Is A Doula Covered By Insurance – Medicaid coverage for doulas and postpartum, black women’s health grants all part of Gov. Tony Evers’ budget proposal
Gov. Tony Evers’ state budget, if passed as recommended, would make significant investments in maternal and child health in Wisconsin.
Is A Doula Covered By Insurance
The Democratic governor’s budget proposal calls for extending Medicaid coverage from 60 days to 12 months in the postpartum period. The move will ensure mothers have health insurance at a crucial time: In Wisconsin, two out of three pregnancy-related deaths occur in the postpartum period.
Medicaid Would Cover Doulas, Postpartum Period Under Evers Proposal
If the measure remains in the final budget, it will join a growing list of states expanding Medicaid coverage after childbirth, including Wisconsin, Illinois and Georgia.
Evers also recommends Medicaid coverage of doula services. Doulas cannot provide clinical care, but research shows that their support can improve maternal and infant health outcomes. Four states, including Minnesota, consider doula services a covered benefit under Medicaid. In 2019, U.S. Rep. Gwen Moore (D-Wis.) proposed statewide Medicaid coverage for doula and midwifery services, but the bill failed to pass.
To protect the incarcerated, Evers calls for restrictions on the use of physical restraint on pregnant and postpartum women. State lawmakers have tried to enact similar protections before, and several people previously incarcerated in Wisconsin have sued for mistreatment during childbirth.
The proposed budget also includes annual grant funding for community organizations that work to improve the health of Black women and reduce racial disparities in infant and maternal mortality. Black child mortality in Wisconsin is among the worst in the nation due to systemic disparities, according to state data. American Indian communities are also disproportionately affected by child mortality.
Doula Series Footnotes
This is the second time Evers has pushed to expand Medicaid coverage for postpartum individuals and invested in doulas. He made similar requests in 2019, but state lawmakers did not include the recommendations in the final budget.
Sara Finger, founder and executive director of the Neutral Wisconsin Women’s Health Alliance, urged state lawmakers to take action.
“It is absolutely critical that we stop sweeping this issue under the rug, ignore it and refuse to make it a national priority,” Finger said. She acknowledged that the legislative budget process has not produced change before, which is why the alliance and other organizations are working with the Wisconsin Legislative Land Group on the birthright bill. The package of laws will resemble the Black Mothers’ Maternal Health Act introduced in Congress. They plan to temporarily introduce the legislation this fall.
Ashley Nguyen, a freelance journalist, addresses the state of doula care and other maternal and child health issues during the nine-month O’Brien Fellowship in Public Service Journalism at Marquette University. She is assisted by O’Brien interns Rachel Ryan and Sarah Lipo.
How To Pay For Doula Services — Doula Joyce
A Tale of Two Loneliness: Loneliness and Anxiety of Caring Family Carers in Community Homes and Congregate Care
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What Is A Doula? Benefits Of Having A Doula
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“My 9 to 5 job is a birth job”: A case study of two compensatory approaches to community bereavement care
Anu Manchikanti Gomez 1, * , Stephanie Arteaga 1 , Jennet Arcara 1 , Alli Cuentos 2 , Marna Armstead 2 , Renee Mehra 3 , Rachel G. Logan 1 , Andrea V. Jackson 4 and Cassondra J. Marshall 5
Expanding Postpartum Medicaid Coverage
Program on Sexual Health and Reproductive Equity, School of Social Welfare, University of California, 110 Haviland Hall, MC 7400, Berkeley, CA 94720, USA
Department of Obstetrics and Gynecology, University of California, 2356 Sutter Street, J-140, San Francisco, CA 94115, USA
Received: June 26, 2021 / Revised: October 9, 2021 / Accepted: October 10, 2021 / Issued: October 14, 2021
With increasing political emphasis on supporting doula care to advance birth equity in the United States, there is a critical need to identify sustainable and equitable approaches to rewarding community doulas that serve clients with the greatest barriers to achieving optimal pregnancy outcomes. This case study examines two different approaches to doula compensation (hourly contractor employment versus fringe benefits) used by the SisterWeb San Francisco doula community network in San Francisco, California. We conducted qualitative interviews with SisterWeb doulas in 2020 and 2021 and with organization leaders in 2020. In general, leaders and doulas agree that the vendor approach, where doulas are paid a flat fee per client, does not adequately compensate doulas who regularly attend training and provide additional support to their clients (such as referrals to supportive housing and food security). In addition, this approach did not provide health benefits for doulas, which was of particular concern during the COVID-19 pandemic. As hourly workers with benefits, doulas enjoyed a greater sense of financial security and well-being because they received a steady wage, compensation for all time worked, and benefits such as health insurance and sick leave, which allowed some to pursue motherhood. Our study suggests that efforts to promote community doula care should integrate structural solutions that provide doulas with adequate compensation and benefits while promoting birth equity and equal employment conditions for community doulas.
Covering Doula Services Under Medicaid: Design And Implementation Considerations For Promoting Access And Health Equity
As health advocates and policy makers view doula care as an intervention to reduce adverse maternal and infant health outcomes in the United States, examining the sustainability of providing this type of care has become critical. A doula is a non-clinical obstetrician who provides physical, emotional and informational support to a pregnant person during pregnancy, birth and the postpartum period . Doulas provide critical support to women in labor and work to ensure that their non-medical needs are met by providing advocacy, counselling, assistance, non-judgmental support and comfort [2, 3]. For example, doulas help laborers learn about care and birth options and provide emotional reassurance during labor . In the postpartum period, doulas provide advice and support for holistic postpartum recovery as well as the transition to parenthood, including neonatal care, infant nutrition, and parent-child bonding . Some doulas also provide support for people experiencing miscarriage, abortion, stillbirth, and adoption . More importantly, doulas do not provide medical care and therefore cannot replace a doctor.
Bereavement care in the US is usually not covered by health insurance. A pregnant person can hire a doula privately for an average of $1,200 per birth (range $800 to $2,500 per birth) . As a result, private doulas are often hired by people who have the financial means to cover these out-of-pocket expenses . Specifically, a 2003 survey of 626 certified and in-process doulas from across the US revealed that doulas were mostly white, college-educated, high-income women, married with children, and working independently as private doulas . Private doula services typically include one or two prenatal home visits, support during labor and one or two postpartum home visits, and ongoing communication via text, phone, and/or email .
Unlike private doulas, community doulas are usually trusted members of the communities they serve, share the culture and language with their clients, and often provide more comprehensive services and referrals [6, 8]. This shared cultural and linguistic knowledge allows community doulas to better understand the issues their clients face, including racial discrimination and language barriers, as well as to provide culturally relevant care . Such tailored intensive support may be particularly effective in mitigating negative birth outcomes experienced by people of color and low-income people. In particular, community doula care is often provided at low cost or free of charge ; this helps improve access to these much-needed services while creating barriers to the sustainability of culturally compatible community-based doula care.
Benefits of doula support include improved health outcomes for: