/Anadolu Agency via Getty Images
(NEW YORK) — Russian President Vladimir Putin’s “special military operation” into neighboring Ukraine began on Feb. 24, with Russian troops invading from Belarus, to the north, and Russia, to the east. Russian forces have since been met with “stiff resistance” from Ukrainians, according to U.S. officials.
In recent days, Russian forces have retreated from northern Ukraine, leaving behind a trail of death and destruction. After graphic images emerged of civilians lying dead in the streets of Bucha, a town northwest of Kyiv, the United States and European countries accused Russia of committing war crimes.
Here’s how the news is developing. All times Eastern:
Apr 11, 10:03 am
Ukraine agrees to 9 humanitarian corridors from the east
Nine humanitarian corridors are expected to open in eastern Ukraine on Monday to allow civilians escape heavy fighting, according to Ukrainian Deputy Prime Minister Iryna Vereshchuk.
She said in a statement via social media Monday that evacuation routes were agreed upon for those traveling by private cars from besieged Mariupol in the Donetsk Oblast, as well as from Berdyansk, Tokmak and Enerhodar in the Zaporizhzhia Oblast — all of which lead to the southeastern city of Zaporizhzhia. Buses from Zaporizhzhia city were also waiting to pass a checkpoint in Vasylivka, according to Vereshchuk.
In the Luhansk Oblast, Vereshchuk said routes were established from the cities of Severodonetsk, Lysychansk, Popasna, Hirske and Rubizhne, leading to the city of Bakhmut in the Donetsk Oblast.
Apr 11, 8:48 am
Russia may use phosphorus munitions in Mariupol, UK warns
The United Kingdom is warning of Russia’s possible use of phosphorus munitions in the besieged Ukrainian city of Mariupol.
Russian forces have already been accused of using phosphorus bombs in Ukraine since launching an invasion on Feb. 24. When deployed as a weapon, phosphorus can inflict excruciating burns and lead to infection, shock and organ failure.
After withdrawing troops from the north, the Russian military is said to be refocusing its offensive on the Donetsk and Luhansk oblasts in eastern Ukraine’s disputed Donbas region, where Russia-backed separatist forces have been battling Ukrainian soldiers since 2014. Mariupol, in the Donetsk Oblast, and its residents have been under heavy Russian bombardment for over a month, but Moscow has so far failed to win full control of the strategic port.
“Russian forces prior use of phosphorous munitions in the Donetsk Oblast raises the possibility of their future employment in Mariupol as fighting for the city intensifies,” the U.K. Ministry of Defense said Monday in an intelligence update.
Meanwhile, Russian shelling has persisted in the Donetsk and Luhansk oblasts, according to the ministry, “with Ukrainian forces repulsing several assaults resulting in the destruction of Russian tanks, vehicles, and artillery equipment.”
“Russia’s continued reliance on unguided bombs decreases their ability to discriminate when targeting and conducting strikes while greatly increasing the risk of further civilian casualties,” the ministry added.
Apr 10, 11:11 pm
Forces preparing to respond to Russian attack on eastern Ukraine, Zelenskyy says
Ukrainian forces are preparing to respond to a planned Russian attack on the eastern side of the country, Ukrainian President Volodymyr Zelenskyy announced in his address on Sunday.
Russian troops are expected to move to an even larger operation in the east of Ukraine, which will enable them to carry out even more bombardments, Zelenskyy said, adding that Ukrainian forces are ready for the attack.
“We are preparing for their actions,” Zelenskyy said. “We will respond. We will be even more active in providing Ukraine with weapons. We will be more active in the international arena. We will be even more active in the information field.”
Zelenskyy added that he and other government officials are doing everything they can to ensure that Ukraine gets the world’s attention, especially as Russia continues to attempt to influence the narrative and justify the invasion.
This coming week will be just as important as previous weeks, Zelenskyy said.
“It will be just as tense and even more responsible,” he added.
-ABC News’ Christine Theodorou
Apr 10, 5:00 pm
Thousands of refugees return to Ukraine
Nearly 23,000 Ukrainian refugees returned to Ukraine on Saturday after fleeing the country following the Russian invasion in February, according to Ukrainian and United Nations officials.
The repatriated Ukrainians are among the more than 4.5 million who left the country between Feb. 24 and April 9, according to the U.N. High Commissioner for Refugees.
More than half of the Ukrainian refugees fled to neighboring Poland, officials said.
The Polish border guard service is reporting that despite the war still raging in Ukraine, the number of refugees voluntarily returning to Ukraine reached the highest figure for a single day on Saturday since the war began, according to Ukraine’s Center for Strategic Communications and Information.
The UNHCR estimated that as of April 8, more than 7.1 million people in Ukraine have been displaced due to the war.
-ABC News’ Christine Theodorou
Apr 10, 3:58 pm
Death toll from Kramatorsk train station attack rises to 57
The death toll climbed to 57 on Sunday from an alleged Russian rocket attack Friday on a crowded train station in the eastern Ukrainian city of Kramatorsk, Ukrainian officials said.
Among those killed in the attack were five children, said Pavlo Kyrylenko, governor of the Donetsk Oblast in the Donbas region. Another 109 people were wounded when two Russian rockets struck the train station.
“There are many people in a serious condition, without arms or legs,” said Kramatorsk Mayor Oleksandr Goncharenko according to the Associated Press.
The number of dead victims in the attack grew from 50 on Friday, officials said.
Ukraine’s state-owned railway company issued a statement on Facebook calling the attack “a purposeful strike on the passenger infrastructure of the railway and the residents of the city of Kramatorsk.”
Graphic images provided by Ukrainian officials showed the aftermath of the attack — bodies lying on the ground next to scattered luggage and debris, with charred vehicles parked nearby.
The remnants of a large rocket with the Russian words painted on its side reading “for our children” was also seen on the ground next to the main building of the train station.
Russia has denied involvement in the attack. Kremlin spokesman Dmitry Peskov claimed involvement of Russian forces was already ruled out by the Russian Ministry of Defense, based on the type of missile that was used — a Tochka-U short-range ballistic missile.
“Our armed forces do not use missiles of this type,” Peskov told reporters during a press briefing Friday. “No combat tasks were set or planned for today in Kramatorsk.”
(LONDON) — Britain’s Queen Elizabeth spoke for the first time publicly about her own battle with COVID-19, saying the virus leaves “one feeling very tired and exhausted.”
The queen, 95, tested positive for COVID-19 in February, just days after it was confirmed that her son, Prince Charles, and his wife, Camilla, Duchess of Cornwall, had also tested positive for COVID-19.
Buckingham Palace said at the time that Queen Elizabeth had “mild cold-like symptoms” as a result of the virus.
Last week, the queen virtually attended the official opening of the Queen Elizabeth Critical Care Unit at Royal London Hospital, of which she is patron. The 155-bed unit was built in five weeks to help care for the surge of patients during the pandemic.
Queen Elizabeth spoke on a video call with health care workers who treated patients during the pandemic as well as a man named Asef, who recovered from COVID-19 in the unit.
Buckingham Palace released video of the call on Sunday.
“I’m glad that you’re getting better,” the queen told Asef. “It does leave one feeling very tired and exhausted doesn’t it, this horrible pandemic.”
Queen Elizabeth has attended most events virtually over the past several months, due to her battle with COVID-19 and other health conditions. In October, she was hospitalized overnight for what Buckingham Palace described as “preliminary investigations.”
The queen’s first in-person appearance since battling COVID-19 was last month, when she attended the Thanksgiving service for her husband, Prince Philip, who died last April at age 99.
Buckingham Palace has announced the queen will not attend the Maundy Service on Thursday, an annual tradition in which she distributes special Maundy money to pensioners ahead of Easter Sunday.
Queen Elizabeth appeared upbeat on the Royal London Hospital call, during which she thanked health care workers for their service during the pandemic.
“It’s been very nice to be able to join you and also to hear what happened and how well it has been achieved,” said the queen. “Thank you very much indeed, all of you.”
Ukrainian Presidency/Handout/Anadolu Agency via Getty Images
(LONDON) — Ukrainian President Volodymyr Zelenskyy warned that an attack from Russian forces in the east is looming. But he said Ukrainian troops are ready.
“Russian troops will move to even larger operations in the east of our state. They can use even more missiles against us, even more air bombs,” Zelenskyy said in a televised address late Sunday. “But we are preparing for their actions. We will respond. We will be even more active in providing Ukraine with weapons. We will be more active in the international arena. We will be even more active in the information field.”
After Russian forces invaded Ukraine from the north, east and south on Feb. 24, they quickly reached the outskirts of Kyiv, but ultimately failed to seize the Ukrainian capital and other major cities in the north. Russian forces were met with strong resistance from Ukrainian troops, despite weeks of relentless bombardment that decimated entire neighborhoods and claimed civilian lives.
The Russian military announced on March 29 it would scale down activities in the north around Kyiv and Chernihiv and instead focus its efforts on the “liberation” of the contested Donbas region in the east, which is home to a mostly Russian-speaking population. Russia-backed separatist forces have controlled two breakaway republics of eastern Ukraine’s Donetsk and Luhanks oblasts in Donbas since 2014, following Russia’s annexation of Ukraine’s Crimean Peninsula.
The Russian troops that have retreated from northern and northeastern Ukraine in recent days are now resting and resupplying in neighboring Belarus and Russia, according to observers, who noted it could take weeks before those troops are redployed for a fresh attack in the east.
“At least some of these forces will be transferred to East Ukraine to fight in the Donbas,” the U.K. Ministry of Defense said in an intelligence update on April 8. “Many of these forces will require significant replenishment before being ready to deploy further east with any mass redeployment from the north likely to take at least a week minimum.”
Nevertheless, NATO Secretary-General Jens Stoltenberg warned that “this is a crucial phase of the war.”
“In the coming weeks, we expect a further Russian push in eastern and southern Ukraine to try to take the entire Donbas and to create a land bridge to occupied Crimea,” Stoltenberg said at a press conference on April 5.
Satellite images collected on April 8 by Maxar Technologies show a large military convoy of hundreds of vehicles, including tanks, that extends for at least 8 miles, moving south through the eastern Ukrainian town of Velykyi Burluk, about 55 miles east of Kharkiv, Ukraine’s second-largest city, and some 65 miles from the border with Russia. Ukrainian authorities have warned citizens in the east that this is their last chance to flee, as Russian forces are expected to push south from Kharkiv and north from Donetsk in an attempt to encircle the battle-hardened Ukrainain troops in Donbas.
In his address on Sunday night, Zelenskyy said this coming “week will be no less important than” the previous ones.
“It will be just as tense and even more responsible. Russia will be even more afraid. Afraid to lose,” he said. “I will continue to address the parliaments and nations of the world. We will meet our partners, leaders of other states in Kyiv and other Ukrainian cities. We will attract even more funds and resources to help Ukraine.
(PARIS) — French President Emmanuel Macron and Marine Le Pen, a far-right presidential candidate, took the top two spots in the first round of the presidential elections on Sunday, according to preliminary results.
The two, who led a crowded field of twelve candidates, will advance to a second and final round of voting on April 24.
Macron, who is seeking reelection, placed first with about 28% of votes cast on Sunday, according to preliminary results. Le Pen carried about 23%.
Experts say the latest trends showed a strong and rapid rise in the number of voters in favor of Le Pen, while those of Macron were falling.
“We’ve seen a positive dynamic in favor of Marine Le Pen,” Henri Wallard, deputy CEO at Ipsos polling, told ABC News. “She has progressed clearly in the last two or three weeks before this first phase.”
The far-right candidate’s message has reached French people concerned about the cost of living.
“The most important concern expressed by the French voters is the purchasing power and and the social issues in general,” Wallard said. “And the fact is Marine Le Pen was early on in the campaign well-positioned on this topic … and the fact is that we have seen as a consequence of the current international crisis a surge in the price of oil and gas and the impact on inflation.”
The war in Ukraine and the COVID-19 pandemic have disrupted this atypical presidential campaign and added uncertainty for voters.
France risks breaking the 2002 record of non-voters, which reached 28% in the whole of France, according to Jean Chiche, emeritus researcher at the SciencesPo Center for Political Research. Abstention hovers over the elections, as the majority of French people don’t feel represented by political office-holders, he said.
“There is a rejection of the political class,” Chiche told ABC News. “It is the young people of the working classes who live in isolated cities, or in peri-urban areas; they are the most abstaining.”
Macron achieved high scores in the first 15 days of the war in Ukraine, according to Chiche, a major boost for the president seeking reelection.
“Faced with the war in Ukraine, he fully assumed his responsibilities as head of state, everyone in France understands that,” Maud Bregeon, spokesperson for Macron’s La République En Marche party told ABC News.
Critics have pointed to Macron’s absence on the campaign trail since the beginning of the war as one cause for his dropping popularity.
Macron is also facing possible trouble at the polls since his government came under fire in February for hiring and paying large amounts to a U.S. consulting firm, as first revealed by two journalists from French newspaper L’Obs. The French government paid up 1.5 billion euros in 2020 to several private consulting firms for services such as counting health masks at the beginning of the pandemic or drafting a military strategy, the newspaper reported.
A senatorial commission of inquiry into the government’s frequent and expensive payments to those firms later unveiled that one of them, McKinsey & Company, did not pay taxes in France between 2011 and 2020, despite the large sums received. The National Financial Prosecutor’s Office opened a preliminary investigation on April 6 for aggravated money laundering of tax evasion.
McKinsey responded the same day, saying in a statement that “the tax approach applied by McKinsey is similar in the countries where it is present and has been consistent for years.”
“As it stands, if Macron doesn’t campaign more, if Marine Le Pen makes it to the second round and at the same time she doesn’t collapse like she had did in 2017, then the probability of her being elected is non-zero; it is between 15 to 30%,” Chiche before Sunday’s vote.
The rise of Le Pen’s party also led to the emergence of new candidates on the far-right, such as polemist Eric Zemmour.
Zemmour, who was found guilty in January of hate speech by a Paris court, has stood out with a campaign focused on what he calls the fight against Islamism, calling on French Muslims to “renounce the practice of Islam, which imposes a legal and political code.”
Proposals from conservative and far-right camps targeting Muslim populations — such as requiring French nationals to have certain first names — have come under strong criticism.
“It’s a reaction of disgust,” Abdallah Zekri, president of the National Observatory for the Fight against Islamophobia, told ABC News. “When he says we have to change our first names? Why change our first names? Zemmour is completely out of bounds.”
Other proposals targeting migrants, such as the conservative candidate Valérie Pécresse’s bid to systematically remove illegal immigrants accompanied by a “zero visa” policy for countries that refuse to take them back have also hit a nerve with migrant communities.
Zekri says speeches like that of Zemmour, conservative party candidate Valérie Pécresse and Le Pen tend to lead to an increase in Islamophobic acts.
“I have been following anti-Muslim acts for over 11 years,” Zekri said. “Whenever an election approaches, Islamophobic acts automatically increase; and it’s getting worse.”
(WASHINGTON) — President Joe Biden and the Department of Justice are set to announce a final rule on “ghost guns” on Monday in the Rose Garden.
A “ghost gun” is a firearm that comes packaged in parts, can be bought online and assembled without much of a trace.
The new rule essentially expands the definition of a “firearm,” as established by the Gun Control Act, to cover “buy build shoot” kits that people can buy online or from a firearm dealer and assemble themselves. It will make these kits subject to the same federal laws that currently apply to other firearms.
“At its core, this rule clarifies that anyone who wants to purchase a weapon parts kit that can be readily be converted to a fully assembled firearm must go through the same process they would have to go through to purchase a commercially made firearm in short weapon parts kits that may be readily convertible into working fully assembled firearms must be treated under federal law,” a senior administration official told ABC News.
Commercial manufacturers of the kits will have to be licensed and include serial numbers on the kits’ frame or receivers. In addition, commercial sellers will have to be federally licensed and run background checks before selling a kit.
The final rule also tackles ghost guns that have already been made and are in circulation. The DOJ will require federally licensed dealers that take in any un-serialized firearms to serialize it before selling the weapon. If a licensed dealer acquires a ghost gun, the rule will require them to serialize it before re-selling it.
“This requirement will apply regardless of how the firearm was made, meaning it includes ghost guns made from individual parts, kits, or by 3D-printers,” a fact sheet of the new rule shared with ABC News.
“If you can put together an IKEA dresser, you can build a ghost gun,” Mia Tretta, a volunteer leader with Students Demand Action and a gun violence survivor who was shot and wounded with a ghost gun in a school shooting in 2019, told ABC News. “Unfortunately, it is that easy to get a weapon that has not only changed my life but has done the same thing to thousands of others. Finalizing this rule is a critical step to making sure no one else has to go through what my family has had to go through.”
The final rule also updates the definition of a “frame” and “receiver” so that all using split or multi-part receivers are covered under existing gun laws and will be subject to serial numbers and background checks.
The rule also extends the 20-year record retention requirement that all Federal Firearm Licensees must adhere to. Under the rule, FFLs must retain records for as long as the dealer is licensed.
From January 2016 to December 2021, the ATF said it received “approximately 45,000 reports of suspected privately made firearms recovered by law enforcement in criminal investigations — including 692 homicides or attempted homicides,” according to the DOJ.
New ATF director
Biden and Deputy Attorney General Lisa Monaco are also set to announce the nomination of Steve Dettelbach as the new director of the Bureau of Alcohol, Tobacco, Firearms and Explosives.
“Steve is a highly respected former U.S. Attorney and career prosecutor,” a senior administration official said. “He has a proven track record of working with federal, state, and local law enforcement to fight violent crime and combat domestic violent extremism and religious violence — including through partnerships with the ATF to prosecute complex cases and take down violent criminal gangs.”
The official did not specify whether the interim ATF director, Marvin Richardson, will remain in place during the confirmation process.
“We applaud the Biden-Harris Administration for doubling down on its commitment to gun safety by taking action to rein in ghost guns and nominating an ATF Director who will end its culture of complicity with the gun industry,” John Feinblatt, president of Everytown for Gun Safety, told ABC News. “Steve Dettelbach will be the strong leader the ATF needs to lead a top-to-bottom overhaul of the agency, and we urge the Senate to swiftly confirm him.”
(NEW YORK) — April 11-17, 2022, is Black Maternal Health Week, a time to put a spotlight on and have a national conversation about Black maternal health in the U.S., according to Black Mamas Matter Alliance, a nonprofit organization that founded the initiative five years ago.
Naomi, a 37-year-old Black woman from Portland, Oregon, will have a doula by her side when she gives birth to her seventh child, a daughter, later this month.
By using a doula — a trained professional who provides support to moms before, during and after childbirth — Naomi is part of a growing trend of Black women who see having a doula, particularly a Black doula, as a potentially lifesaving advocate during birth.
“I know the intensity of what’s happening can lead to a lot of complications,” Naomi, who asked that only her first name be used, told Good Morning America. “When you’re tapped out because you’re having contractions that take your breath away, you want someone who can step in and knows what to do and knows what you want.”
As a Black woman in the U.S. — which continues to have the highest rate of maternal mortality among developed nations — Naomi is more than twice as likely to die during childbirth or in the months after than white, Asian or Latina women, according to the U.S. Centers for Disease Control and Prevention (CDC).
Black women like Naomi are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.
Naomi said she only learned about doulas eight years ago, when she was pregnant with her sixth child and needed someone to be a support person in the delivery room. She was able to access a doula free of cost thanks to a local nonprofit organization, Black Parent Initiative (BPI), that matches Black women with Black doulas in hopes of improving their odds during pregnancy and delivery.
“All those times I gave birth, I wish I would have had a doula,” said Naomi, who had her first child in her late teens. “I wish it was available 20 years ago like it is now.”
Linda Bryant-Daaka, a labor and postpartum doula and manager BPI’s doula program, said interest in the program has increased every year since its founding in 2016, and especially during the past year of the coronavirus pandemic, which both disproportionately impacted Black people and put a glaring spotlight on racial disparities in health care.
“What we’ve heard from women is that there was so much stress around the pandemic and they had so many family members pass away, they now want to use these services,” said Bryant-Daaka. “And they want someone who has that shared, common background or lived experience as them.”
How doulas can help Black pregnant women
Why Black women die at a higher rate than any other race during childbirth is the result of a web of factors, experts say.
Pregnancy-related deaths are defined as the death of a woman during pregnancy or within a year of the end of pregnancy from pregnancy complications, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiological effects of pregnancy, according to the CDC.
One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the CDC.
But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions, data shows. And Black women often have inadequate access to care throughout pregnancy which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.
Anecdotal reports also show that the concerns of Black women experiencing negative symptoms during pregnancy and postpartum are specifically ignored by some physicians until the woman’s conditions significantly worsen, at which point it may be too late to prevent a deadlier outcome.
That is where doulas come in, according to Tracie Collins, a doula and CEO and founder of the National Black Doulas Association (NBDA), a nonprofit organization that connects Black birthing families with Black doulas.
“Black women hire doulas because they want to make sure that they live,” said Collins. “It’s not a status quo for us.”
“It’s about, ‘I’m getting ready to go into an experience that I know I need support in and I’m unfamiliar with processes. I’m unfamiliar with what I’m about to face. I’m unfamiliar with bureaucracy and the hospital procedures. I’m unfamiliar with the personnel. I’m just unfamiliar and I want to make sure that not only are my voice and my wishes respected, but that I have somebody there to help advocate so everybody can be healthy on the other side,'” she said.
Dr. Ashanda Saint Jean, a board-certified OBGYN and chair of OBGYN for the Health Alliance Hospitals and Westchester Center Medical Health Network in New York, notes that doulas are a source of non-medical support for pregnant women before, during and after childbirth.
“A doula is a support person who has been trained and educated in labor and delivery,” said Saint Jean. “I’ve had a number of Black patients feel that having a doula is an extra layer of support where they’re able to more ask questions about their birthing experience and explore all measures to ensure a healthy outcome.”
In Naomi’s experience, she and her doula created a birthing plan so that Naomi’s doctors and partner would know what she wanted, and the doula made sure the plan was executed during labor.
“With a doula, I can relax and focus on labor,” said Naomi. “She can even tell my partner things like, ‘Rub her back right here.'”
Dr. Jacquelyn McMillian-Bohler, a certified nurse-midwife and assistant professor in Duke University’s school of nursing, describes doulas as bridging the communication gap between health care providers and Black female patients.
“Our health literacy is poor across the board, and then when you add racism on top of that, it just creates another layer,” she said. “That’s what we’re doing with the doula, we’re trying to attack that health literacy piece that really affects outcomes.”
Studies show that continued support like doulas for pregnant women can help reduce the rate of C-sections, which are higher among Black women.
The postpartum care offered by doulas also helps to increase the rates of breastfeeding, which improves health outcomes for new moms and babies, and decreases the rates of postpartum complications, like blood clotting and blood hemorrhaging, both of which impact Black postpartum women, data shows.
Stephanie Devane-Johnson, Ph.D., associate professor at Vanderbilt University’s school of nursing, said she sees doulas as filling a lifesaving role in the birthing process for Black women.
“It takes a village not only to raise a child, but also to give birth,” said Devane-Johnson. “What we’re trying to accomplish here is to create the village to support Black mothers.”
An effort to get more Black doulas for Black women
Devane-Johnson and McMillian-Bohler are among the health experts leading the fight to get more Black doulas trained to meet the need of expectant Black women.
They and other experts point to the issue of racial bias in medicine and say it is critical to have doulas who understand and share the same lived experiences as their clients.
“It’s very important that we have health care providers that look like the community we serve and birth workers that look like the community that we serve,” said Devane-Johnson. “I still actively practice at Vanderbilt University and it’s amazing how Black patients, whenever I walk into a room they’re like, ‘Where did you come from?'”
“It gives them a sense of comfort,” she said.
Venus Standard, assistant clinical professor in the University of North Carolina-Chapel Hill’s School of Medicine’s department of family medicine, recently received a $75,000 grant to train Black doulas, a program she is working on alongside Devane-Johnson and McMillian-Bohler.
The funding will allow the trio to recruit and train 20 Black women to earn doula certification — which can cost hundreds of dollars and is often a barrier to entry for Black women — and also provide business and marketing seminars to “help the newly-trained doulas establish viable businesses,” according to UNC.
“There’s a lack of trust in within the Black community toward the medical community,” said Standard. “There is a better trust value when [a Black pregnant woman] knows that you’re going to give them accurate information and information that’s needed for them and their particular situation, especially if her provider team does not look like her.”
McMillian-Bohler pointed out the trust factor between doulas and patients is especially important because the birthing process is so personal.
“You think about someone being in your intimate space, being with you in your home and potentially coming to the hospital and and sitting in a room with you for 20 hours,” she said. “It can be a hard sell so that’s why this grant is so important and projects like this are important, so that not only do people know doulas are out there, but that we’re growing the body of doulas that look like the people we are caring for.”
A help, but not a complete solution to the maternal mortality crisis
Health care providers who are on the front lines of helping Black pregnant women describe a heartbreaking situation of watching women live in fear during what it supposed to be a joyous time.
“I cannot have another Black patient come to me and say, ‘I’m scared I’m going to die having this baby,'” said Saint Jean, the OBGYN in New York. “It breaks my heart that in 2021 we still have women in the United States afraid that they will die in childbirth.”
And while having a doula is helpful for Black mothers, it is not a cure-all for the maternal mortality crisis in the U.S., experts say.
For one, doulas can cost upwards of $1,000 per birth. While there are efforts to have doulas funded by Medicaid and more insurance plans and there are initiatives like the Black Parent Initiative (BPI) in Oregon that offers doulas free of charge, the access is not equal, according to BPI’s Bryant-Daaka.
“Everyone should be able to have a doula, no matter what the cost is,” she said. “If we know that these services are helpful and are going to save lives and reduce cost on the backend, why would you not want them offered to women who are giving birth?”
Having doulas present is also not going to eliminate all of the underlying issues that put Black pregnant women in more danger, according to McMillian-Bohler.
“Black doulas are not going to fix the oppression and discrimination and those things that are still happening,” she said. “Because what you hear [from Black women] that’s very consistent is, ‘I don’t feel heard, ‘I’m not listened to;’ ‘I don’t feel comfortable explaining how I’m feeling because I’m not taken as seriously as someone else.'”
“We have example after example after example of where that has happened, and until we get to that issue, it’s not going to go away,” she said.
ABC News’ Dr. Adjoa Smalls-Mantey, Dr. Alexis E. Carrington and Danielle Genet contributed to this report.
