Missouri, consistently ranked as one of the worst states for pregnant women, is taking urgent steps to address its alarmingly high maternal mortality rate. On September 27th, the Department of Social Services announced its new emergency rule. The state will begin reimbursing doula services for low-income women through its Medicaid program, a move advocates have long pushed for.
Between 2017 and 2021, Missouri women on Medicaid were seven times more likely to die within a year of pregnancy compared to those with private insurance. Of the 70 pregnancy-related deaths in the state each year, 77% were deemed preventable. Cardiovascular disease and mental health issues stand out as the top causes, mirroring a national crisis where 85% of women grapple with postpartum depression and anxiety. In addressing these critical health issues, more attention is being given to the role of doulas as essential support figures in pregnancy and postpartum care.
Doulas play a vital role in pregnancy and childbirth, offering emotional and physical support, including assistance during delivery, lactation education, and navigating social services. In the postpartum period, they provide home visits, monitoring new mothers for signs of mental health struggles, substance abuse, and domestic violence—key factors in maternal deaths during the year after childbirth. In line with these efforts, leaders like Okunsola Amadou and Hakima Payne have been at the forefront of advocating for doula services in Missouri.
Okunsola Amadou, founder and CEO of the doula training organization Jamaa Birth Village, has been in conversation with the state for years regarding the improvements needed to support pregnant women. In the Spring of 2022, Amadou and Hakima Payne, co-founder and CEO of Uzazi Village, co-authored a policy brief championing the benefits of doula services. Their presence has been shown to reduce the risk of complications and improve overall birth outcomes.
For the next six months, the state Department of Social Services will reimburse doula services for Medicaid mothers, covering a total of six prenatal and postpartum visits under the new program. State representative LaKeySha Bosley, a vocal advocate for reproductive rights, emphasized, “Access to doula services ensures that women, particularly those from underserved communities, receive the support they need during pregnancy, childbirth, and postpartum recovery. It’s about saving lives and improving health outcomes for both mothers and babies.”
While the program is scheduled to conclude at the end of March 2025, advocates hope it will lead to a permanent, expanded initiative that could significantly reduce maternal mortality rates across the state.
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