Doulas are trained professionals who offer care and emotional support to families before, during, and after childbirth. Pregnant people who use doulas have been shown to have better birth outcomes, including lower rates of cesarean delivery and preterm births.

“There’s this saying which is not mine, although I use it all the time, which is that — If doulas were a medication, as a physician it would be unethical for me to not prescribe it to every single patient I encountered,” said Ashley Lakin, a family medicine doctor in Woonsocket.

Doula services can run upwards of one thousand dollars, however, and are unaffordable to many families who have to pay out of pocket.

Advocates of increased doula access say it is a health equity issue, particularly for families of color. In Rhode Island, Black people are nearly four times more likely than white people to die from pregnancy-related causes. Black infant mortality is three times greater than white infant mortality.

Doulas play an important role in addressing these alarming disparities by advocating for families of color in medical spaces, and helping birthing people feel more comfortable during delivery.

When their services are not covered by insurance, however, Rhode Island doulas say they sometimes have to choose between financially sustaining themselves and working with the low and middle-income clients who most need their help.

“In the state of Rhode Island, we want to make sure that every family deserves a doula, receives a doula — but also that every doula deserves to be paid,” said Providence doula Quatia Osorio. “Families are seeking qualified, trained professionals who can assist them in the most vulnerable time of their lives.”

The Senate Committee on Health and Human Services held a hearing Wednesday night on a bill that would make doula services eligible for reimbursement through Medicaid and private insurance.

Providence Senator Ana Quezada, who is sponsoring the legislation, said investing in doulas is cost-effective because of the unnecessary medical procedures they can help prevent during pregnancy and childbirth.

“When women don’t know and go to the hospital for any little thing that they feel because they’re not sure, or maybe when they’re having their first baby, a doula is very helpful,” Quezada said. “It saves money.”

Quezada said she was thrilled Governor Dan McKee has also included reimbursement for perinatal doula services in his proposed budget for the next fiscal year.

Over 900 people signed an open letter in support of the bill. Senator Joshua Miller, who chairs the Health and Human Services Committee, called it a “record-breaking package of written testimony.”

Lawmakers have introduced similar proposals in recent years, but none have been signed into law.

At Wednesday’s hearing, the Senate Committee on Health and Human Services voted to hold the bill for further study. 

Antonia Ayres-Brown can be reached at