You are republishing this story through Crosscut Republish:

A person sitting in a chair smiles and poses for the camera

More Washington companies offer doula services in health benefits

Businesses like Microsoft and Walmart are covering costs for birth workers, which advocates say can help lower racial disparity in pregnancy outcomes.

Megan Burbank

/ February 15, 2024

Get the Story

Download Everything

Download a ZIP file to your computer that contains all the code, text and web-quality images you’ll need to republish the story. If you prefer to copy and paste, scroll down for more options.

Download Packaged Assets (.ZIP)

HTML

Paste this code in your CMS to keep all text, images, videos, formatting and links from the original article. Tracking pixel included (more information below).

<article>
  <header>
    <hgroup>
      <h1>More Washington companies offer doula services in health benefits</h1>
              <h2><p>Businesses like Microsoft and Walmart are covering costs for birth workers, which advocates say can help lower racial disparity in pregnancy outcomes.</p></h2>
          </hgroup>
    <p>By <a href="https://uat1.crosscut.com/author/megan-burbank?r=repub" hreflang="en">Megan Burbank</a> / <a href="https://uat1.crosscut.com/?r=repub">Crosscut.com</a></p>
    <p>
      <time datetime="2024-02-15T05:00:00-08:00">February 15, 2024</time>
    </p>
      </header>
      <div>
      <p>For a small but increasing number of Washingtonians – including, possibly, people covered by Medicaid – doulas at birth could be covered by their medical insurance. Doula support has become increasingly recognized as a way to improve birth outcomes and equity in pregnancy care. But advocates say universal access remains a far-off goal.&nbsp;</p>

<p>A few major employers now offer doula coverage as a paid benefit, and – after a push from a coalition of local birth workers – Medicaid reimbursement is in the works for Washington. Birth-justice advocates say more reforms in access to doulas are needed to offset medical racism and undo the harm of long-standing health inequities.</p>
    </div>
    <div><p>In October, Walmart, the nation’s largest employer, began offering a doula support benefit to almost all its employees, including more than 20,000 in Washington. Microsoft is also piloting a doula benefit through Premera Blue Cross, available to employees in King and Snohomish Counties.</p>

<p>“For us, a company supporting doula access is a step in the right direction for supporting pregnant people,” said Rokea Jones, community engagement specialist with Open Arms Perinatal Services, which offers doula support and community education resources to pregnant and parenting people throughout King, Pierce and Snohomish counties. But the ultimate goal, she said, is even more expansive and inclusive access.&nbsp;</p>

<p>According to leading doula certification organization DONA, a doula is “a trained professional who provides continuous physical, emotional and informational support to their client before, during and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible.”<strong>&nbsp;</strong></p>

<p>For too long, said Jones, a doula herself, access to doula support has been framed as a privilege or additive service. Jones says that’s a myth.</p>

<p>“When really, as long as there have been people birthing, there has been someone to support them.” For clients navigating birth, she said, “I’m that sister, neighbor, friend, cousin, auntie that is trained in this work, but it’s also really, really here to hold your hand and walk you through this process.”</p>

<p>For Jones, birth is “a rite of passage." For doulas, “It’s a part of life that we show up to support and to make sure that people come out on the other side whole and ready for this new identity that they carry.”</p>

<p>Research shows that having access to one can improve birth outcomes – which is especially critical for people of color, who face disproportionate rates of maternal mortality. “We believe that everyone should have access to a doula, whether or not they can pay, or whether or not a company’s able to provide it,” she said.</p>

<p>This support has the potential to save lives, and to ameliorate long-standing racial disparities in maternal and infant mortality. In the U.S., Black and Alaska Native and American Indian women face <a href="https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/"><u>disproportionate rates of pregnancy-related death</u></a>, and in Washington, they’re more likely to give birth to babies of low birth weight. Doulas in the Pacific Northwest have provided new parents a greater sense of control over their own care as well as<a href="https://crosscut.com/equity/2022/06/working-doula-can-be-life-changing-mothers-color"> <u>ballast against medical racism</u></a>, said Jones.</p>

<p>“Particularly in my practice, I often remind families, ‘Hey, you are the primary member of your care team,’” she said. “‘You get to make the decisions here. Yes, our medical providers are trained. This is their specialty, so to speak. They’ve spent many years learning this situation, but you know your body best.’”</p>

<p>The benefits of this kind of advocacy are well-documented. The American College of Obstetricians and Gynecologists, the nation’s leading professional organization for obstetrician/gynecologists, <a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth#:~:text=or%20maternal%20fatigue.-,evidence%20suggests%20that%2C%20in%20addition%20to%20regular%20nursing%20care%2C%20continuous%20one-to-one%20emotional%20support%20provided%20by%20support%20personnel%2C%20such%20as%20a%20doula%2C%20is%20associated%20with%20improved%20outcomes%20for%20women%20in%20labor.,-Data%20suggest%20that"><u>recommends the presence</u></a> of a doula or other support person as one way to limit the need for interventions during birth.</p>

<p>In a 2019 review of clinic evidence, the group found that support people like doulas helped people have shorter labors, better pain management, fewer assisted vaginal births, and greater satisfaction among patients with their birth experiences.</p>

<p>Despite the financial and health advantages of access to doulas, it’s still rare for companies to provide it in their medical coverage. But as the police killing of George Floyd in 2020 sparked demands for reform of many systems through the lens of racial justice and equity,&nbsp; medical coverage for doula support has been seen as one way to address health inequities. According to the Centers for Disease Control and Prevention, Black women are almost three times more likely to die from a cause related to pregnancy than white women. Research posted by maternity care advocacy group Every Mother Counts <a href="https://everymothercounts.org/wp-content/uploads/2019/03/Advancing-Birth-Justice-CBD-Models-as-Std-of-Care-3-25-19.pdf"><u>showed</u></a> that the presence of a doula improves pregnancy outcomes and can therefore help reduce Black maternal mortality and other perinatal racial disparities.</p>

<p>Some companies have explicitly framed their new maternity policies in terms of equity. When in March 2021 CVS announced a new paid doula benefit for its employees of up to $1,200 a year, the health care and pharmacy chain <a href="https://www.cvshealth.com/news/womens-health-care/improving-your-maternity-experience.html"><u>overtly stated</u></a> that its new coverage option was “an outgrowth of CVS Health’s work to help solve disparities in maternity care.” Melinda King, a doula employed as a nurse with CVS, told the company in a blog post that she hoped the benefit would ensure a greater sense of agency for Black women navigating pregnancy and birth.</p>

<p>Microsoft also introduced that benefit in 2021, according to <a href="https://www.washingtonpost.com/gender-identity/some-big-companies-are-starting-to-cover-the-cost-of-doulas-will-others-follow/"><u>The Washington Post</u></a>. A spokesperson for the software company declined to be interviewed by Crosscut for this story, but confirmed that the benefit covers a $1,000 reimbursement allowance for doulas through Microsoft’s Health Connect Plan, which is available to employees in the Puget Sound region.</p>

<p>When Walmart announced its doula support benefit in October, it became the largest employer nationwide to offer one. The retailer is the biggest employer in the U.S., with over two million employees,<a href="https://corporate.walmart.com/about/location-facts/united-states/washington"> <u>23,231</u></a> of whom work in Washington. (By contrast, CVS employs 300,000 people nationally, putting it closer in scope to Microsoft, which employs just over 220,000.)</p>

<p>Before launching its national benefit, Walmart offered it to employees in Georgia, Louisiana and Illinois as a pilot. A health plan that gives access to doulas is now available to most of the retailer’s employees, with the exception of those in Hawaii. Walmart covers up to $1,000 for doula services during pregnancy. Walmart vice president of physical and emotional wellbeing Lisa Woods said on the company’s website that she hoped it would help employees who live in areas where maternity care access is in short supply – or nonexistent. “Doulas are especially important in health care deserts where access to care may be limited,” she said. These deserts could grow as <a href="https://crosscut.com/news/2023/08/activists-sue-idaho-over-abortion-trafficking-travel-ban"><u>maternity care units shut down</u></a> in states like Idaho in the fallout from <em>Dobbs v. Jackson Women’s Health</em>.</p><h3>Medicaid access in Washington</h3>

<p>Birth advocates in Washington have also made progress on trying to ensure access to doulas for low-income Washingtonians. The Doulas for All Coalition, which is led by queer, trans, Black, Indigenous, and people of color birth-justice advocates, has pushed for and taken steps toward getting Medicaid reimbursement for doulas, which would extend access for more than half of births in the state. Over the summer, the coalition – which includes Open Arms – started working with the state Department of Health to create a credentialing pathway for birth doulas, the first step toward reimbursement under Medicaid. The coalition has plans to lobby for additional legislation, including budgeting consideration, this winter. If passed, enrollments could start by summer.</p>

<p>But even with possible Medicaid reimbursement in the future and a handful of corporate plans broadening access to doula support, a wide swath of Washingtonians will still have to pay out-of-pocket. And in other states without strong resources for doulas, many are doing their work for free. “A lot of folks in between are trying to figure this thing out,” said Jones.</p>

<p>There are few examples of how mainstream insurance and health care systems can incorporate doula support, which is highly individualized and often culturally specific. Still, said Jones, the evidence is clear, and medical and systems can and do catch up. “We have enough research,” she said. “We have enough science to know that there are some things that just work. And so if we can understand that, our systems are there trying to get it right.”</p></div>
</article>
<hr/><div><p>Visit <a href="https://crosscut.com/donate"><u>crosscut.com/donate</u></a> to support nonprofit, freely distributed, local journalism.</p></div>

<link rel="canonical" href="https://uat1.crosscut.com/equity/2024/02/more-washington-companies-offer-doula-services-health-benefits" />


<script type="application/javascript">
  window.addEventListener('DOMContentLoaded', () => {
    fetch(`https://www.google-analytics.com/mp/collect?measurement_id=G-QCJDXX4VFK&api_secret=KQLK8PlFTqKTOwqBrlj21w`, {
      method: 'POST',
      body: JSON.stringify({
        client_id: '555',
        events: [{
          name: 'pageview',
          params: {
            'page_location': "https\u003A\/\/uat1.crosscut.com\/equity\/2024\/02\/more\u002Dwashington\u002Dcompanies\u002Doffer\u002Ddoula\u002Dservices\u002Dhealth\u002Dbenefits",
            'page_referrer': window.location.href,
            'page_title': "More\u0020Washington\u0020companies\u0020offer\u0020doula\u0020services\u0020in\u0020health\u0020benefits",
          },
        }]
      })
    });
  });
</script>

Plain Text

The unformatted text of the article with no embedded photos, videos or links.

MORE WASHINGTON COMPANIES OFFER DOULA SERVICES IN HEALTH BENEFITS

BUSINESSES LIKE MICROSOFT AND WALMART ARE COVERING COSTS FOR BIRTH
WORKERS, WHICH ADVOCATES SAY CAN HELP LOWER RACIAL DISPARITY IN
PREGNANCY OUTCOMES.

By Megan Burbank / Crosscut.com

February 15, 2024

For a small but increasing number of Washingtonians – including,
possibly, people covered by Medicaid – doulas at birth could be
covered by their medical insurance. Doula support has become
increasingly recognized as a way to improve birth outcomes and equity
in pregnancy care. But advocates say universal access remains a
far-off goal. 

A few major employers now offer doula coverage as a paid benefit, and
– after a push from a coalition of local birth workers – Medicaid
reimbursement is in the works for Washington. Birth-justice advocates
say more reforms in access to doulas are needed to offset medical
racism and undo the harm of long-standing health inequities.

In October, Walmart, the nation’s largest employer, began offering a
doula support benefit to almost all its employees, including more than
20,000 in Washington. Microsoft is also piloting a doula benefit
through Premera Blue Cross, available to employees in King and
Snohomish Counties.

“For us, a company supporting doula access is a step in the right
direction for supporting pregnant people,” said Rokea Jones,
community engagement specialist with Open Arms Perinatal Services,
which offers doula support and community education resources to
pregnant and parenting people throughout King, Pierce and Snohomish
counties. But the ultimate goal, she said, is even more expansive and
inclusive access. 

According to leading doula certification organization DONA, a doula is
“a trained professional who provides continuous physical, emotional
and informational support to their client before, during and shortly
after childbirth to help them achieve the healthiest, most satisfying
experience possible.” 

For too long, said Jones, a doula herself, access to doula support has
been framed as a privilege or additive service. Jones says that’s a
myth.

“When really, as long as there have been people birthing, there has
been someone to support them.” For clients navigating birth, she
said, “I’m that sister, neighbor, friend, cousin, auntie that is
trained in this work, but it’s also really, really here to hold your
hand and walk you through this process.”

For Jones, birth is “a rite of passage." For doulas, “It’s a
part of life that we show up to support and to make sure that people
come out on the other side whole and ready for this new identity that
they carry.”

Research shows that having access to one can improve birth outcomes
– which is especially critical for people of color, who face
disproportionate rates of maternal mortality. “We believe that
everyone should have access to a doula, whether or not they can pay,
or whether or not a company’s able to provide it,” she said.

This support has the potential to save lives, and to ameliorate
long-standing racial disparities in maternal and infant mortality. In
the U.S., Black and Alaska Native and American Indian women face
disproportionate rates of pregnancy-related death, and in Washington,
they’re more likely to give birth to babies of low birth weight.
Doulas in the Pacific Northwest have provided new parents a greater
sense of control over their own care as well as ballast against
medical racism, said Jones.

“Particularly in my practice, I often remind families, ‘Hey, you
are the primary member of your care team,’” she said. “‘You
get to make the decisions here. Yes, our medical providers are
trained. This is their specialty, so to speak. They’ve spent many
years learning this situation, but you know your body best.’”

The benefits of this kind of advocacy are well-documented. The
American College of Obstetricians and Gynecologists, the nation’s
leading professional organization for obstetrician/gynecologists,
recommends the presence of a doula or other support person as one way
to limit the need for interventions during birth.

In a 2019 review of clinic evidence, the group found that support
people like doulas helped people have shorter labors, better pain
management, fewer assisted vaginal births, and greater satisfaction
among patients with their birth experiences.

Despite the financial and health advantages of access to doulas,
it’s still rare for companies to provide it in their medical
coverage. But as the police killing of George Floyd in 2020 sparked
demands for reform of many systems through the lens of racial justice
and equity,  medical coverage for doula support has been seen as one
way to address health inequities. According to the Centers for Disease
Control and Prevention, Black women are almost three times more likely
to die from a cause related to pregnancy than white women. Research
posted by maternity care advocacy group Every Mother Counts showed
that the presence of a doula improves pregnancy outcomes and can
therefore help reduce Black maternal mortality and other perinatal
racial disparities.

Some companies have explicitly framed their new maternity policies in
terms of equity. When in March 2021 CVS announced a new paid doula
benefit for its employees of up to $1,200 a year, the health care and
pharmacy chain overtly stated that its new coverage option was “an
outgrowth of CVS Health’s work to help solve disparities in
maternity care.” Melinda King, a doula employed as a nurse with CVS,
told the company in a blog post that she hoped the benefit would
ensure a greater sense of agency for Black women navigating pregnancy
and birth.

Microsoft also introduced that benefit in 2021, according to The
Washington Post. A spokesperson for the software company declined to
be interviewed by Crosscut for this story, but confirmed that the
benefit covers a $1,000 reimbursement allowance for doulas through
Microsoft’s Health Connect Plan, which is available to employees in
the Puget Sound region.

When Walmart announced its doula support benefit in October, it became
the largest employer nationwide to offer one. The retailer is the
biggest employer in the U.S., with over two million employees, 23,231
of whom work in Washington. (By contrast, CVS employs 300,000 people
nationally, putting it closer in scope to Microsoft, which employs
just over 220,000.)

Before launching its national benefit, Walmart offered it to employees
in Georgia, Louisiana and Illinois as a pilot. A health plan that
gives access to doulas is now available to most of the retailer’s
employees, with the exception of those in Hawaii. Walmart covers up to
$1,000 for doula services during pregnancy. Walmart vice president of
physical and emotional wellbeing Lisa Woods said on the company’s
website that she hoped it would help employees who live in areas where
maternity care access is in short supply – or nonexistent. “Doulas
are especially important in health care deserts where access to care
may be limited,” she said. These deserts could grow as maternity
care units shut down in states like Idaho in the fallout from _Dobbs
v. Jackson Women’s Health_.

MEDICAID ACCESS IN WASHINGTON

Birth advocates in Washington have also made progress on trying to
ensure access to doulas for low-income Washingtonians. The Doulas for
All Coalition, which is led by queer, trans, Black, Indigenous, and
people of color birth-justice advocates, has pushed for and taken
steps toward getting Medicaid reimbursement for doulas, which would
extend access for more than half of births in the state. Over the
summer, the coalition – which includes Open Arms – started working
with the state Department of Health to create a credentialing pathway
for birth doulas, the first step toward reimbursement under Medicaid.
The coalition has plans to lobby for additional legislation, including
budgeting consideration, this winter. If passed, enrollments could
start by summer.

But even with possible Medicaid reimbursement in the future and a
handful of corporate plans broadening access to doula support, a wide
swath of Washingtonians will still have to pay out-of-pocket. And in
other states without strong resources for doulas, many are doing their
work for free. “A lot of folks in between are trying to figure this
thing out,” said Jones.

There are few examples of how mainstream insurance and health care
systems can incorporate doula support, which is highly individualized
and often culturally specific. Still, said Jones, the evidence is
clear, and medical and systems can and do catch up. “We have enough
research,” she said. “We have enough science to know that there
are some things that just work. And so if we can understand that, our
systems are there trying to get it right.”

-------------------------

Visit crosscut.com/donate to support nonprofit, freely distributed,
local journalism.

Tracking Pixel

Please help us keep track of our stories by including the code snippet below anywhere in the story's HTML. The tracker captures views only; no other information will be gathered. You don't need to add this if you copy and pasted the HTML from above.

<script type="application/javascript">
  window.addEventListener('DOMContentLoaded', () => {
    fetch(`https://www.google-analytics.com/mp/collect?measurement_id=G-QCJDXX4VFK&api_secret=KQLK8PlFTqKTOwqBrlj21w`, {
      method: 'POST',
      body: JSON.stringify({
        client_id: '555',
        events: [{
          name: 'pageview',
          params: {
            'page_location': "https\u003A\/\/uat1.crosscut.com\/equity\/2024\/02\/more\u002Dwashington\u002Dcompanies\u002Doffer\u002Ddoula\u002Dservices\u002Dhealth\u002Dbenefits",
            'page_referrer': window.location.href,
            'page_title': "More\u0020Washington\u0020companies\u0020offer\u0020doula\u0020services\u0020in\u0020health\u0020benefits",
          },
        }]
      })
    });
  });
</script>

Photos

The photo files available for download below are suitable for digital use. If you require high resolution photos for print, please contact editor@cascadepbs.org.

Download Low-Res Jpg files for web (.ZIP)

There are lots more stories available to republish for free through Crosscut Republish!

Browse Collection

Filter by category, geography, multimedia features and more to find the stories that are right for your publication.

What is Crosscut Republish?

Thanks for following the terms of our license agreement!

See complete terms and conditions.

Summary

You may reprint in any medium
You may edit only for tense and timeliness
If republishing in print you can edit for length if you follow our print republishing guidelines.
You may write your own headline
Include a byline and shirttail with credit and link to Crosscut
Include our tracking pixel
Remove if we ask
Only use photos in context
Feel free to embed our videos
Link back to the original article.