Two years ago we spent time talking about the issues facing mothers and children during our nine-month series on Maternal & Early Childhood Issues. Part of that focus was on the work done by doulas, particularly by Amy Wilt and her group at Dauphin County Doulas.
Since then, doulas have received a lot of attention across Pennsylvania, with lawmakers in Harrisburg taking the lead on working to increase the access to doulas and their coverage by insurance.
Doula services are now covered under Medical Assistance after changes by the Shapiro Administration. In order to be recognized by Medicaid, doulas must be certified through the Pennsylvania Certification Board. Department of Human Services Secretary Dr. Val Arkoosh and Department of Health Acting Secretary Dr. Debra Bogen recently stressed the importance of doulas as part of care teams for historically underserved populations.
With this in mind, we talked once again with Amy Wilt to see what she though of the increased awareness.
“I’m so happy about that. That’s great movement,” she said. “Even two years ago when we first spoke, we weren’t recognized as a profession. Nobody talked about us. Nobody knew what we did….There’s a lot more who are learning about us, which is fabulous.
“I’ve seen this huge shift, with late-in-pregnancy moms–‘oh I just learned what a doula is and I really need you on board.’ We’re filled up until August and September is my first opening.”
But there is still progress to be made. Wilt says she is grateful for the increase in insurance coverage. But she would like to see the coverage give doulas more up-front coverage to ensure client commitment.
“I’m not allowed to charge you a deposit to hold your spot. I’m not allowed to charge you anything,” Wilt said, referring to the restrictions involved with the current form of insurance coverage. “That then causes a problem because I don’t know that you are going to call me for your birth. They need to take a look at that. ”
Wilt says she has found that moms without a financial commitment, like a deposit, are less likely to call for the birth.
“If they don’t call for the birth, then we lose a significant amount of money. We’re just getting paid for a pre-natal visit.” And they have difficulty knowing whether or not to reserve time for moms in the months ahead.
Wilt says it will end up hurting the doula industry if things don’t change.
