Doulas Are on the March and They Want More Damn Insurance Coverage

Doulas want some respect around here, and also they want more insurance reimbursements.

So says the New York Times, checking in on the growing field. Not to be confused with midwives, who generally do more hands-on delivery work, doulas tend to serve more as advocates and assistants, and they don’t have to be professionally certified. As one Brooklyn-based doula told the Times, “We’re not there to change what the parents get,” adding, “We’re there to help get what they want.”

Chances are you’ve already heard this—the piece certainly qualifies as a case of the New York Times being ON IT. The interesting part is the bit about the future of the discipline. Overall, doulas are still a small part of American birthing culture; in New York, they attend something like 5 percent of births. (And God knows, New Yorkers can’t help but hop on the latest and greatest.) Many hospitals treat them more as friends-of-mom than health-care providers, and might require you to choose between having your sister or your doula in the room.

But they’re increasingly popular, and they’re pressing for more recognition and looking more organized. Doulas do have the option of certification, through groups like Dona International, and more emphasis on a formal credentialing process could make it easier to achieve one of their goals, which is more insurance and Medicaid coverage for their services. That would, in turn, make doulas an option for a broader array of women. But New York-Presbyterian Hospital/Weill Cornell Medical Center’s obstetrics director Dr. Amos Grunebaum warns that there’s a catch:

He said many doulas might be surprised to find they would have to take a cut in pay if they switched from cash to insurance. The $2,000 fee commanded by some experienced New York City doulas, he said, was “not far away” from his insurance fee for a normal birth, excluding prenatal care.