Bill to expand Medicaid maternity care to cover doula services passes in Pa. House

An initiative to reduce maternal mortality among women of color in Pennsylvania advanced Monday with the unanimous passage of a bill to expand Medicaid to cover doula services and create an advisory board to ensure doulas are properly accredited.

The bill, introduced by state Rep. Morgan Cephas , D-Philadelphia, is part of a package of legislation on Black maternal health — nicknamed the “Momnibus” by supporters — that includes a requirement for Medicaid to pay for blood pressure monitors, which also passed Monday in the state House with a 164-37 vote.

Both bills will now go to the Republican-controlled state Senate for consideration, where a similar bill to require Medicaid reimbursement for doulas was introduced last year by Sen. Judith Schwank, D-Berks. It has yet to be considered since it was referred to the to Senate Health and Human Services Committee in January 2023.

Doulas are non-medical, trained professionals who provide emotional, informational and physical support before, during and after pregnancy and childbirth, such as helping with breast feeding and breathing techniques during labor.

Cephas noted the recent Maternal Mortality Review Committee report that showed 107 Pennsylvania women died in 2020 during pregnancy or within one year of giving birth. Making doula services more readily available to women in parts of the state in maternal health care deserts, where resources are sparse, will improve outcomes, Cephas said.

“Doulas can play a critical role in filling this gap in these deserts, and because of their close proximity to their clients they are able to track early warning signs of mental health concerns, as well as guiding them to proper resources to receive the care that they need,” Cephas said.

The doula legislation passed unanimously, with several Republican lawmakers speaking in support.

“As a new father and somebody that utilized doula services in the pregnancy of my son, I want to recognize the importance of these services for all new parents across our Commonwealth,” Rep. Ryan Mackenzie, R-Lehigh, said. “We want to make sure that they’re available not just to Medicaid, but hopefully to private pay insurance recipients as well.”

Mackenzie added that Medicaid coverage for doulas is “just one step on the path.”

The bill is in accord with an effort by the Pennsylvania Department of Health to include doulas in the maternity care provided by Medicaid.

The department’s Office of Medical Assistance Programs has assisted the nonprofit Pennsylvania Doula Commission, which works to promote access to doula services through workforce development initiatives, such as the creation of a certification for professional doulas.

At least some within the doula community have concerns about the way the bill was pieced together and whether it truly reflects their interests.

“I’m very uneasy about it,” Amber Edmunds, a doula and director of civic engagement at MAYA, a nonprofit serving pregnant, postpartum and incarcerated people, told PublicSource. “I don’t have enough context. I don’t have the information I need.” Edmunds said she is concerned about whether Medicaid money would come with strings attached that would compromise the independence and effectiveness of doulas.

Cephas’s bill would create a Doula Advisory Board responsible for determining the approved accreditation organizations for doulas, the skills required and setting standards for best practices for doula professionals.

“Research has shown that doula support leads to improved birthing outcomes including reduced rates of cesarean sections, shorter labor durations … [and] breastfeeding initiation,” Cephas said. “By providing continuous support, doulas contribute to safer and more positive birth experiences.”

PublicSource staff contributed to this report.

This story was first published by Pennsylvania Capital-Star. Read more of their coverage here .

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