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Vermont considers Medicaid coverage for Doula services

MONTPELIER, Vt. (WCAX) – Studies show having a Doula by your side during pregnancy can improve health outcomes – but not everyone can cough up the cash.

Pregnant Vermonters on Medicaid and many on private insurance can’t afford Doula services. The state’s solution: Act 97.

Lindie Holtzman labored for nearly an entire day during her last pregnancy, and her Doula never left her side.

“I felt like I could do it because I had a Doula there with me. I really don’t think I could have gone through it without a Doula,” said Holtzman.

At Vermont Doula Company, patients like Holtzman see doulas for physical and emotional support throughout pregnancy.

“Made me feel very empowered and very just overall happy with how my birth went even though it didn’t go as planned,” said Holtzman.

Unlike medical professionals, Doulas aren’t regulated. Instead, they take certification courses or learn through years of experience.

That’s about to change through Act 97. Passed this legislative session, it’s kickstarting a statewide review into best regulation practices for Doulas, considering registration, certification, or licensure.

That will help the state decide whether or not to provide Medicaid coverage for Doula services.

Act advocate Senator Martine Gulick hopes to see expanded coverage and the benefits it can bring.

“Not only financial savings in terms of better health outcomes but also just, you know, healthier people and happier people as well,” said Gulick.

Mary Kate Shanahan, co-owner of Vermont Doula Company with Haley Parizo, says people on Medicaid often lack the support system needed during pregnancy.

“I think it’s even more critical for folks who qualify for Medicaid to be able to get that support in such a critical and vulnerable time,” said Shanahan.

Holtzman has seen it first hand, watching a pregnant friend on Medicaid struggle without a Doula’s support.

“I do feel like it would have eased a lot of postpartum depression and anxiety and helped her work through not only physically the birth process, but also emotionally,” said Holtzman.

While Shanahan supports expanded coverage, she cautions the state from setting overly restrictive regulations.

She worries this could exclude Doulas who can’t afford certification or don’t need it after years of experience.

“It’s really coming at it from an approach of making sure that all that want to be accounted under this are fairly given the chance,” said Shanahan.

Under the right regulations, Shanahan believes more pregnant Vermonters could thrive.

“Everyone deserves a Doula,” said Shanahan.

The state will present the findings of its regulation review at the next legislative session.

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