Ohio Medicaid started covering doula services in October of last year.
It’s part of a state effort to reduce Ohio's higher-than-average infant mortality rate.
The rate was at 7.1 in 2023, higher than the national average of 5.6 deaths per 1,000 live births in the same year.
Marie McCausland, a doula in Solon, is questioning why the state's House members are using the budget to hamper the program before it has a chance to make an impact.
"While doulas aren't the solution to all of these issues, the statistics have shown that we have an impact. And we can't just be ending this before we get a chance to start," she said.
Doulas help navigate pregnancy, childbirth and the postpartum period. Though the process hasn’t been without problems, the state has certified dozens of doulas in at least 20 counties. The health professionals can earn up to $1,200 a pregnancy.
But the House budget advances a measure that would limit Medicaid reimbursement for doulas to just the six counties where the most infants die. That’s even though at least 65% of Ohio’s counties have infant mortality rates above the national average.
Doulas could only be reimbursed if their client's baby lives in one of those counties. It's unclear what data would be used to calculate which counties qualify.
McCausland said if these changes are allowed to move forward, it will reduce the ability of doulas to make an impact on the state's infant death rates, which are higher than the national average in at least 65% of Ohio's 88 counties.
"If we can't be in the room, how are we supposed to help eliminate these disparities? It seems mind boggling to me," McCausland said. “It makes no logical sense.”
McCausland is a postpartum doula, and serves on the state’s doula advisory board. She said the program should get a chance before lawmakers dismantle most of it.
"The data suggests that when folks have doulas, there are decreased c-section rates, decreased rates of pre-mature birth. And that's where you see the Medicaid savings," she said.
The state budget is now in the hands of Ohio's senators. Lawmakers and the governor are expected to finalize the state budget in June.
McCausland said she hopes to sway lawmakers to remove the provision from the budget.
