Jess Mador, WABE, Author at ��ϳԹ�� News

Demoralized CDC Workforce Reels From Year of Firings, Funding Cuts, and a Shooting

Jess Mador, WABE — Wed, 25 Mar 2026 09:00:00 +0000

On the coffee table at her home in Atlanta, Sarah Boim has a pile of documents from her old job at the Centers for Disease Control and Prevention. They are printouts of her employment records.

Boim lost her job in the first big wave of CDC firings — more than 1,000 people were last February.

“This is the termination letter. I also printed off my performance review from 2024,” she said. “I knew I wouldn’t have access to it, and everything was so chaotic that I needed proof of what was happening.”

Boim worked in the , handling communications about radon, substances known as forever chemicals, lead poisoning, and other health threats.

Rereading her termination letter, she still can’t believe what it says.

Former CDC employee Sarah Boim rereads her termination letter at home in Atlanta. Boim lost her job in the first big round of firings in mid-February 2025, just weeks into the second Trump administration. (Jess Mador/WABE)

“The agency finds you are not fit for continued employment because your ability, knowledge, and skills do not fit the agency’s current needs, and your performance has not been adequate to justify further employment at the agency,” the emailed letter reads.

“And that floored me,” Boim said, “because my performance was rated outstanding, and I even got a raise. It was just deeply insulting. So I was more upset than I think I was prepared to be.”

The Trump administration later brought back some of the workers who were fired in the first round, but it has also cut more staff and funding.

The CDC has been without a permanent director for more than six months. Recently the Trump administration made Jay Bhattacharya the CDC’s , while he also runs the National Institutes of Health.

The leadership uncertainty comes amid a year of disruption and dismissals at the Atlanta-based institution, from which more than 3,000 public health workers are now gone. That includes staffers the Trump administration terminated and workers who accepted early retirement.

Ripple effects of the turmoil are still hitting the Atlanta region.

By the end of 2025, the CDC had lost roughly a quarter of its workforce.

Dozens of protesters rally across the street from CDC headquarters in Atlanta, marking a year since mass firings began at the agency under the Trump administration. Affecting thousands of workers at multiple federal agencies, the cuts began around Feb. 14, 2025, leading some CDC staffers to dub it the “Valentine’s Day massacre.” (Jess Mador/WABE)

Boim now works as a contractor in the health field, while also working a non-health-related freelance job. But she mourns the cuts at the CDC, and how the loss of expertise and resources will trickle down to communities. A goes directly to .

“It will cause generational harm, which always makes me tear up,” Boim said. “The harm that’s going to come to people that don’t even know what CDC was protecting them from.”

“But for Atlanta, there’s a lot of us; there are thousands of CDC employees that live here,” she added. “We are your friends, your neighbors, your family, and — with the lost income — it has an impact on local businesses also.”

At the SriThai restaurant across the street from the main CDC campus, more than a third of the customers are CDC employees, said manager Nathan Chanthavong.

The restaurant saw a “small dip” in business in 2025 after the mass firings, and also during the government shutdown, he said.

Nathan Chanthavong manages a SriThai restaurant in Atlanta. The restaurant saw a drop in catering orders from the CDC campus across the street in 2025. (Jess Mador/WABE)

“Typically, we would get a catering order for the CDC. We saw it less, less, and less. It’s not a really big impact, but catering is a big order; it is a lot of money,” he said. “So it does affect us.”

The CDC falls under the purview of the .

“HHS under the Biden administration became a bloated bureaucracy, growing its budget by 38% and its workforce by 17%,” HHS spokesperson Andrew Nixon said of the cuts and attrition. “The Department continues to close wasteful and duplicative entities, including those that are at odds with the Trump administration’s Make America Healthy Again agenda.”

Since the mass firings began, former CDC workers and their supporters have protested outside the agency’s main entrance during the afternoon rush hour.

On a recent Tuesday, a bigger crowd than usual — about 75 people — lined up along the sidewalk. It had been a year since the first massive cuts, which occurred in mid-February 2025. CDC workers dubbed it the “Valentine’s Day massacre.”

Protesters waved handmade signs with slogans such as “We love CDC workers” and “Save Public Health.” Passing drivers honked in solidarity.

Among the protesters was Ben McKenzie, who is still employed as a CDC researcher.

“It’s been heartbreaking to see so many talented, able colleagues be forced out or leave,” he said.

People continue to leave flowers and notes at a memorial for DeKalb County police officer David Rose, who was killed in the Aug. 8, 2025, shooting outside CDC headquarters in Atlanta. (Jess Mador/WABE)

Current employees also need support, he said, especially after a man opened fire on CDC buildings last summer. The DeKalb County police officer David Rose before killing himself.

“I think we’ve all felt the emotional impact of being targets,” McKenzie said. “Right now, to work at CDC is in a lot of ways to be a target.”

Multiple CDC employees told ��ϳԹ�� News and NPR the federal government has yet to fully fix the damage to the windows and buildings hit in last year’s shooting.

Bullet holes are seen in windows at CDC headquarters in Atlanta on Aug. 9, 2025, following a shooting the previous day. The gunman killed a DeKalb County police officer then himself. (Elijah Nouvelage/Getty Images)

McKenzie helps run a , one of several that have sprung up in Atlanta. He said the group has distributed more than $200,000 to help former CDC workers with rent and other needs.

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Work Requirements and Red Tape Ahead for Millions on Medicaid

Jess Mador, WABE — Mon, 04 Aug 2025 09:00:00 +0000

Now that the Republicans’ big tax-and-spending , new bureaucratic hurdles have emerged for millions of Americans who rely on Medicaid for health coverage. A provision in the new law dictates that, in most states, for the first time, low-income adults must start meeting work requirements to keep their coverage.

Some states have already tried doing this, but Georgia is the only state that has an active system using work requirements to establish Medicaid eligibility — and recipients must report to the system once a month.

When she first started using the system, , a social worker in Atlanta, wasn’t opposed to work requirements — in principle.

But when she left her job at a faith-based nonprofit to start her own project, the , she needed health coverage. She soon came face-to-face with how daunting it can be to prove you are meeting the state’s work requirements.

“I would have never thought that I was going to run into the challenges that I did, with trying to get approved, because I’m like, I know the process,” Corporal said. “I’ve been in human services.”

Corporal has been a social worker for more than two decades in Georgia and was familiar with the state’s social service programs. For years, it had been her job to help others access benefit programs.

But her challenges with paperwork and the process had only begun.

Health advocates point to Georgia’s system as a sign that the new law will lead to excessive red tape, improper denials, and lost health coverage.

Beginning in 2027, the law will require adults on Medicaid who are under 65 to report how they engaged in at least 80 hours per month of work, education, or volunteer activities. Alternatively, these adults could submit documentation showing they qualify for an exemption, such as being a full-time caregiver.

Most states will have to set up verification systems similar to Georgia’s, which can be . In the two years since launching its program, Georgia has spent more than $91 million in state and federal funds, according to . More than $50 million of that was spent on building and operating the eligibility reporting system. Right now, just under 7,500 people are enrolled in Georgia.

For Corporal, 48, forgoing coverage wasn’t an option. She had been diagnosed with pre-diabetes and had other medical concerns.

“I have breast cancer in my family history,” she said. “So it was like, I gotta get my mammograms.”

On paper, it looked as if she qualified for Georgia’s program, called .

It offers Medicaid to adults — who otherwise wouldn’t qualify for traditional Medicaid in Georgia — with incomes up to the federal poverty level ($15,650 per year for an individual, or $26,650 per year for a family of three), as long as they can show that for at least 80 hours a month they’re working, attending school, training for a job, or volunteering.

Corporal was eager to apply. She was already volunteering at least that much, including with the nonprofit , and helping with other community improvement efforts.

She gathered up the various documents and forms needed to verify her duties and volunteer hours, then submitted them through Georgia’s .

“And we were denied. I was like, this makes no sense,” said Corporal, who has a master’s degree in social work. “I did everything right.”

Information about the Georgia Pathways to Coverage program at a job fair in Atlanta, in June. (AP Photo/Sudhin Thanawala)

In the end, it took eight months fighting to prove that she and her son, a full-time college student in Georgia, qualified for Medicaid. She repeatedly uploaded their documents, only for them to bounce back or seemingly disappear into the portal. She went through numerous rounds of denials and appeals.

Corporal recently pulled up one of the denial notices on her cellphone to read aloud: “Your case was denied because you didn’t submit the correct documents. And you didn’t meet the qualifying activity requirement,” she read from the email.

When she tried to call the state Medicaid agency for answers, it was difficult reaching anyone who could explain what was wrong with her application paperwork, she said.

“Or, they’ll say they called you, and we look at our call log. Nobody called me,” she said. “And the letter will say, you missed your appointment, and it’ll come on the same day” as it was scheduled.

Corporal’s Pathways to Coverage application was finally approved in March after she spoke about her experience at a covered by Atlanta news outlets.

When asked about the delays and difficulties Corporal experienced, , a spokesperson for Georgia’s Department of Human Services, emailed this statement: “Due to state and federal privacy laws, we cannot confirm or deny our involvement with any person related to a benefits case.”

Brown added that Georgia is implementing tech fixes to streamline the uploading and processing of participants’ documents. They include “rolling out a refresh to the in late July that will include easier navigation and training videos for users as well as built-in prompts to ask customers to upload required documents.”

Now that Corporal has coverage, she is having to recertify her volunteer hours every month using the same glitchy reporting system. It’s stressful, she said.

“It’s still a nightmare, even once I got through the red tape and got approved,” Corporal said. “Now maintaining it is bringing another level of anxiety.”

But she wonders how anyone without her professional background manages to get into the program at all.

“I think the system has to be simplified,” she said.

Because Georgia set up its work requirement before the recently passed law, it needed permission from the federal government through a special waiver.

It is now seeking an to continue the Pathways program beyond its current expiration of September 2025. In the application, officials said they would by which participants needed to reverify their hours from once a month to once per year.

But for now, Corporal’s experience remains typical. And many health advocates fear it will be replicated under Trump’s budget law with its new national Medicaid work mandate.

“In Georgia, we have seen that people just can’t get enrolled in the first place. And some folks who do get enrolled lose their coverage because the system thinks they didn’t file their paperwork or there’s been some other glitch,” said who leads the advocacy group .

Another state, Arkansas, tried work requirements in 2018.

But it there, said , who leads the Center for Children and Families at Georgetown University.

“A lot of the problems were similar to Georgia,” she said, “in terms of the website closed at night, people couldn’t get a hold of people.”

Some Republicans who backed the spending and tax legislation said the idea behind the national Medicaid work mandate was to ensure that as many people as possible who can work, do work. And to eliminate what the Trump administration deems waste, fraud, and abuse.

“What we’re doing is restoring common sense to the programs in order to preserve them because Medicaid is intended to be a temporary safety net for people who desperately need it,” U.S. House said during a June appearance on “The Megyn Kelly Show.” “You’re talking about the elderly, disabled, you know, young single pregnant moms who are down on their luck, right? But it’s not being used for those purposes because it’s been expanded under the last two Democrat presidents and to cover everybody. So, you’ve got a bunch of able-bodied young men, for example, who are on Medicaid and not working. So what we’re doing is restoring work requirements to Medicaid. OK, this is common sense.”

National work requirements are unlikely to actually boost employment, Alker said, because of Medicaid recipients ages 19-64 already have jobs. The remainder includes students, or those who are too sick or disabled to work.

“Work requirements don’t work, except to cut people off of health insurance,” she said.

The logistical steps required to report one’s activities assume that a recipient has reliable internet or transportation to travel to an agency — things that low-income Georgians may not have.

The paperwork requirements to gain coverage are time-consuming, said one Medicaid recipient, .

Mikell is a licensed truck driver but does not have coverage through that job. He’s also an electrician who currently does property maintenance in exchange for free housing.

Mikell has had Medicaid through Pathways for nearly two years and has had problems navigating the Pathways web portal.

“And I know it wasn’t my device because I would go to the library and use the computer, I would try different devices, and I’ve had the same issues,” he said. “Regardless of the device, it’s something with the website.”

Another time, he said, his attempt to recertify his work hours was delayed because of paperwork issues.

“They said I was ineligible for everything because of a typo in the system or something, I don’t know what it was. I eventually was able to speak to someone and she fixed it,” he said.

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A Brain-Dead Pregnant Woman Was Kept Alive in Georgia. It’s Unclear if State Law Required It.

Jess Mador, WABE — Tue, 29 Jul 2025 09:00:00 +0000

A Georgia woman declared brain-dead and kept on life support for more than three months because she was pregnant was removed from a ventilator in June and died, days after doctors delivered her 1-pound, 13-ounce baby by emergency cesarean section. The baby is in the neonatal intensive care unit.

The case has drawn national attention to Georgia’s six-week abortion ban and its impacts on pregnancy care.

Adriana Smith was put on life support at Emory University Hospital in Atlanta in February. The then-30-year-old Atlanta nurse was pregnant and suffering dangerous complications.

Her condition deteriorated as doctors tried to save her life, Smith’s mother told .

“They did a CT scan, and she had blood clots all in her head,” April Newkirk said. “So they had asked me if they could do a procedure to relieve them, and I said yes. And then they called me back and they said that they couldn’t do it.”

She said doctors declared Smith brain-dead and put her on life support without consulting her.

“And I’m not saying that we would have chose to terminate her pregnancy,” Newkirk said, “but what I’m saying is, we should have had a choice.”

Emory Healthcare declined to comment on the specifics of Smith’s case. After doctors removed Smith from life support, Emory issued a statement.

“The top priorities at Emory Healthcare continue to be the safety and wellbeing of the patients and families we serve,” the health system said. “Emory Healthcare uses consensus from clinical experts, medical literature and legal guidance to support our providers as they make medical recommendations. Emory Healthcare is legally required to maintain the confidentiality of the protected health information of our patients, which is why we are unable to comment on individual matters and circumstances.”

In a previous statement, Emory Healthcare said it complies “with Georgia’s abortion laws and all other applicable laws.”

Abortion Laws and Fetal Personhood

Georgia’s — the Living Infants Fairness and Equality, or LIFE, Act — passed in 2019. It took effect shortly after the U.S. Supreme Court overturned Roe v. Wade with its ruling in Dobbs v. Jackson Women’s Health Organization on June 24, 2022.

The law bans abortion after the point at which an ultrasound can detect . Typically, this occurs about six weeks into pregnancy, often before women know they’re pregnant.

The law also gave fetuses the same rights as people.

It says that “unborn children are a class of living, distinct persons” and that the state of Georgia “recognizes the benefits of providing full legal recognition to an unborn child.”

Nineteen states now ban abortion at or before 19 weeks of gestation; 13 of those have a near-total ban on all abortions with very limited exceptions, according to the , a nonpartisan research group that supports abortion rights.

Like Georgia, some of these states built their abortion restrictions around the legal concept of “personhood,” thus conferring legal rights and protections on an embryo or fetus during pregnancy.

Smith’s case has represented a major test of how this type of law will be applied in certain medical situations.

Despite mainly being unified in their opposition to abortion, conservatives and politicians in Georgia do not publicly agree on the scope of the law in cases like Smith’s.

For example, Georgia , a Republican, said that the law should not restrict the options for care in a case like Smith’s and that removing life support wouldn’t be equivalent to aborting a fetus.

“There is nothing in the LIFE Act that requires medical professionals to keep a woman on life support after brain death,” Carr said in a statement. “Removing life support is not an action ‘with the purpose to terminate a pregnancy.’”

But Republican state , who authored the LIFE Act, disagreed. Emory’s doctors acted appropriately when they put Smith on life support, he .

“I think it is completely appropriate that the hospital do what they can to save the life of the child,” Setzler said. “I think this is an unusual circumstance, but I think it highlights the value of innocent human life. I think the hospital is acting appropriately.”

a law professor at the University of California-Davis and author of “Personhood: The New Civil War Over Reproduction,” said the problem is that Georgia’s law “isn’t just an abortion ban. It’s a ‘personhood’ law declaring that a fetus or embryo is a person, that an ‘unborn child,’ as the law puts it, is a person.”

The legal concept of “personhood” has implications beyond abortion care, such as with the regulation of fertility treatment, or the potential criminalization of pregnancy complications such as stillbirth and miscarriage.

Under Georgia’s law, extending rights of personhood to a fetus changes how child support is calculated. It also allows an embryo or fetus to be claimed as a dependent on state taxes.

But the idea of personhood is not new, Ziegler said.

“It has been the goal for virtually everyone in the anti-abortion movement since the 1960s,” she said. “That doesn’t mean Republicans like that. It doesn’t necessarily mean that that’s what’s going to happen. But there is no daylight between the anti-abortion movement and the personhood movement. They’re the same.”

The personhood movement has gained more traction since the Dobbs ruling in 2022.

In Alabama, after the state’s Supreme Court ruled that frozen embryos are people, the state legislature had to step in to allow fertility clinics to continue their work.

“This is sort of the future we’re looking at if we move further in the direction of fetal personhood,” Ziegler said. “Any state Supreme Court, as we just saw in Alabama, can give them new life,” she said referring to personhood laws elsewhere.

Fetal Personhood Laws Can Delay Care

In Georgia, dozens of OB-GYNs have said that the law interferes with patient care — in a state where the is one of the worst in the U.S. and where Black women are more than twice as likely to die from a pregnancy-related cause than white women.

Members of Georgia’s — who were later dismissed from the panel — linked the state’s abortion ban to delayed emergency care and the deaths of at least two women in the state, as .

The personhood provision is having a profound effect on medical care, said Atlanta OB-GYN .

“These laws create an environment of fear and attempt to coerce us as providers to align with the state, as opposed to aligning with our patients that we work so hard to serve,” Lucier-Julian said.

Lucier-Julian said that’s what happened to Emory Healthcare in Smith’s case.

, president of the Frontline Policy Council, a conservative Christian group, said the state’s abortion law shouldn’t have affected how Emory handled Smith’s care.

“This is a pretty clear-cut case, in terms of how it’s defined in the language of HB 481,” he said. “What this bans is an abortion after a heartbeat is detected. That is the scope of our law.”

“Taking a woman off life support is not an abortion. It just isn’t,” Muzio said.“Now, I am incredibly grateful that this child will be born even in the midst of tragic circumstances. That is a whole human life that will be able to be lived because of this beautiful mother’s sacrifice.”

A and its impact on public health is working its way through the courts. A coalition of physicians, the American Civil Liberties Union of Georgia, Planned Parenthood, the Center for Reproductive Rights, and other groups filed the suit.

Newkirk said her daughter had initially gone to a different Atlanta-area hospital for help with severe headaches, was given some medicine, and was sent home, where her symptoms quickly worsened.

“She was gasping for air in her sleep, gargling,” she told WXIA in May. “More than likely, it was blood.”

Now, Newkirk said, the family is praying for her grandson to make it after the stress from months of life support.

He is fighting, she said.

“My grandson may be blind, may not be able to walk, wheelchair-bound,” she said. “We don’t know if he’ll live.”

She added that the family will love him no matter what.

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Current, Former CDC Staff Warn Against Slashing Support to Local Public Health Departments

Jess Mador, WABE — Mon, 24 Mar 2025 09:00:00 +0000

On a sunny weekday in Atlanta, a small crowd of people gathered for a rally outside of a labor union headquarters building.

The event, put together by Atlanta-area Democratic U.S. Rep. , was attended mostly by union members and recently fired federal workers, including Ryan Sloane.

“I was fired by an anonymous email at 9 p.m. in the middle of a holiday weekend,” he said.

Sloane is still seeking reinstatement, but he feels he no longer has much to lose by speaking out.

“I’m only here today because they cannot fire me twice,” Sloane said.

When he received his termination notice, he was a few months into a job as a public affairs specialist at the Centers for Disease Control and Prevention.

At the CDC, his days were spent updating far-flung local TV, radio, and newspaper journalists about threats such as seasonal flu, measles, and food safety in their communities.

A judge has ordered the reinstatement of some fired federal employees, at least temporarily. But their jobs are still on the line.

Sloane said his former colleagues at the CDC whose jobs aren’t yet in limbo are scared.

“They are terrified that their life’s work is going to be deleted from servers and not backed up because it does not comport with the ideologies of the new administration,” he said. “No one is benefiting from this.”

From the end of January to mid-February, the Trump administration some CDC webpages and froze external communications, including its widely read epidemiological digest.

The webpages that were removed included CDC public health reports, datasets, and guidance on infectious diseases and sexual health. After a court order, was restored, at least for now.

But even temporary disruptions to CDC communications could have big ripple effects.

It is information that state and local health departments, hospitals, university researchers, and others rely on to help them respond to outbreaks.

“CDC is there to provide technical information, provide funding, provide support, but it’s a collaborative work, working together to keep Americans safe,” said former CDC Director Tom Frieden, who headed the agency from 2009 to 2017. He is now president and CEO of the nonprofit organization . “In this country, we have a patchwork or network of public health. It’s really up to the local, city, and state health departments to get the job done.”

City and state health agencies also need the collaboration of CDC experts to help investigate local disease outbreaks and other threats to public health.

A clinician who has worked at the agency for more than two decades pointed to the CDC’s singular ability to send medical supplies and deploy highly specialized teams of scientists to help local communities identify and contain outbreaks. ��ϳԹ�� News agreed not to use the clinician’s name because she fears she will be fired for airing these views publicly.

“A lot of them are assigned to state and local health departments, so really even beyond individual positions, any funding cuts that the agency takes are also passed on to state and local health departments,” the clinician said. “A lot of their budget comes from federal money as well.”

The Trump administration has attempted to terminate hundreds of employees from the CDC alone, along with hundreds more workers at the National Institutes of Health and other federal agencies with a U.S. health and safety role.

Many public health and science researchers are concerned about the cuts’ impacts on the nation’s ability to respond to threats — and about whether state and local public health departments will be able to keep communities healthy without the CDC’s partnership.

Billionaire Elon Musk has said his intends to keep cutting federal agencies’ budgets and staff, targeting what it calls “fraud.”

“Anytime someone gets fired, it’s always difficult. But with $36 trillion in debt, we have to reduce the size of the federal government,” Republican U.S. Rep. Marjorie Taylor Greene told during a March visit to the Georgia State Capitol.

includes parts of suburban Atlanta about 30 miles from CDC headquarters.

Greene also chairs a House subcommittee also called “DOGE,” for “Delivering on Government Efficiency.”

“Fortunately, with all the investments that are being brought back into the country under President Trump, I really hope that those federal workers are able to find new jobs,” she said.

She did not comment on whether local public health departments around the country would be able to work efficiently without the support of CDC experts who have been terminated.

But many U.S. public health experts are expressing concern.

The CDC has long been a key training ground for the next generation of U.S. public health researchers.

Emory University epidemiology professor was one of them earlier in his career. The HIV expert previously worked at the CDC for about 15 years.

“When I started working in HIV prevention at CDC in the early 1990s, we didn’t have the treatments that essentially allowed people living with HIV to have a full, healthy, normal lifespan,” he said. “We didn’t have the treatments that essentially allowed people living with HIV to have a test that people could take home to test themselves.”

Sullivan said the progress he has seen over the last several decades gave him optimism, and that advances in HIV treatment and prevention are a great example of the importance of federal support for public health work.

“Discovery science and pharmacy science really have given us the tools that we need to end the HIV epidemic in the United States,” he said.

But, to have those scientific tools without adequate public health staff or funding to use them, he said, will cost American lives.

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Maternity Care in Rural Areas Is in Crisis. Can More Doulas Help?

Jess Mador, WABE — Mon, 29 Jul 2024 09:00:00 +0000

When went into labor with her son in 2015, her contractions were steady at first. Then, they stalled. Her cervix stopped dilating. After a few hours, doctors at in Albany, Georgia, prepped Clark for an emergency cesarean section.

It wasn’t the vaginal birth Clark had hoped for during her pregnancy.

“I was freaking out. That was my first child. Like, of course you don’t plan that,” she said. “I just remember the gas pulling up to my face and I ended up going to sleep.”

She remembered feeling a rush of relief when she woke to see that her baby boy was healthy.

Clark, a 33-year-old nursing student who also works full-time in county government, had another C-section when her second child was born in 2020. This time, the cesarean was planned.

Clark said she’s grateful the physicians and nurses who delivered both her babies were kind and caring during her labor and delivery. But looking back, she said, she wishes she had had a doula for one-on-one support through pregnancy, childbirth, and the postpartum period. Now she wants to give other women the option she didn’t have.

Clark is a member of Morehouse School of Medicine’s first class of rural doulas, called .

The program recently graduated a dozen participants, all Black women from southwestern Georgia. They have completed more than five months of training and are scheduled to begin working with pregnant and postpartum patients this year.

“We’re developing a workforce that’s going to be providing the support that Black women and birthing people need,” , an associate professor of obstetrics and gynecology at Morehouse School of Medicine, said at the doula commencement ceremony in Albany, Georgia.

Albany is Morehouse School of Medicine’s second Perinatal Patient Navigator program site. The first has been up and running in Atlanta since training began in the fall of 2022.

Georgia has one of the highest rates of maternal mortality in the country, according to an , a health information nonprofit that includes ��ϳԹ�� News. And Black Georgians are as white Georgians to die of causes related to pregnancy.

“It doesn’t matter whether you’re rich or poor. Black women are dying at [an] alarming rate from pregnancy-related complications,” said Hernandez-Green, who is also executive director of the at Morehouse School of Medicine. “And we’re about to change that one person at a time.”

The presence of a doula, along with regular nursing care, is associated with , reduced stress, and higher rates of patient satisfaction, according to the American College of Obstetricians and Gynecologists.

Multiple studies also link doulas to , including cesarean births.

“We’re developing a workforce that’s going to be providing the support that Black women and birthing people need,” says Natalie Hernandez-Green, an associate professor of obstetrics and gynecology and the executive director of the Center for Maternal Health Equity at Morehouse School of Medicine. (Matthew Pearson/WABE)

Doulas are not medical professionals. They are trained to offer education about the pregnancy and postpartum periods, to guide patients through the health care system, and to provide emotional and physical support before, during, and after childbirth.

Morehouse School of Medicine’s program is among a growing number of similar across the country as more communities look to doulas to help address and poor maternal health outcomes, particularly for Black women and other women of color.

Now that she has graduated, Clark said she’s looking forward to helping other women in her community as a doula. “To be that person that would be there for my clients, treat them like a sister or like a mother, in a sense of just treating them with utmost respect,” she said. “The ultimate goal is to make them feel comfortable and let them know ‘I’m here to support you.’” Her training has inspired her to for maternal health issues in southwestern Georgia.

Grants fund Morehouse School of Medicine’s doula program, which costs $350,000 a year to operate. Graduates are given a $2,000 training stipend and the program places five graduates with health care providers in southwestern Georgia. Grant money also pays the doulas’ salaries for one year.

“It’s not sustainable if you’re chasing the next grant to fund it,” said , a professor of health and racial equity at the .

Thirteen states cover doulas through Medicaid, according to the Georgetown University Center for Children and Families.

Hardeman and others have found that when Medicaid programs cover doula care, in health care costs. “We were able to calculate the return on investment if Medicaid decided to reimburse doulas for pregnant people who are Medicaid beneficiaries,” she said.

That’s because doulas can help reduce the number of expensive medical interventions during and after birth, and improving delivery outcomes, including reduced cesarean sections.

Doulas can even reduce the .

“An infant that is born at a very, very early gestational age is going to require a great deal of resources and interventions to ensure that they survive and then continue to thrive,” Hardeman said.

There is growing demand for doula services in Georgia, said , director of research for . Her group recently completed a that offered doula services to about 170 Georgians covered under Medicaid. “We had a waitlist of over 200 clients and we wanted to give them the support that they needed, but we just couldn’t with the given resources that we had,” Jama said.

Doula services can cost hundreds or thousands of dollars out-of-pocket, making it too expensive for many low-income people, rural communities, and communities of color, many of which suffer from shortages in maternity care, according to the .

The Healthy Mothers, Healthy Babies study found that matching high-risk patients with doulas — particularly doulas from similar racial and ethnic backgrounds — had a positive effect on patients.

“There was a reduced use of pitocin to induce labor. We saw fewer requests for pain medication. And with our infants, only 6% were low birth weight,” Jama said.

Still, she and others acknowledge that doulas alone can’t fix the problem of high maternal mortality and morbidity rates.

Bristeria Clark kisses her husband while he holds their daughter after the commencement ceremony for Morehouse School of Medicine’s first class of rural doulas, called Perinatal Patient Navigators. (Matthew Pearson/WABE)

States, including Georgia, need to do more to bring comprehensive maternity care to communities that need more options, Hardeman said.

“I think it’s important to understand that doulas are not going to save us, and we should not put that expectation on them. Doulas are a tool,” she said. “They are a piece of the puzzle that is helping to impact a really, really complex issue.”

In the meantime, Joan Anderson, 55, said she’s excited to get to work supporting patients, especially from rural areas around Albany.

“I feel like I’m equipped to go out and be that voice, be that person that our community needs so bad,” said Anderson, a graduate of the Morehouse School of Medicine doula program. “I am encouraged to know that I will be joining in that mission, that fight for us, as far as maternal health is concerned.”

Anderson said that someday she wants to open a birthing center to provide maternity care. “We do not have one here in southwest Georgia at all,” Anderson said.

In addition to providing support during and after childbirth, Anderson and her fellow graduates are trained to assess their patients’ needs and connect them to services such as food assistance, mental health care, transportation to prenatal appointments, and breastfeeding assistance.

Their work is likely to have ripple effects across a largely rural corner of Georgia, said who co-founded and directs , a nonprofit organization in southwestern Georgia.

“So many of the graduates are part of church networks, they are part of community organizations, some of them are our government workers. They’re very connected,” Byrd said. “And I think that connectedness is what’s going to help them be successful moving forward.”

This reporting is part of a fellowship with the Association of Health Care Journalists supported by The Commonwealth Fund. It comes from a partnership that includes , , and ��ϳԹ�� News.

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Drive-Thru Baby Showers Serve Express Needs of Pregnant Veterans in Atlanta

Jess Mador, WABE — Thu, 11 May 2023 09:00:00 +0000

When 28-year-old Navy veteran Carisma Carter pulled her car up to the front of the Atlanta VA Clinic, her seat was pushed far back from the steering wheel to make room for her big belly. Carter was 8 months pregnant.

“I’m having two boys, twins. It’s my first pregnancy,” she said.

Carter knows the pregnancy risks she could face as a Black woman, especially in Georgia, where Black women are more than twice as likely as white women to die during or within a year after a pregnancy.

“I take care of my body during the pregnancy, but, yeah, I’m very aware,” Carter said. “And I just try to stay positive.”

In 2021, women made up of the U.S. military’s active-duty force. And women are the in the country, according to the Department of Veterans Affairs.

A from Rand Corp. outlines some of the ways the health needs of women differ from men’s, including pregnancy and childbirth. And health researchers have said women veterans may be at for pregnancy complications, compared with their civilian counterparts.

A few years ago, the Atlanta VA Clinic got creative with its outreach to pregnant patients. It began throwing surprise baby showers for small groups of patients. The goal is to cement relationships with the clinical staff, make sure pregnant veterans get to all their regular and specialist appointments, and help ensure pregnant people have the supplies they need as they near delivery. A trained maternity care coordinator manages each pregnant veteran’s care.

After the covid-19 pandemic emerged, the VA transformed the showers into low-contact “drive-thru” events, which occur about every three months, and serve roughly 20 pregnant veterans each time.

At a shower in February, volunteers set up in front of the main entrance of the Atlanta VA. The building is concrete, beige, and bland. But the volunteers created a celebratory atmosphere by decorating a folding table and stacking it high with free diaper bags and other baby supplies.

A car pulled up to the table and a volunteer with a clipboard began hyping up the small crowd, which then burst into applause and cheers.

“Thank you for your service!” they called out. “Congratulations!”

The pregnant veteran behind the wheel looked surprised at first. Then she broke into a big smile. She rolled down her car window.

Volunteers and VA staff members clustered around the car and offered her a tiara of green, white, and pink flowers.

“Would you like to wear it?” one asked. “Stunning! Remind us what you’re having?”

“I’m having a girl,” the woman said.

While they chatted through the open window about her due date and health, other volunteers rushed forward with supplies. Some piled boxes of diapers into the back seat. The final, parting gesture was a $100 gift card.

Kathleen O’Loughlin, who manages the at the Atlanta VA, said the events offer “last-minute baby needs.”

“Because we know there’s a lot,” she said.

O’Loughlin said the health center can’t invite every pregnant veteran to these group baby showers, so they focus on women with higher-risk pregnancies, including veterans carrying multiples or those who have a disability related to their military service.

“Now, a lot of the women have different musculoskeletal issues because of their service, [or] a lot of service-connected disabilities that civilian women aren’t exposed to because they don’t have those same job responsibilities,” O’Loughlin said. “This is an extra set of eyeballs on them. Are you making sure you’re taking your blood pressure medicines? Are you getting all of your appointments, are you meeting with your doctors?”

U.S. maternal mortality rates increased again during the , according to the Centers for Disease Control and Prevention.

Physical and psychological injuries linked to military service can increase the risk of poor maternal outcomes, according to Jamya Pittman, an internist and the medical director for the women veterans program in Atlanta.

“A lot of our women veterans have the diagnoses of anxiety, depression. They may also have PTSD, in addition to a myriad of other diagnoses like hypertension and diabetes,” Pittman said. “We also know that pregnancy in itself can be a stressor on the body.”

The Atlanta VA designed the baby showers to boost veterans’ well-being, she explained. Program volunteers are predominantly also women veterans.

“This visible showing of support, this community engagement, this celebration,” she said, “is our way of helping to decrease stress and allow the woman veteran to know that she has a partner in her health care and with the arrival of the baby.”

Nationally, the Department of Veterans Affairs is focusing on at all life stages.

The Atlanta women veterans program serves more than 24,000 veterans in the region, and about 9% of them are pregnant at any time.

Two years ago, Congress passed mandating a national study of pregnancy outcomes among veterans, including any racial disparities.

“There has never been a comprehensive evaluation of how our nation’s growing maternal mortality crisis is impacting our women Veterans, even though they may be at higher risk due to their service,” wrote co-sponsor Sen. Tammy Duckworth (D-Ill.) on .

The law, called the Protecting Moms Who Served Act, also provided $15 million to support maternity care coordination programs at VA facilities.

Carisma Carter, a Navy veteran pregnant with twins, is working with a maternity care coordinator from the Atlanta VA’s women veterans program during her pregnancy — her first. (Jess Mador/WABE)

The Atlanta VA is using some of its share of that money to make sure pregnant veterans receive ongoing medical care for a full year after giving birth.

Carter, the Navy veteran who stopped by the baby shower, said she appreciated the outreach from the VA.

“Just checking on the women, supporting them, making sure that they have everything that they need for the baby,” she said, “because a lot of people don’t have that support, they don’t have family, they’re doing this on their own.”

Carter gave birth to her twins on Feb. 25. She and the babies are doing well, she said. The women veterans program’s maternity care coverage continues for 12 months after the twins’ birth.

This article is from a partnership that includes , , and ��ϳԹ�� News.

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