Mothers-to-be on Medicaid in New York will now have easier access to doula services, which can be key to a healthy pregnancy and birth, state officials said Monday.
Experts also believe doulas can also help close the maternal mortality gap — Black women are more likely to die from pregnancy-related causes than white women, according to the state Health Department.
State Health Commissioner Dr. James McDonald issued a standing order on Monday that says, “All New Yorkers who are pregnant, birthing or postpartum would benefit from receiving doula services.”
The standing order serves as a recommendation that allows all pregnant women with Medicaid access to doula services. In the past, they needed to get an order from their individual licensed health care practitioner.
Doulas provide physical and emotional support for pregnant women and can serve as their advocates when dealing with doctors and their offices. They can also help women craft birthing plans.
In the order, McDonald pointed out that labor and delivery can come with medical risks and that doula services can help address “the statewide crisis of racial and income-based maternal health disparities.”
State data from 2018 to 2020 showed that while Black, non-Hispanic women accounted for 14.3% of all live births, they comprised 29% of all pregnancy-associated deaths. White non-Hispanic women accounted for 49.1% of all live births and 47.7% of all pregnancy-associated deaths.
Black women in New York State, according to the data, died at over four times the rate of white women, 55.8 deaths per 100,000 live births as opposed to 13.2 deaths per 100,000 live births.
Nationally, maternal mortality dropped between 2021 and 2022, according to a CDC report released earlier this year. The maternal mortality rate for 2022 decreased to 22.3 deaths per 100,000 live births, compared with a rate of 32.9 in 2021. Even though rates among Black women dropped in 2022 to 49.5 deaths per 100,000 live births from 69.9, it was still much higher than the rates for white women at 19.0, Hispanic women at 16.9 and Asian women at 13.2.
Some of the factors leading to this disparity include lack of access to healthy food, poor management of chronic diseases, and structural racism, according to the report.
In a recent report, the New York State Maternal Mortality Review Board said it believed 76% of pregnancy-related deaths were preventable.
The order removes “a barrier: to doula services, said Martine Hackett, chair of Hofstra University’s Department of Population Health and co-founder of Birth Justice Warrior of Long Island, which advocates for healthier pregnancies and babies.
“This is one of many steps being taken to simplify and streamline the process of connecting Medicaid members to community doulas,” she said, noting that the state has been trying to make it easier for doulas to handle the complex billing and claims process.
“(This) is an effort to make a complicated process a little easier so that Medicaid members can receive doula services during pregnancy, labor and postpartum,” Hackett said.