Last week, Childbirth Connection, a program of the National Partnership for Women & Families, and Choices in Childbirth released an informative and useful issue brief: Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health. Both of these organizations are long time well-known and respected players in the field of maternal and infant health advocacy.

These two organizations, in partnership, are strongly calling for both Medicaid and private insurance to begin covering doula services as soon as possible. The time has come to bring the professional doula out of the shadows and into the light of acceptance and recognize the full benefits of doula care. Having doula attended births improves outcomes, with no reported risks. Families and babies are the deserving recipients of better birth outcomes. The USA is smack in the middle of a maternity care crisis. Our neonatal mortality ranking is shameful. Our maternal mortality is not much better. We spend a tremendous amount of health care dollars to achieve these poor outcomes. One in three people who birth in the USA do so through an incision in their abdomen.

Currently only 6% of birthing families utilize the services of a doula. Lamaze International recognized the importance of the doula role in their Third Healthy Birth Practice: Bring a Loved One, Friend or Doula for Continuous Support. Doulas have long been thought of as a 'luxury' but two decades of research say otherwise. It is time to recognize that if we want better birth outcomes, increased birth satisfaction, lower healthcare costs and mother/baby dyads (and families) starting out healthier, than we need to officially recognize the role of the doula and make doulas a covered expense for both publicly and privately insured families, in a way that fairly compensates the professional doula while easing the financial burden of the consumer.

It is important that everyone, both consumers and professionals, step up to the plate and do everything they can to help bring about coverage and reimbursement for doula services by talking to and engaging insurers, policy makers, state and federal politicians and others involved in public and private health care management.

There are a multitude of resources included with the issue brief that I urge you to explore now.

1. News release: Widespread Insurance Coverage of Doula Care Would Reduce Costs, Improve Maternal and Infant Health
2. Issue Brief: Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health
   Full Issue Brief (PDF)
   Executive Summary (PDF)
3. Infographic (PDF) (PNG image) (PNG longform image)

This issue brief provides action steps that you can take now including:

• Select and advocate for a policy pathway for reimbursement covered in the brief
• Send the brief to a leader in your insurance plan who helps make coverage decisions
• Engage maternity care providers and hospital leaders in learning how doulas can improve women's experience of care, and in helping to make doula care available
• If you work for a large company that negotiates health insurance benefits, share the brief with the relevant HR people, and ask them to secure doula care reimbursement
• Have you read this issue brief already? Do you talk about the evidence for doula support in your childbirth classes? With your clients? Do you share what the research shows? What steps can you take now to help provide doula care to all the families that want one - regardless of their financial situation? Let us know in the comments section below.

Published: January 11, 2016

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