Missouri emergency rule targets high maternal mortality rate

KANSAS CITY, Mo. — An emergency ruling is now in effect in Missouri, targeting the state’s high maternal mortality rate.

The rule will only help people through the state’s Medicaid program who are using a doula.

Doulas do not help with live birth, instead they act as a support system, helping expecting mothers through their pregnancy and even after.

The Missouri Department of Social Services wants to reimburse their services for people on the state’s Medicaid program.

Shariah Edwards is perinatal doula with the non-profit Altruism Inc. Hearing about Missouri’s emergency rule hits close to home for her.

“A lot of our women have Medicaid. I had Medicaid when I was a birthing person and just to have the support of a doula would have been amazing and that’s why I am here,” Edwards said.

The emergency rule comes at a time when Missouri has dealt with high maternal mortality rates.

The state recently published a multi-year look at maternal mortality in Missouri, a report that covers 2017 through 2021.

Key findings included:

• From 2017 to 2021, there were 349 deaths total
• The pregnancy related ratio was 32.2 deaths per 100,000 live births
• 77 percent of all pregnancy-related deaths were determined to be preventable, including all due to mental health conditions and substance abuse

In the ruling, the department of social services says the risk of maternal mortality was higher based on several factors including socio-economic status.

The state says reimbursing doula services to people enrolled in the state’s Medicaid program is a step towards healthier pregnancies and birth.

Edwards, who worked as a doula for years, agrees.

“We’re talking about consent, choices, and that empowers them each step of their journey through pregnancy, through delivery and also through postpartum into parenthood because the journey doesn’t stop,” Edwards said.

The state’s order requires doula providers must be enrolled as MO HealthNet providers and be certified.

Reimbursement services include six combined prenatal/postpartum visits, birth attendance and lactation education.

Edwards says this help gets her clients through the non-profit connected to even more support.

“This support means for them to have access to other resources being connected in the community so we can help with lights, gas, water, food insecurity.”

The program is set to begin Tuesday, but only lasts for six months.

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