Policy Resolution HHS-22-22

WHEREAS, a doula is defined as a trained, non-medical person who provides physical, emotional, and educational support before, during, and after childbirth;

WHEREAS, according to The White House A Proclamation on Black Maternal Health Week, 2021, America’s maternal mortality rates are among the highest in the developed world, and they are especially high among Black mothers, who die from complications related to pregnancy at roughly two to three times the rate of white, Hispanic, Asian American, and Pacific Islander women — regardless of their income or education levels;

WHEREAS, according to the Centers for Disease Control and Prevention, in 2019, the maternal mortality rate for non-Hispanic black women was 44.0 deaths per 100,000 live births, 2.5 times the rate for non-Hispanic white women (17.9) and 3.5 times the rate for Hispanic women (12.6);

WHEREAS, according to the Institute for Healthcare Improvement, for Black women, income level, education, and insurance access do not serve as protective factors against maternal mortality as they do for White women due to structural and systemic racism as well as implicit and explicit bias;

WHEREAS, as it currently stands, most doula care is not a covered healthcare service in most states, and clients are forced to pay out of pocket; people with low income and communities of color, who would benefit the most, are left without access, creating a noticeable health disparity;

WHEREAS, pregnant and postpartum people receiving doula care have been found to have improved health outcomes for themselves and their infants, including higher breastfeeding initiation rates, fewer low birthweight babies, and lower rates of cesarean births;

WHEREAS, doulas offer a unique opportunity for healthcare systems to reduce workloads for nurses and frontline providers with many simultaneous responsibilities, retain patients for future pregnancies and other services, and attract new patients by providing a unique, valuable service;

WHEREAS, the benefits of doula care can also have a financial impact in helping families and the State avoid the cost associated with low birthweight babies, cesarean births, and other pregnancy-related complications; and

WHEREAS, in response to the COVID-19 pandemic, area hospitals in across the country amended their visitor policies from prohibiting all visitors, to allowing a professional or certified doula to be present during childbirth, thus recognizing their essential nature.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL), recognize that doulas are both vital childbirth team members and community health workers and acknowledge their contribution in ending maternal and infant health disparities;

BE IT FURTHER RESOLVED, that the NBCSL believes that the benefits of doulas in childbirth should be examined for the long-term cost saving potential for private health care plans and government covered plans like Medicaid; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR(S): Representative London Lamar (TN) and Representative Karen Camper (TN)
  
• Committee of Jurisdiction: Health and Human Services (HHS) Policy Committee
  
• Ratified in Plenary Session: December 2, 2021
  
• Ratification certified by: Representative Billy Mitchell (GA), NBCSL President