LANCASTER, PA — The halls of Pennsylvania’s Department of Human Services (DHS) and Department of Health (DOH) are alive with hope. The Secretary of DHS, Dr. Val Arkoosh, and the Acting Secretary of DOH, Dr. Debra Bogen, recently ventured to Patients R Waiting to articulate the initiatives brewing within the Shapiro Administration. The primary agenda? Tackling maternal health discrepancies by broadening Medicaid’s reach to doulas.
To the uninitiated, a doula refers to a birthing specialist, a beacon of support for women during pregnancy, childbirth, and postpartum. Despite their value to mothers and families, they remain relatively underutilized, particularly among populations that have historically lacked adequate healthcare services.
The recent expansion of Medicaid in Pennsylvania has woven a new path for doulas, allowing them to become certified providers. In essence, it aids in weaving doulas more securely into the fabric of women’s care teams, a move anticipated to uplift birth outcomes across the state.
“Pregnancy, childbirth, and the postpartum periods are a medley of emotions, laden with excitement yet marred by stress for new parents,” Secretary Arkoosh illuminated. The provision of physical, emotional, and educational support by doulas can alleviate these pressures, enhancing outcomes for mothers and newborns alike.
From this viewpoint, the expansion of Medicaid access to doulas signifies a recognition of their critical role in the continuum of care. It also forecasts an era of improved health outcomes for Pennsylvania’s mothers, babies, and communities.
In light of maternal health disparities, particularly among Black and Latino Pennsylvanians who often encounter more significant barriers to care, the Shapiro Administration further widened access to doulas for Medicaid recipients. Doula services, heralded for easing the pregnancy journey and boosting birth outcomes, are now within reach for more Pennsylvanian women.
“The Shapiro-Davis Administration is committed to addressing maternal health issues across the Commonwealth, and expanding access to doula support is a proven strategy,” expressed Acting Secretary of Health, Dr. Debra Bogen. As a pediatrician, she asserted the crucial role of doulas in helping families navigate the ebbs and flows of childbirth.
The benefits of expanding doula services extend beyond individual families. The United States has been grappling with an uneasy rise in pregnancy-associated deaths, with Pennsylvania standing at a discomforting 82 deaths per 100,000 live births. Moreover, Black women are twice as likely to succumb during or within a year post-pregnancy compared to their white counterparts.
The welcoming arms of a doula during labor and postpartum can help change this narrative. Their support correlates with fewer clinical procedures during childbirth, diminished complications, and more fulfilling childbirth experiences.
“Doulas are professionals trained to guide people through pregnancy and childbirth,” said Sharee Livingston, DO, an obstetrician-gynecologist at UPMC MageeWomens. Noting the often prohibitive cost of accessing a doula for those who need it most, she celebrated the Commonwealth’s decision to widen doula access via Medicaid.
To illustrate the potential impact, UPMC’s ‘Diversifying Doulas Initiative’ in Lancaster has supported over 300 women with fully subsidized doula services and trained 38 people of color as doulas since 2020. With the Medicaid change, more can be done for women in Lancaster and central Pennsylvania.
The DHS encourages all doulas in Pennsylvania to pursue certification, enabling them to formally participate in Medicaid and dissolve barriers to care for Medicaid beneficiaries intrigued by having a doula in their care team. To further incentivize this, the PA Doula Commission is currently offering financial scholarships for the Certified Perinatal Doula application fee process.
Through these important shifts in approach, the Commonwealth of Pennsylvania continues to underline the value of doulas in improving maternal health outcomes, particularly for underserved populations. The labor of love undertaken by doulas can represent a new chapter in healthcare, one where every mother, regardless of background or economic status, can feel supported and heard throughout their journey.
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