On January 31, the RHC submitted public comment in support of proposed rule 13 CSR 70-25.160 Doula Services, which would establish the Department of Social Services’ MO HealthNet Division guidelines regarding coverage and reimbursement for community doula services.    

Maternal and infant mortality rates in Missouri are consistently one of the highest in the nation, and people of color (POC) are at increased risk for poor maternal and infant health outcomes compared to their white peers. Missouri’s maternal mortality rate is especially dire for Black women, who are three to four times more likely than white women to die within a year of pregnancy.  In the St. Louis region, Black babies are three times more likely to die in their first year of childbirth compared to white babies. Doulas are part of their local community – sharing their culture, strengths, and vulnerabilities – and can reduce these health disparities, bridge gaps in healthcare and support maternal and child wellbeing.  

Doulas are non-medical professionals who provide continuous emotional, physical, informational support and guidance for pregnant, birthing, and postpartum people.  Recent studies have shown that having continuous emotional support during this time can provide significant health benefits to birthing people, such as the decreased need for pain medication during birth, lower rate of C-section, faster labor and more positive birthing experience. These benefits are increased for communities of color. Increasing access to doulas is one intervention to address the stark racial disparities in maternal and infant mortality in our state.  

The proposed rule would allow doulas to provide prenatal support in a manner that is culturally relevant and that is targeted to Medicaid participants, who are disproportionately POC. With maternal health outcomes worsening and Black women and birthing people being disproportionately harmed, it is critical that doula care be made financially accessible for Black families and communities. For this reason and those outlined above, the RHC is in strong support of the proposed rule, 13 CSR 70-25.160, which provides MoHealthNet coverage and reimbursement for doula services.

To read the official RHC testimony in full, please click here or download a copy using the button below.

If you have any additional questions or requests for information, please contact Kate Kasper, Manager of Policy and Advocacy at kkasper@stlrhc.org.  

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