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Birth Workers Call for Expanded Coverage of Pregnant Women, Doulas

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Wednesday, July 3, 2019   

[STORY UPDATED 7/09/19]

RICHMOND, Va. – Virginia's Medicaid agency has launched a new outreach program to help lower the maternal mortality rate of black women, but birth workers who care for women of color say the state can do a lot more.

Noting that black mothers in Virginia consistently have died at more than twice the rate of white mothers, during and after pregnancy, the Virginia Department of Medical Assistance Services announced this week the use of new technology to ensure that qualifying low-income women don't experience a gap in health-insurance coverage.

For Kenda Sutton-El, co-founder of Birth in Color RVA, a network of doulas and birth workers, part of the problem is lack of access to care.

"Postpartum depression doesn't peak until almost 120 days," she said. "So, why aren't we allowing them to have Medicaid up until a year after giving childbirth?"

DMAS, which administers Medicaid in Virginia, said some women do lose their coverage 60 days after giving birth, but not all. The state's decision to expand Medicaid also means more 290,000 people have health insurance, about 60% of them women.

The agency has said it will work with other state agencies and managed-care organizations to strengthen early-childhood interventions, and launch an outreach campaign this fall to reach more pregnant women.

Sutton-El said she thinks the state should invest more to support doulas, or non-medical professionals who provide physical and emotional support through a person's pregnancy. For centuries, she said, doulas and midwives of color have been crucial to ensuring the safety of birthing women of color.

"I'd also like to see some funding given to doulas as well, but not a criteria – where New York has developed ... doulas have to be dona-certified," she said. "There's other organizations that have really, really, good training for doulas."

She said she thinks New York went too far by forcing a largely cultural practice to be subjected to licensure and certification from the state.

Last month, Gov. Ralph Northam announced a goal of eliminating racial disparities in mortality rates by 2025. It's part of his pledge to focus on Virginia's longstanding history of racial inequity after a blackface scandal nearly forced him out of office in February.

More information is online at birthincolorrva.org, and the New York doula law is at nysenate.gov.


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