Anzhe Zhang

For many, doulas are just as integral to the process of giving birth as doctors and nurses. More than the clinical aspects of ensuring a pregnant woman is healthy, doulas provide critical emotional and physical support during this trying event in life.

Which is why Michigan Medicaid will soon begin paying reimbursements for services from doulas, which advocates say will not only aim to decrease health and birth outcome disparities in the state, but also create a better network for doulas to provide their services.

Dawn Shanafelt, director of the Division of Maternal and Infant Health at the state Department of Health, notes that doulas contribute to better birth outcomes but that “in Michigan, we don’t have equitable access to doulas. To correct that, the Medicaid reimbursement will go into effect in 2023. Otherwise, accessing doula care requires paying out of pocket or finding one working under a grant, which is really limited,”

Residents will have to be enrolled in Medicaid to be eligible, while doulas will have to be on the state Department of Health’s Doula Registry to qualify for reimbursements, which would otherwise cost up to $2,000 depending on the level of service.

“Doulas don’t just coach a person through labor. Doulas remind parents of their rights as a human. Doulas help families find the best care options for them,” Elon Geffrard, program director at Birth Detroit, said.

The reimbursement, as well as the formation of the Michigan Doula Advisory Council, which will count doulas from across the state as members, aim to close the gaps in health disparities among communities in Michigan.

“When you look at the statistics, Black infants are 2.6 times more likely to die in Michigan in their first year of life than White infants,” Farah Hanley, the state chief deputy director for health, said.

“Our maternal mortality rates are 4.5 more times higher in Black women than White, and to address this, we’ve proposed doulas as a Medicaid benefit,” Hanley continued.

In 2020 alone, 700 infant deaths occurred in Michigan, with Detroit having a high infant mortality rate.

“With the inequities that exist and are apparent in our data across the board, it is essential that we have this. It’s a great step forward,” Shanafelt said.