In New York state, black women are four times more likely to die during childbirth than white women. In order to combat this deeply alarming trend, the state’s health department is piloting a program that will expand Medicaid coverage to cover doula services.
According to NBC, the program will be tested in parts of Brooklyn and Erie County beginning in March, and health officials plan to start training and education efforts this month. These two locations were chosen on the basis that they have New York’s highest number of both Medicaid births and infant mortality rates.
New York Governor Andrew Cuomo announced the Medicaid expansion back in April, since studies have shown the doulas—coaches who offer support to women during and after childbirth—tend to reduce birth complications. Currently, Minnesota and Oregon both offer Medicaid reimbursement for doula services, but New York faces at least one apparent double-bind: Doulas are not licensed in the state, and Medicaid programs must pay licensed providers to receive matching federal funds. As one doula told the New York Times,
“When doulas get paid by someone other than the mother, it gets to the question of, Who does the doula work for?” Ms. Deutschbein said. “I’d have to see more of the details.”
In the past, doulas have pushed for more insurance reimbursements, though the other side of the coin is that they’d make less money switching from cash.
But perhaps more to the point, Democrats have seized control of New York’s state Senate for the first time in a decade, opening the door for the state to adopt a single-payer system that would allow more equitable health care across the board. If we’re really interested in lowering the mortality rates among black women, this would be a sure-fire way of doing it.