Shapiro Administration Announces Expansion Of Access To Doulas Through Change In Medicaid, Highlights Budget Investments To Improve Maternal Health

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Lancaster, PA - Department of Human Services (DHS) Secretary Dr. Val Arkoosh and Department of Health (DOH) Acting Secretary Dr. Debra Bogen today visited Patients R Waiting to discuss the Shapiro Administration’s recent work to address maternal health disparities through expanded Medicaid access to doulas. Secretary Arkoosh and Acting Secretary Bogen also stressed the importance of doulas as part of care teams for historically underserved populations and to highlighted investments in Governor Josh Shapiro’s 2024-25 Budget that address the national trend of rising pregnancy-associated deaths. 

Pennsylvania’s recent expansion in Medicaid creates a path for doulas to become certified providers, increasing women’s access to doulas as part of their care teams and helping to improve birth outcomes in Pennsylvania. 

“Pregnancy, childbirth, and the postpartum periods are exciting but often stressful times for a new parent and easing barriers to the incredible physical, emotional, and educational support that doulas provide can improve outcomes for both moms and babies,” said Secretary Arkoosh. “By increasing access to doulas for Medicaid recipients giving birth, we recognize the important contribution doulas make in the continuum of prenatal, delivery, and postpartum care and are taking another significant step to improving health outcomes for mothers, babies, and communities more broadly.” 

To help address maternal health disparities in access to quality health care for mothers, especially Black and Latino Pennsylvanians who may experience greater barriers to care and less representation in care settings, the Shapiro Administration recently expanded access to doulas for Medicaid recipients. Doula services have been found to ease the pregnancy and labor process and improve birth outcomes for both mother and child. This recent change now allows certified doulas to enroll as Medicaid providers and enables Medicaid managed care organizations to enter into network agreements with them, allowing them to bill directly for services offered through pregnancy and postpartum.  

In order to be recognized by Medicaid, doulas must be certified through the Pennsylvania Certification Board. DHS strongly encourages all doulas in the Commonwealth to complete their certification so they can participate in Medicaid formally and help reduce the barriers to care for Medicaid recipients interested in having a doula as part of their care team. The PA Doula Commission is currently offering a financial scholarship for the cost of the Certified Perinatal Doula application fee. 

In the United States, the rate of pregnancy-associated deaths has been on the rise in recent years. In Pennsylvania, there are 82 pregnancy-associated deaths per 100,000 live births. Black women are two times more likely to die during or in the first year after a pregnancy than white women. The support of a doula during labor and postpartum results in a reduced need for clinical procedures during labor and birth, fewer birth complications, and more satisfying experiences during labor, birth, and postpartum.  

In addition to increasing access to doulas, the Shapiro Administration is actively combatting maternal health issues by proposing an additional $2.7 million in the 2024-25 proposed budget to address and prevent maternal mortality. 

“The Shapiro-Davis Administration is committed to addressing maternal health issues across the Commonwealth. One evidence-based strategy is to increase access to doula support,” said Acting Secretary of Health Dr. Debra Bogen. “As a pediatrician, I worked hand-in-hand with expecting and new, or growing, families. I have seen firsthand the positive impact doulas have before, during, and after childbirth. Doulas get to know families well, identify their strengths and needs, and provide personalized care to support positive outcomes for mothers, babies and families.”    

“Doulas are trained professionals that help people navigate pregnancy and childbirth,” said Sharee Livingston, DO, obstetrician-gynecologist, UPMC Magee-Womens. “Women who most need a doula often can't afford one. At UPMC, we applaud and welcome the Commonwealth's decision to expand access to doulas through this change in Medicaid. Our ‘Diversifying Doulas Initiative’ in Lancaster has provided more than 300 women with fully subsidized doula services and has trained 38 people of color to become doulas since 2020. With this new change, we can do so much more for women in Lancaster and across central Pennsylvania.” 

More information on DHS’ maternal-child health programs available across Pennsylvania is available online here

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