The recently formed Doula Alliance of Arkansas is pushing for legislation to have doula services covered by the state’s Medicaid program.
Doulas provide nonclinical, emotional, physical and informational support to women during pregnancy and throughout the postpartum period.
The alliance also is searching for an executive director and hopes to have one in place by the end of September.
Part of the job will be lobbying the state’s Medicaid program and private insurers to pay for doulas’ services. The Arkansas General Assembly’s regular session begins in January.
Twelve states have Medicaid reimbursement for doula services, said Nicolle Fletcher, the group’s chairman. Fletcher and other board members and supporters gathered Aug. 7 for a press conference to announce the start of the organization thanks to a $250,000 grant from Ingeborg Initiatives, a fund of the Arkansas Community Foundation. Ingeborg Initiatives works to improve maternal health and women’s economic opportunities in Arkansas. Excel by Eight of Little Rock, which works to improve health and education of Arkansans from prenatal to age 8, will advise the doula group.
“We are excited to come together as doulas with a unified voice and grow together and have the opportunity to make doula care more accessible in our state,” said Cora Crain, vice president of the Doula Alliance.
So far, more than 50 doulas have registered with the organization. Women are typically providing doula services in isolation and without backup, resulting in burnout, which drives many doulas out of the profession after a few years, Fletcher said. “The alliance will come together and create additional support” to lengthen careers, she said.
Expanding doula care could also is improve maternal health outcomes in Arkansas, which is “at the bottom of the barrel,” said Cara Osborne, senior fellow at Heartland Forward and a maternal health expert for Ingeborg Initiatives. “Our maternal mortality rate is about twice the national average.”
She said that more than half of Arkansas’ counties are in a maternal health desert, where not a single person is licensed to deliver a baby. While they aren’t licensed to deliver babies, “doulas can help bridge a lot of gaps in our system,” Osborne said.
The state’s poor maternal health outcomes have received attention from Gov. Sarah Huckabee Sanders. In March, she signed an executive order to create a committee to address the crisis.
One of the committee’s assignments is to research ways to expand telehealth, home visits and doula services.
The idea for an alliance emerged last year when doulas were “really trying to build the case to make sure that doulas are part of the conversation about moving maternal health care forward in Arkansas,” said Anna Strong, the executive director of the Arkansas Chapter of the American Academy of Pediatrics.
Doulas have the support of OB-GYNs, Strong said. The American College of Obstetrics & Gynecology has endorsed the inclusion of doulas on a birthing team. Two OB-GYNs are on the alliance’s board.
“In general, doulas have really done a great job in establishing their value,” Strong said. “They are there throughout the mom’s time in the hospital, often for 24 to 48 hours. And they are able to be there with that family and support that mom in ways that the physician simply doesn’t have time to do.”
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