Representative Marcia Ranglin-Vassell (Democrat, District 5, Providence) and Senator Ana Quezada (Democrat, District 2, Providence) have announced that they will be reintroducing their bill in the next session to make doula services eligible for reimbursement through private insurance and Medicaid programs.

“While we are disappointed that the doula bill did not pass this year, we are hopeful for the future and look forward to reintroducing the bill next year. Doulas are an incredibly important resource for pregnant women, particularly women of color, whose maternal mortality rate is significantly higher than that of white women” said Representative Ranglin-Vassell. “Ensuring that doula services are covered by insurance will save the lives of women of color, and will ensure that they will be around to watch their children grow up.”

Senator Quezada echoed these sentiments. “There is no question that this bill will save lives and be good for women of color in Rhode Island,” she said, “but it also makes strong economic sense. Women who use doulas often require fewer expensive medical interventions during childbirth, which will save them, the hospitals, and the insurance companies money and make the childbirth process much easier for all involved.”

Doulas are trained healthcare professionals who provide the mother with continuous physical, emotional and informational support during pregnancy, childbirth and the first few weeks after giving birth. During childbirth, they help make women comfortable by providing breathing techniques, massages and advice, and also help advocate for the woman’s needs that she may not be able to express on her own. Births assisted by doulas also have significantly lower rates of cesarean sections, with one study showing a 39 percent reduction.

The bill (2019-H 5609, 2019-S 0678aa) aims to achieve healthier outcomes for women and babies during childbirth. In particular, the bill aims to help black women, who experience significantly higher rates of death or injury during childbirth than white women do. The bill passed the Senate and was held for further study in the House.

Under the bill, services from a trained, qualified doula would be eligible for up to $1,500 in coverage per pregnancy through both private insurance and Medicaid, including the state medical assistance program. Additionally, the bill would set industry standards and create a statewide registry of doulas in order to help women connect with a professional and ensuring that the work of the doula is fairly compensated.

The United States has the highest maternal mortality rate in the developed world at 23.8 per 100,000 live births in 2014. It is also one of two developed nations (the other being Serbia) that has seen an increase in the maternal mortality rate, which rose 26.6 percent between 2000 and 2014. The rate in Rhode Island was 11.2 per 100,000 live births from 2013 to 2017.

American maternal mortality rates show stark differences based on the mother’s race. For white women, the mortality rate is 12.4 for every 100,000 live births. The maternal mortality rate for black women is more than triple that at 40 per 100,000 live births.

The two sponsors said that the use of a doula, whose primary focus is on the mother’s wellbeing and comfort, would better ensure that women of color have their needs met during childbirth.

“Studies have shown that doulas greatly improve health outcomes for women and babies during pregnancy and childbirth. Their assistance can prevent complications and reduce the cesarean and preterm rates. Ultimately, they are a win-win because they make childbirth safer while saving health care dollars,” said Senator Quezada.

Said Representative Ranglin-Vassell, “All women, but particularly women of color, who are three to four times more likely to die due to pregnancy-related reasons than white women, should be encouraged to use a doula during pregnancy and childbirth.”

[From a press release]