{"id":8939,"date":"2026-03-16T08:00:59","date_gmt":"2026-03-16T13:00:59","guid":{"rendered":"https:\/\/westplexnews.com\/index.php\/2026\/03\/16\/missouri-doula-program-shows-early-success-as-lawmakers-look-to-expansion\/"},"modified":"2026-03-16T08:00:59","modified_gmt":"2026-03-16T13:00:59","slug":"missouri-doula-program-shows-early-success-as-lawmakers-look-to-expansion","status":"publish","type":"post","link":"https:\/\/westplexnews.com\/index.php\/2026\/03\/16\/missouri-doula-program-shows-early-success-as-lawmakers-look-to-expansion\/","title":{"rendered":"Missouri doula program shows early success as lawmakers look to expansion"},"content":{"rendered":"
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\n

Christian King, a doula with Uzazi Village in Kansas City, wraps Mikia Marshall, 33, with a kanga cloth to help take pressure off her stomach on Feb. 27, 2024 (Anna Spoerre\/Missouri Independent).<\/p>\n<\/figcaption><\/figure>\n

In the past year, Christian King, a doula based in Kansas City, has supported more than 40 mothers enrolled in Medicaid through their pregnancy, birth and postpartum.\u00a0<\/span><\/p>\n

In that role, she helps educate and support families about birth and babies, but her work also takes on a more nontraditional approach.<\/span><\/p>\n

When one mother\u2019s water was shut off at four weeks postpartum, King helped her find reconciliation services to turn the utilities back on. When another mom couldn\u2019t afford car repairs, King found an organization in Raytown that provided financial assistance. She helped one client secure a car seat from the local health department and another fill her closet with baby clothes.<\/span><\/p>\n

King, 35, hopes that soon, \u201cjust like going to the dentist and going to the eye doctor, obtaining a doula and having a doula present is also one of those things that you just have to have on your team as part of services for maternity.\u201d<\/span><\/p>\n

Doulas do not deliver babies. They advocate for the physical and mental wellbeing of mothers and their families.\u00a0<\/span><\/p>\n

For the past 15 months in Missouri, anyone enrolled in Medicaid while pregnant and postpartum can have a doula by their side for free. Now, a group of bipartisan lawmakers are hoping to expand the program in an effort to continue combating the state\u2019s poor infant and maternal outcomes.\u00a0<\/span><\/p>\n

\u201cThe statistics tell a devastating story of the lives lost that could\u2019ve been saved if we put in the proper measures,\u201d said state Sen. Barbara Washington, a Democrat from Kansas City who proposed one iteration of the <\/span>legislation<\/span><\/a>. \u201cThere are third-world countries that have better maternal mortality rates than we do.\u201d\u00a0<\/span><\/p>\n

The bill is estimated to cost around $300,000. While substantial amid a predicted state budget shortfall, state Rep. <\/span>Becky Laubinger, a Republican from Park Hills who <\/span><\/a>also filed legislation to expand the program, said she believes the long-term savings of having fewer Missourians who require medical attention will make up for the cost.<\/span><\/p>\n

On average, 70 women die each year in Missouri during childbirth or in the first year postpartum. Of those deaths, <\/span>80% are deemed preventable.\u00a0<\/span><\/a><\/p>\n

In Missouri, <\/span>women on Medicaid were seven times more likely to die within a year of pregnancy<\/span><\/a> than women on private insurance, according to a 2024 report published by the state\u2019s Pregnancy-Associated Mortality Review that looked at women who gave birth between 2017 and 2021.\u00a0 A 2023 <\/span>March of Dimes report gave Missouri a D- for preterm births, <\/span><\/a>and also pointed to doulas as a solution.<\/span><\/p>\n

In fall 2024, the Missouri Department of Social Services issued an <\/span>emergency rule authorizing Medicaid to reimburse doula services<\/span><\/a>, citing \u201can immediate danger to the public health, safety or welfare of pregnant women in Missouri.\u201d<\/span><\/p>\n

Since the program\u2019s inception, there have been about 625 participants insured through Medicaid who accessed doulas during their pregnancy and postpartum, said <\/span>Baylee Watts, a spokeswoman for the Department of Social Services. <\/span>As of this month, 108 doulas were enrolled in the program.<\/span><\/p>\n

\u201cThe department is encouraged by the level of engagement so far,\u201d Watts said in a statement. \u201cAnd views the doula benefit as an important component of broader efforts to improve maternal health outcomes across Missouri.\u201d<\/span><\/p>\n

Legislation filed by state Rep. Tara Peters, a Rolla Republican, has moved the farthest this year, clearing committee in February as part of a <\/span>sweeping health care bill. <\/span><\/a>Her bill seeks to increase the number of covered doula visits from six to 16.<\/span><\/p>\n

The average out-of-pocket cost for a doula in Missouri is about $1,500, according to the Missouri Doula Association.\u00a0\u00a0<\/span><\/p>\n

\u201cI\u2019ve just noticed how much extra care a doula can provide, especially for women in high need situations,\u201d said <\/span>Laubinger.<\/span><\/a> \u201cDoulas can provide some great education and support for people who maybe don\u2019t have the extra support.\u201d\u00a0<\/span><\/p>\n

This support can also look like serving as an interpreter between medical professionals and pregnant people, navigating insurance, ensuring access to nutritious food or coordinating transportation to medical <\/span>appointments.\u00a0<\/span><\/p>\n

Laubinger<\/span><\/a>, who previously served as executive director of Monarch Family Resource Center in Farmington, said expanding the number of covered visits can be particularly helpful for women who experience postpartum depression in the year after giving birth.<\/span><\/p>\n

Her legislation, like Peters\u2019, expands the number of reimbursable visits from six to sixteen, and includes access to doulas for prenatal, birth, postpartum and lactation support.<\/span><\/p>\n

\n

Bill clarifying women\u2019s right to divorce while pregnant heads to Missouri governor<\/a><\/p>\n<\/blockquote>\n

She said the legislation also hopes to correct some issues doulas have had getting full reimbursement after being in the room for a scheduled c-section, listed as a scheduled surgeries, a classification she said muddled the reimbursement process.\u00a0<\/span><\/p>\n

The Department of Social Services previously said the reimbursements could lead to savings for the state in the coming years, including by potentially reducing the Cesarean rate. Watts said it\u2019s too early to get an accurate look at this result.<\/span><\/p>\n

Laubinger<\/span><\/a> said doulas can be a lifesaving set of eyes and ears in homes where women experience domestic violence, a leading cause of pregnancy-associated deaths in Missouri.\u00a0<\/span><\/p>\n

\u201cThe doula birth worker can also have a voice in those situations and see what\u2019s going on outside of that medical office,\u201d she said. \u201cAnd maybe be able to provide some rescuing relief from dangerous situations for mom.\u201d<\/span><\/p>\n

To be eligible, <\/span>doulas must be credentialed<\/span><\/a> and certified through a national or Missouri-based doula training organization. From there, they will be added to a list of eligible doulas overseen by <\/span>the Missouri Community Doula Council<\/span><\/a>.<\/span><\/p>\n

Sandra Thornhill, a social justice doula who has advocated in Jefferson City for better legislation for doulas, said it was beautiful to see this policy issue reach across the aisle. And she was happy to see some of the proposals pushing for increased visits, especially in postpartum.<\/span><\/p>\n

She said it\u2019s not a question of if doulas should be reimbursed, but of how the state honors the traditional practices and values of doulas in that process. She is wary of any policies that place community health workers under medical or state authority. Instead she hopes to see more collaborative models.\u00a0<\/span><\/p>\n

\u2029\u201dMy concern is not with recognizing doulas in the Medicaid policy, but with how the bill structures authority and governance over that work,\u201d said Thornill, who <\/span>describes herself as a womb warrior and policy griot.<\/span> \u201cThe question is whether the policy structure strengthens community birth workers or will it place unnecessary burden or medical authority that doesn\u2019t reflect the roots of the work.\u201d<\/span><\/p>\n

But she said the progress made in acknowledging and supporting doula\u2019s work in the past few years is striking, especially as many doulas live \u201cbirth to birth\u201d as they struggle to pay the bills.\u00a0<\/span><\/p>\n

Prior to the state\u2019s Medicaid reimbursement plan, <\/span>The Independent spoke with several doulas who spoke of giving up wages <\/span><\/a>to help families in need for free as they navigated growing their families.<\/span><\/p>\n

\u201cThey do it because they love their people and their community so much that they\u2019re willing to make this great sacrifice,\u201d Thornhill said. \u201c\u2029However, it is not healthy. And it is not fair for the community to have to suffer like that when there are resources available to change that. But again, those resources cannot come with a slap on the wrist. They cannot come with a backlash of \u2018now you\u2019re under our thumb.\u2019\u201d\u00a0<\/span><\/p>\n

A representative with America\u2019s Health Insurance Plans voiced opposition to Washington\u2019s bill in a committee hearing last month.<\/span><\/p>\n

\u201cWe are very concerned about issues with education, standardization and making sure doulas are all on the same page and we know exactly how they\u2019ve been trained,\u201d he said. \u201cThere seems to be some resistance out there and a lot of independence within the organizations.\u201d\u00a0<\/span><\/p>\n

Washington\u2019s legislation also seeks to ensure health benefit plans offer coverage for midwifery services. She said this is especially crucial in rural parts of the state, where families don\u2019t have access to nearby hospitals with maternity wards.\u00a0<\/span><\/p>\n

\u201cCurrently, our law does not explicitly require private health plans to cover midwifery. This would close that loophole,\u201d Washington said, adding that this change would shift power back to patients to choose their own provider, especially in rural communities \u201cwhere the hospitals are closing at alarming rates.\u201d\u00a0<\/span><\/p>","protected":false},"excerpt":{"rendered":"

Christian King, a doula with Uzazi Village in Kansas City, wraps Mikia Marshall, 33, with a kanga cloth to help take pressure off her stomach on Feb. 27, 2024 (Anna Spoerre\/Missouri Independent). 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