However, a new pilot program launched by Governor Cuomo is expanding Medicaid coverage for doulas. Doulas are trained professionals that serve as a physical and emotional support to women before, during, and after pregnancy, and also help to connect them with other social supports. As we discussed yesterday, the United States is the only developed country where maternal mortality is increasing – and the rates of maternal mortality are 3-4 times higher for black moms than for white moms. Most babies in New York are born with Medicaid coverage.

Patients with doulas for pre-natal, labor and post-partum support have better birth outcomes and are less likely to have cesarean births (which are associated with the highest maternal mortality rates). Currently, doulas are mainly affordable only for upper middle-class or affluent women and families who can pay out-of-pocket for these services. The initiative will expand next to Syracuse and Brooklyn.

New York’s initiative seeks to make doulas more accessible to low-income women and women of color as one way to help address maternal health disparities. In early November 2018, NYSDOH hosted a webinar to share information with stakeholders, including doulas, providers and managed care organizations, on the final details of the pilot program. The state began accepting Medicaid enrollment applications for doulas on December 1, 2018.

Implementation started in Buffalo on March 1. Maternal health advocates, including doulas, have welcomed this step but advise that greater collaboration with existing community-based doula groups and increased reimbursement rates are necessary to ensure that the program is sustainable and effective in addressing long-standing health disparities.