Doulas save lives. They haven’t always been paid for it.
By Elizabeth B. Kim, Cincinnati Enquirer
Childbirth isn’t as simple as it’s made out to be. Kimberly McGinnis, a doula with kids of her own, finds herself explaining this to a lot of new moms.
“When we see labor on TV, the water breaks, contractions start, the baby is delivered,” said McGinnis, of Golf Manor, laughing. “They skip hours, and for some women, days.”
Doulas are trained nonclinical professionals who provide physical, emotional and educational support for birthing people and their families.
Research shows that doulas like McGinnis improve the health of new moms and babies. Moms who have doula support are less likely to deliver babies who are premature or have a low birth weight. They’re more likely to breastfeed and less likely to experience postpartum depression.
Doula work draws from a history of Black midwives supporting Black pregnant women when segregated hospitals denied them entry. So since their inception, doulas have largely worked outside the view of the government.
That’s changing. Last October, Ohio joined 17 other states and Washington, D.C., in allowing moms to use Medicaid to cover doula care.
States now see doulas as an important part of solving an ongoing maternal mortality crisis where more than 80% of all pregnancy-related deaths are preventable.
Childbirth is especially risky for Black women and Native American or Alaska Native women, who are at least three times as likely as white moms to experience death due to pregnancy. And in Hamilton County, moms face a higher maternal mortality rate in the last five years than they did in the first half of the past decade.
In Ohio, the new Medicaid reimbursement could benefit thousands. In 2022, Medicaid financed over 51,000 – 40% – of births in the state. (A pregnant person must earn about $30,000 a year or less to qualify for Medicaid).
It’s a step in the right direction, said Jena’ Bradley, director of community partnerships for bi3.
Ideally, the Medicaid reimbursement will enable parents who face the highest risk of birthing complications to hire doulas – and pay doulas enough to want to keep working. Still, doulas are doubtful that the $1,200 rate is enough to cover their costs, according to Bradley.
“The national burnout rate for doulas is about two years,” said Bradley. “The job is hard.”
