Faced with a crisis in maternal mortality, particularly among women of color, more states are extending Medicaid coverage to doula services.
Doulas are trained professionals who provide emotional, physical and educational support to women before, during and after childbirth.
According to an analysis by the Georgetown Center for Children and Families, at least 17 states are considering, planning or implementing policies to provide Medicaid reimbursement for the services of doulas.
Advocates in the area of maternal health say access to doulas can help combat the country’s poor record on maternal mortality, which is particularly pronounced among Black, American Indian and Alaska Native women, who are as much as three times as likely to die from pregnancy-related complications compared with White women.
According to the Georgetown analysis, which also relied on work done by the National Health Law Program, an organization that promotes health equity, Virginia this year joined five other states—Florida, Maryland, Minnesota, New Jersey and Oregon—in providing Medicaid reimbursement for doula services.
Additionally, Washington, D.C., and five other states—California, Illinois, Indiana, Nevada and Rhode Island—all plan to apply to the U.S. Centers for Medicare and Medicaid Services for permission to begin providing Medicaid reimbursement for doulas.
The Georgetown center says five additional states—Arizona, Connecticut, Georgia, Louisiana and Washington—are considering adding a Medicaid doula benefit.
The six states that offer Medicaid doula benefits have different wrinkles in their programs, according to the National Health Law Program. For instance, Minnesota covers up to six prenatal and postpartum doula visits with a reimbursement rate of $47 per session and total labor and delivery services reimbursed at a rate of $488, for an overall reimbursement of $770.
Oregon requires that doulas register with the state, after which they can be reimbursed for two prenatal visits, two postpartum visits, and labor and delivery, for a total benefit of $350.
New Jersey reimburses for up to eight visits, including for labor and delivery and provides total reimbursement for $900 per birth. For patients under 19, New Jersey includes an increased reimbursement rate and additional visits.
In Florida, the benefit is available only to beneficiaries in a Medicaid managed care plan. The reimbursement ranges from $400 to $1,100 depending on the rate negotiated by each managed care organization.