Oklahoma adds doula services to SoonerCare benefits

Expecting mothers enrolled in SoonerCare can now receive doula services for emotional, physical and informational support during the prenatal, delivery and postpartum periods. Beginning July 1, all SoonerCare members who are pregnant or within the postpartum period are eligible for up to eight doula visits per pregnancy.

Doulas are trained, non-medical birth workers who provide emotional, educational and physical support during pregnancy and postpartum. They can also advocate on behalf of women during labor and delivery. SoonerCare members must be referred to doulas by their medical providers and should not replace the services of other licensed medical professionals.

“Doulas have an important role in maternal health,” said Kevin Corbett, Oklahoma Health Care Authority CEO. “By providing accessible information to women on topics such as risk factors and warning signs, they can provide critical support during pregnancy and postpartum periods to help new mothers make healthy choices to optimize outcomes for themselves and their newborns.

Doula services can include: 1. Emotional/physical support and person-centered, culturally competent care; 2. Prenatal counseling and assisting in preparing for and carrying out birth plans; 3. Teaching and advocating on behalf of the birthing parent during appointment visits; 4. Facilitating and assuring access to resources that can improve birthrelated outcomes; 1. Ongoing education with an emphasis on postpartum care and resources; 2. Supporting the whole birth team including a birthing parent’s partner, family members, and other support persons.

“Doula support during pregnancy, birth, and during the postpartum period has been shown to be an effective best practice that can enhance the birthing experience, reduce complications, and improve outcomes for Oklahoma women and infants,” said State Medicaid Director, Traylor Rains. “Further, this coverage will help address social disparities by providing individually tailored care and advocacy through information, education and emotional support.”

Oklahoma is the 11th Medicaid program nationally to cover doula services. During 2021, one in six births were preterm and 33% of live births were cesarean deliveries. SoonerCare covered more than 27,000 births in Oklahoma in 2021, about half of all births in the state.

Nationally, one-third of maternal deaths occur in the postpartum period, including up to 1 year after childbirth. Almost 12% occur past the sixweek postpartum visit. Postpartum depression affects one in nine new mothers with 40-60% of low-income new mothers reporting depressive symptoms.

According to a report by the Office of Health Policy, research shows women whose labor and delivery were supported by doula care had lower cesarean and preterm birth rates and improved rates of breastfeeding initiation. An observational study of low-income women found that doula-assisted mothers were four times less likely to give birth to a baby with low birthweight, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding.

OHCA recently expanded pregnancy and postpartum SoonerCare coverage by raising the income threshold for full-scope pregnancy-related benefits to 205% of the federal poverty level and providing new mothers with 12 months of continuous postpartum coverage.