Healthcare activists want doulas included under insurance

February 22, 2023 : Georgia mothers are dying of avoidable deaths at the second highest rate in the country, as per the national maternal death rates data.

Therefore, healthcare advocates now want to include insurance coverage for doulas – who present physical and mental health aid and patient advocacy for pregnant women – guaranteed via state legislation.

As per, doulas are “trained professionals who supply continuous physical, inspirational and informational support to their client earlier, during and shortly after childbirth to help them achieve the wholesome, most satisfying experience imaginable.”

23-year-old Dynalee Rael is among the 56% of Georgia women whose pregnancies are protected through Medicaid. During her current pregnancy, Rael – who had a doula of her own – said she stayed for hours in active labor in a local hospital to allocate her a delivery space.

“From my own individual experience where I felt neglected and differentiated against, having my doula … it was everything to me,” Rael stated. Finally, with her doula’s support, Rael left the hospital and went to another, where she had baby KJ.

The family’s doula was Zania Mathis, a Georgia Coalition of Healthy Mothers, Healthy Babies provider. Mathis’ role was to aid in creating a preferred birthing plan, help the family comprehend their medical rights, and use training procedures and massages for the mother’s physical discomfort and emotional support during pregnancy and postpartum.

“The work is unique. That is all doulas are trying to do: just ensure that families are taken care of,” Mathis stated. “They’re seen, they are heard, and their rights are heard to honestly.”

In an example, Mathis became a doula four years ago because of her own challenges during pregnancy. Data shows expectant black mothers like Mathis are four times as usual as white women to suffer PTSD.

The disparities with adverse health outcomes don’t cease there. The Centers for Disease Control and Prevention witnessed the rate of maternal mortality is more times higher for women of color.

In a statewide study by Healthy Mothers, Healthy Babies shows contributing factors are not only pre-existing health conditions like asthma, diabetes, and hypertension but also dearth of access to quality care based on racial and economic inequities, containing systemic racism within healthcare.

In a research by the Georgia Department of Public Health shows that parts of the state have yet to improve its prenatal care significantly. Statistics state from 2016-2020 in Atlanta, roughly 20% of all births had insufficient prenatal care.

This percentage is based on the Kotelchuck Index, which calculates sufficient prenatal care based on factors like the times a doctor visits or incomprehensive treatment.

That is why Healthy Mothers, Healthy Babies, is among the institutions that believe Medicaid-insured doula coverage could be important. Florida, Minnesota, Maryland, New Jersey, Oregon, Rhode Island, Nevada, Virginia, Washington D.C., and California already actively giving some form of doula insurance coverage.

One hundred seventy-five pregnant women in Atlanta took part in the Healthy Mothers, Healthy Babies, doula Medicaid pilot program. They are taking the program results to Georgia legislators in hopes of offering doula insurance coverage a statewide norm.

“Having a doula is a needed and not a luxury at all, particularly if you are a Black or brown birthing person,” stated Chanel Stryker-Boykin, education and development coordinator with Healthy Mothers, Healthy Babies, who managed the program. “It’s not that doulas want to substitute nurses, replace doctors, or aspire to be any of those needs. It’s an addition, an important piece to the whole environment.”

A federal bill introduced in 2021 calls for 12 new U.S. laws to enhance maternal healthcare.

While historical data has been hugely absent on doulas, new research conducted by the National Institute of Health saw expectant mothers linked with a doula saw better birth outcomes than mothers who did not.

“In the healthcare procedure it’s possible to feel pressured as if you don’t have any choices, especially as a woman of color,” asserts Rael. “I’m thankful that she was there for me.”