By STEPHANIE RAUHE
Capital News Service
LANSING – The state has embraced the crucial role of doulas and is taking the initiative to ensure they’re treated with respect, receive expanded training and are compensated for their services.
A doula is there to support new parents through the entirety of childbirth and the postpartum period. No matter whether the birth takes place in a hospital, birthing center or at home, a doula can provide whatever support that parents need.
Doula services have been shown to positively impact both the childbirth experience and birth outcomes, according to the Department of Health and Human Services.
The department defines a doula as “a trained birth worker who provides non-clinical emotional, physical and informational support to pregnant people and their families before, during and after birth.”
They don’t replace trained health care professionals but respond to clients ’needs and wishes, according to the American College of Obstetricians and Gynecologists.
The department’s Doula Initiative program works to ensure equitable access to doulas, said Dawn Shanafelt, the director of its Division of Maternal and Infant Health.
“Our goal is to increase the number of trained doulas available for families in Michigan,” she said. “We want to make sure that not having the funds to pay isn’t stopping people from being able to choose to have a doula as part of their care team.”
The program now has 278 registered doulas, with 161 of them enrolled in Medicaid plans.
Medicaid is a health care program that provides services to low-income children and adults, covering medical services such as dental and doctor visits, medical supplies and surgery, according to the department.
Starting in January, Michigan Medicaid began reimbursing doula services at a rate of $700 for the labor and delivery of a baby. Doulas also receive $75 per visit, up to a maximum of six visits, which can take place during both the prenatal and postpartum periods, according to Shanafelt.
“As a doula, reimbursement depends on the number of clients you have, if you’re a full-time doula and can serve more clients, or if you have a smaller practice and serve a limited number,” Shanafelt said.
One of the department’s main goals for the upcoming year is to increase the number of training tools available. Currently, there are 26 Michigan-approved training programs throughout the state.
The department also has a 26-member advisory council that reviews training courses and organizations and approves more training. The council consists of certified doulas.
“They’re increasing access to training for individuals who want to be doulas,” Shanafelt said. “They’re also increasing the number of doulas who are Medicaid-enrolled so they can get reimbursement and provide services to families who have Medicaid insurance.”
Members include Melinda Britton of Doulas of Marquette, Alaina Bierema of Humble Beginnings Birth Services in Grand Rapids, Kristen Schell of Kristen Schell Birthing Services of Benton Harbor, Krystal Barnhart of Northern Sun Birth Services in Oscoda and Nyasia Countee of Ancient Wisdom Birth Services in Detroit.
Bierema witnessed her first birth when she was around 16 and fell in love with it all, she said. She dove headfirst into the birth world and began offering full-time doula services in 2021.
“I love watching people become parents because there’s this shift that happens from when it was just the two of them,” she said. “The whole dynamic changes, and they did this incredible thing together and it’s really magical to watch.”
Countee was in Tuskegee, Alabama, when she learned that the closest hospitals were 55 minutes away in Montgomery and 45 minutes away in Opelika.
“It was very common for people to have car births because there’s not a hospital or even an urgent care in Tuskegee,” she said. “When I got back to Detroit, I was on fire for birth and I began to train as a home-birth midwife and a doula at the same time.”
Fueled by her own experiences with childbirth, Countee was drawn to this line of work.
“My favorite part of working as a doula is seeing the clients feel empowered and able to advocate for themselves,” she said. “I’m able to bridge the gap between the health care system and the moms because I’ve been both.”
The Department of Health and Human Services has a doula registry to provide support for services. To be a part of the registry, doulas must apply and show proof of completing a department-approved training program.
In an effort to remove barriers that prevent people from becoming doulas, the department compensates trainees.
“We’re covering the cost of training and providing an hourly rate for those who attend training,” Shanafelt said. “We also cover things such as lodging and reimburse mileage because we respect their time and their investment in improving outcomes.”
While the price of training varies among programs, the average doula training costs around $800.
“We want to make it clear how valuable and important doulas are as a profession and advocates for their clients,” Shanafelt said. “They are respected members of the community and they are part of the care team that really does improve outcomes and benefit families.”