Birth doulas are not officially medical providers but they are trained to provide support during labor and delivery. According to a recent study, Medicaid patients who received care from birth doulas were less likely to have cesarean sections. Based upon the results of the study authors suggest state Medicaid programs start covering doulas to reduce the overall pregnancy costs. Study results were published in the American Journal of Public Health.
As Medicaid programs currently stand, taxpayers pay for almost 50% of all births in the United States. The average cost for a vaginal birth is about $9000, but costs for cesarean sections can reach more than $13,000. If doulas reduced the risk of cesarean sections, they would also be reducing the overall costs of the pregnancy paid by U.S. taxpayers.
Recent studies have proven that women living in low income situations are at increased risk of poor pregnancy outcomes. The same women cannot afford to hire a doula so Medicaid regulations would have to change in order for low income women to receive doula care. Currently doula care is considered an alternative form of medicine by most insurance companies. If Medicaid were to change regulations to approve doula care costs, more doulas would be encouraged to provide care for at-risk women and may spawn a change in insurance communities leading to additional coverage for women with standard insurance.
Researchers note that providing doula care coverage will initially increase costs of Medicaid program but over time should substantially reduce costs associated with caesarean deliveries. The Medicaid program will pay less in the long run. Theoretically, doula care can also make the birthing experience more positive for women in low income situations and provide an additional level of support for breastfeeding and postnatal care.
Source: Katy Backes Kozhimannil, Rachel R. Hardeman, Laura B. Attanasio, Cori Blauer-Peterson, and Michelle O’Brien. (2013). Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries. American Journal of Public Health.2013. doi: 10.2105/AJPH.2012.301201.