Healthy Voices

Doula Care and Improving Maternal Health Outcomes

Infant mortality is a crisis in Ohio, one that is more deeply felt by black mothers. From 2009 to 2019, Ohio saw a decline in infant mortality of 10%, however, during this same period, Ohio’s Black-white infant mortality disparity increased by 26%. Disparity in areas such as access to maternity care, financial stability, safe, stable housing, and health insurance status are some factors that are driving this increase. To put this into perspective, Ohio is in the bottom quartile of states for infant and maternal health.

The use of a doula is one evidence-based strategy for addressing the dismal health outcomes facing women and infants in Ohio.

Unfortunately, without Medicaid coverage, many of the women who would benefit most from doula care cannot afford to access that care.

Why a Doula?

The doula’s goal and role is to help the client feel safe, emotionally supported, and comfortable, complementing the role of the healthcare professionals who provide the client’s medical care.

• The doula’s role is critical in mitigating stress and toxic stress levels that can be experienced by an expectant mom during pregnancy.

• Doula care can result in lower rates of cesarean and pre-term births, improved quality of life for the family, as well as significant cost-savings for the birth event.

• The use of a doula was shown to decrease preterm births (a leading cause of infant mortality), reduce delivery rates by cesarean section, and improve a baby’s APGAR score. The Apgar score is a test given to newborns soon after birth to check a baby’s heart rate, muscle tone, and other signs to determine a newborn’s well-being.

Doula Advocacy in Ohio

H.B. 142, which provides access to doula care services through Medicaid, is sponsored by Rep. Tom Brinkman (R-27 th District) and former Rep. Erica Crawley. The bill was reported favorably out of the House Families, Aging and Human Services Committee on May 23, 2022, and passed favorably out of the full House on June 1, 2022.

As passed by the House, HB 142 will:

1. Cover the cost of doulas through Medicaid for eligible women. 

2. Certify doulas through existing training organizations 

3. Certification of doulas resides under the nursing board

4. Require the nursing board to develop standards and procedures for doula certification including continuing education requirements and develop a registry of certified doulas available to the public.

5. Require the nursing board will set certificate application and renewal fees, as well as a waiver of those fees for applicants with a family income not exceeding 300% of the federal poverty line.

6. Sets up a doula pilot program in the Department of Rehabilitation and Corrections as part of the prison nursery program.

Healthy Voices Coalition Members

Accomplishments

As the COVID-19 crisis has raged on, we’ve advanced economic and healthcare justice for all Ohioans. Last year, the campaign made huge strides in our state budget to support childcare providers and extend the safety net to new parents:

• We won a year of guaranteed postpartum care for those who’ve given birth, to help bring down Black mother and infant mortality rates. 

• We won guaranteed Medicaid treatment for breast cancer and cervical cancer. 

• We won a delay in work requirements to Medicaid. 

• We won funding to reduce lead poisoning that was increased in the budget of the Department of Medicaid and the Department of Health.

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