Pennsylvania adds perinatal doulas to its Medicaid program

Professionals and maternal health advocates hope this will expand access to doula services for people who may not otherwise be able to afford them out-of-pocket, and ultimately help close racial disparities in maternal and infant outcomes.

“People were already afraid, specifically Black birthing people, were afraid of giving birth,” said Gerria Coffee, president of the Pennsylvania Doula Commission. “Then the pandemic really expanded that fear and it really exposed gaps in access to support.”

Doulas who have or will get state certification in perinatal care can enroll in Medicaid to partner with managed care organizations that oversee and administer Medicaid health insurance in local communities.

The managed care organizations will pay doulas for in-network services that they provide as members of a maternity care team or service, according to a bulletin from the Pennsylvania Department of Human Services.

Coffee said the new partnership pathway is still in preliminary stages, so exact details on billing and payment structures will be explained in upcoming training sessions.

“This is completely new,” she said. “The majority of us have never done this before, and so we want to make sure that we have all the information available.”

Reimbursement is an important factor in the equation, Coffee said, because doulas need to know that their work is being valued for the time and expertise it takes to provide these services.

Hedway has been working full time as a doula and lactation consultant since last year. Making sure she’s able to meet demand in her community and make enough money has been difficult, she said.

“I quickly found out it is not the most sustainable thing, and it should be,” Hedway said.

Hedway said the new opportunity with the state’s Medicaid program could provide some financial stability or supplementation for doulas like herself.

While many remain optimistic about the new opportunity, Coffee said a lot of doulas still have some reservations about what the partnerships will entail and how receptive medical providers will be in working with doulas on these care teams.

It won’t be for everyone, Coffee said. For those who do participate, she hopes it leads to better support for both doulas and the communities they serve.