Lawmakers seek to professionalize birth-care doulas

OLYMPIA — Aijanae Young is a birth postpartum doula, a person who delivers non-medical care after birth. She said she didn’t realize the value she brought to her clients until she was the one in need.

Young said before her doula arrived, she felt her pain and symptoms weren’t being addressed, and she had to fight to have the support she needed.

“My doula listened to my cries, saw my struggles, she said. “I was afraid and suddenly didn’t know what to ask.”

Doulas can provide physical, emotional, and informational support during and after pregnancy, but Medicare and Medicaid won’t cover the cost unless the doula is a credentialed health professional. House Bill 1881, sponsored by Rep. Kirsten Harris-Talley D-Seattle, establishes a voluntary certification process for birth doulas in Washington State.

To be accredited, the doula must submit a completed application and satisfactorily complete competencies established by the Secretary of Health.

Supporters say the move would boost health outcomes, especially for Black and Indigenous parents.

“Many clients seek me out because they are afraid the medical racism they face in their birth space could lead to their death or the death of their baby,” said Jasmyne Bryant with Surge Reproductive Justice.

She said establishing doulas as a profession and getting them accredited is a crucial step in getting Medicare and Medicaid reimbursement for doulas and addressing disparities in black and indigenous perinatal healthcare.

Madeline Rider is an Algonquin Anishinaabe mother of two and the Operations Manager at Columbia Legal Services, a firm dedicated to providing free legal services to people facing poverty and oppression.

She said with the help of her doula she was able to heal from the birth of her first child. Her first child was born in a hospital with no doula support and she said she was denied the opportunity to participate in requested cultural practices, due to hospital policy. Rider also said she didn’t feel fully informed about procedures and on multiple occasions didn’t know what was happening to her body or her baby.

“My body rebelled and my delivery was traumatic… I felt like the hospital had taken my agency and my personal body autonomy.”

According to Kristin Reichl with the state Department of Health, studies show using the services of doulas for those giving birth reduces health disparities and improves birth outcomes, such as a reduction in cesarean rates and higher birth rates, particularly for black, and indigenous people.

Dur'Shrika Moore, Doulas for All Coalition, said it’s hard to feel safe and comfortable giving birth when there’s no one like you around.

“Access to doula support is crucial to the survival of a birthing person's life. The support of a doula allows a birthing person to feel safe which allows their body to open up and successfully bring life to their side,” Moore said.

The bill passed through the House with 85 yeas and five nays and is now under consideration in the Senate.