Doulas can be a great support for moms prior to giving birth and during labor, but they don't always get much love for their work. That's why a recent news story about doula support in one particular state in the United States so encouraging. New York state is going to use doulas to help reduce childbirth deaths, and it's really a revolutionary idea for the Empire State.
Here's the scoop: on Sunday, Gov. Andrew M. Cuomo announced new initiatives meant to address the high rate of maternal mortality among black women in the state because, according to a study released in 2017, they are almost four times more likely to die in childbirth than white women. His plan includes a program to expand Medicaid coverage for doulas.
A doula is "a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible," according to DONA International: Doula Training and Doula Certification. Studies report that the presence and support of doulas can help increase birth outcomes and reduce birth complications for both mom and baby, The New York Times reported. Doulas develop a relationship with mothers-to-be, and are knowledgeable about different aspects of labor and delivery. However, doulas don't provide medical advice the way a midwife or obstetric doctor would, the Mayo Clinic reported.
While doulas can be a great support to expectant mothers and new moms, they rightfully charge for their skilled services, and those services are not always covered by insurance. Under New York's doula pilot program, they would be — at least under Medicaid. That's great news for mothers who may want to access doula services, but can't afford it because it's not covered by their insurance and they can't afford the costs out of pocket.
In a statement about the "Taskforce on Maternal Mortality and Disparate Racial Outcomes" on the New York governor's website, Cuomo specifically brought up the issue of equal access to these services, and said:
Maternal mortality should not be a fear anyone in New York should have to face in the 21st century. We are taking aggressive action to break down barriers that prevent women from getting the prenatal care and information they need. This comprehensive initiative will work to correct unacceptable racial disparities in maternal mortality and help ensure a healthier and stronger New York for all.
The design of the doula program has to be finalized by the state’s Health Department within 45 days, and the program will launch right after, according to The Watertown Daily Times. If the program is a success, New York would become the third state to allow Medicaid reimbursements for doula services, joining Minnesota and Oregon, according to The New York Times.
The program is a notable turnaround for the state, where the health department didn't support the idea of expanding Medicaid coverage for doulas back in 2011, The New York Times noted. In response to a letter from Élan McAllister — the president of Choices in Childbirth at the time — about offering Medicaid coverage of doula services, a department director said it was a “complex issue," and they didn't pursue the idea.
The decision to form the doula pilot program now, after the state declined to make such a move in recent years, might not be just because of the recent study on maternal mortality mentioned above. Cuomo is currently dealing with pressure from progressive groups and primary challengers in an election year, according to CNN. He's made a lot of recent moves that more left-leaning organizations and voters may approve of — for example, on Monday, Cuomo called for a statewide ban on single-use plastic bags by the year 2019, and he previously said he would issue an executive order to allow parolees in New York to vote, according to The State of Politics blog.
But whatever the reason is that New York and Cuomo are pursuing this idea now, increasing the access to and the use of doulas in the state is a revolutionary move nonetheless. State officials hope that Medicaid coverage for doula services will help "bridge racial disparities and reduce maternal deaths," according to The New York Times. That's definitely an outcome I'm more than happy to support, and the rest of New York should get behind it too.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.