New study suggests funding for doula care for low-income women may ultimately save taxpayer dollars

A new study by the University of Minnesota’s School of Public Health showed that women insured by Medicaid who have access to doula care have lower cesarean birth rates than women without access to this kind of care. A doula is not a doctor, but an experienced professional who offers guidance during childbirth, otherwise known as a labor coach.

Not only do doulas help with the physical aspects of childbirth, such as breathing, but they also can help through the emotional aspects as well. When it comes to cesareans, which are more expensive than vaginal child birth, many are unnecessary and doula’s can serve as a person to stick up for the mother if they deem the cesarean childbirth is not needed.

Currently, Medicaid does not provide mothers with coverage for doulas, but the study suggests that if policy changes that offered this support were added, then overall costs would decrease. This is because a cesarean birth costs Medicaid about $13,590 as opposed to  $9,131 for a normal birth.

“When we compared birth outcomes among culturally-diverse Medicaid recipients who received prenatal education and childbirth support from trained doulas with those from a national population of similar women, we estimated a 40 percent reduction in cesarean rates,” said Katy Backes Kozhimannil, Ph.D., an assistant professor within the School of Public Health’s Division of Health Policy and Management and a lead author in the study said in a press release. “When you look at the potential cost savings associated with a rate reduction of this magnitude, Medicaid reimbursement for birth doulas could be a case where adding coverage on the front end could ultimately result in real dollars saved.”

Previous research has proved that the benefits of the use of doulas during childbirth, but this study was the first to analyze the financial possibilities. Kozhimannil notes that the funding for doulas would initially cost state Medicaid programs a good deal of money, but suggests that the reduction in cesarean births will eventually offset these costs and end up saving money.

“In a time of increasing fiscal pressures on health care systems and state Medicaid budgets, the need to stem the rising cost of care is urgent,” said Kozhimannil. “We believe the option of doula support for Medicaid-funded pregnancies would not only be financially beneficial, but may also improve quality and enhance the mother’s birth experience.”

Tags: cesarean, childbirth, doulas, healthcare policy, Katy Backes Kozhimannil, medicaid, Ph.D., University of Minnesota's School of Public Health