A pilot program launching on March 1st in two New York state counties will allow the cost (or almost the full cost) of doula services to be covered by Medicaid with the aim of supporting more women before and after pregnancy, and increasing the chances of positive birth outcomes.
Starting tomorrow, New York’s Department of Health will grant families in Brooklyn and Erie County access to doulas for their upcoming deliveries. Studies have shown that having a doula present reduces the chance of complications for mothers and babies during and after childbirth. For example, according to Choices in Childbirth, a nonprofit organization that advocates for equity in maternal health care, women supported by doulas generally have shorter labours, lower c-section rates, fewer requests for pain medication, improved newborn well-being assessments and the greater likelihood for successful breastfeeding.
“We are committed to continue working with doulas on implementing this pilot program and look forward to expanding these important services to more women throughout the state,” said spokesperson Caitlin Girouard.
Doulas do not replace medical and health care professionals, but instead, they act as coaches and emotional support systems for labouring mothers and new parents. They complete a certification process and are trained in the birthing practice.
Unfortunately, not everyone is feeling as enthusiastic about this new initiative. Many doulas themselves have criticized the program for not providing enough funding and offering inadequate reimbursement for participating doulas. In New York City, for example, hiring a doula can cost anywhere from US$250 to $4,000, but this pilot program would only reimburse a total of $600 by Medicaid.
The program includes coverage of four prenatal and four postpartum visits, plus labour and delivery.
“Even if you do one-hour visits, that’s seven hours right there already. And then most people’s birth is going to be at least 10 hours,” said Yael B. Yisrael, a doula herself and the owner of Flatbush Doulas. According to Yisrael, the reimbursement is not a livable wage for these birth workers.
In response, the New York governor’s office said that reimbursement rates and covered services may be subject to change.
This new initiative comes on the heels of some sobering pregnancy and childbirth statistics in the state, specifically when it comes to women of color. According to the city's Department of Health, black women are 12 times more likely to die from pregnancy-related complications than white women.
“Doulas, midwives and alternative health practitioners have long been a part of maternal and family health in communities of color," said Tremaine Wright, New York State Assembly Member. "Capturing these important practitioners in Medicaid repayment is a major recognition and will go a long way to increase healthy births.”