Labor support

Mamas on Bedrest: “Widespread Insurance Coverage of Doula Care Would Reduce Costs, Improve Maternal and Infant Health”

January 14th, 2016

Hello Mamas,

As we roll into 2016 one thing is certain: We are on the brink of change in the maternity world! At no time in history have there been so many groups and so many initiatives determined to improve maternity care and birth outcomes. Below is a press release put out by two leading maternity advocacy groups, Choices in Childbirth and Childbirth Connection (a program of the National Partnership for Women and Families) to raise awareness not only of the cost benefit of doula care, but also the tremendous benefit doulas provide to mamas and infants in improving birth outcomes. A doula is “a trained birth attendant who provides non-medical emotional, physical and informational support before, during and after childbirth.” Here is more from the press release: 

“Widespread coverage of doula care is overdue,” said Michele Giordano, executive director of Choices in Childbirth. “Overwhelming evidence shows that giving women access to doula care improves their health, their infants’ health, and their satisfaction with and experience of care. Women of color and low-income women stand to benefit even more from access to doula care because they are at increased risk for poor maternal and infant outcomes. Now is the time to take concrete steps to ensure that all women can experience the benefits of doula care.”

 “Doula care is exactly the kind of value-based, patient-centered care we need to support as we transform our health care system into one that delivers better care and better outcomes at lower cost,” said Debra L. Ness, president of the National Partnership. “By expanding coverage for doula care, decision-makers at all levels and across sectors – federal and state, public and private – have an opportunity to improve maternal and infant health while reducing health care costs.”

 The brief provides key recommendations to expand insurance coverage for doula care across the country. They have also provided an informative infographic which also summarized the major points (see below).

  • Congress should designate birth doula services as a mandated Medicaid benefit for pregnant women based on evidence that doula support is a cost-effective strategy to improve birth outcomes for women and babies and reduce health disparities, with no known harms.
  • The Centers for Medicare & Medicaid Services (CMS) should develop a clear, standardized pathway for establishing reimbursement for doula services, including prenatal and postpartum visits and continuous labor support, in all state Medicaid agencies and Medicaid managed care plans. CMS should provide guidance and technical assistance to states to facilitate this coverage.
  • State Medicaid agencies should take advantage of the recent revision of the Preventive Services Rule, 42 CFR §440.130(c), to amend their state plans to cover doula support. States should also include access to doula support in new and existing Delivery System Reform Incentive Payment (DSRIP) waiver programs.
  • The U.S. Preventive Services Task Force should determine whether continuous labor support by a trained doula falls within the scope of its work and, if so, should determine whether labor support by a trained doula meets its criteria for recommended preventive services.
  • Managed care organizations and other private insurance plans as well as relevant innovative payment and delivery systems with options for enhanced benefits should include support by a trained doula as a covered service.
  • State legislatures should mandate private insurance coverage of doula services.

Read the entire Issue Brief Here. For more information, visit Choices in Childbirth or Childbirth Connection.

 

 

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Mamas: Support for Dads During Pregnancy, Labor and Delivery

June 13th, 2014

Greetings Mamas!

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This dad was all in for the birth of his child! Photo courtesy of Photographer Kelsi Scheel, Grace Ray Photography. See this photo and the story behind it in From Mamas to Mamas: The Essential Guide To Surviving Bedrest

Father’s Day is upon us! Have you spoken with your partner about his feelings on being present at the birth of his child? On becoming a dad? I ask this question in light of this post on one of my birth providers chat lists: (Paraphrasing to protect privacy!)

Have any of you ever had this happen:  You connected wonderfully with the momma and the energy between you two was phenomenal, yet you weren’t able to click with their partner? I feel a very awkward energy with the dad, even though the momma said that he is pretty much on board with my presence and role in the birth and is glad I’ll be there. He doesn’t attend prenatal visits and hasn’t really seemed interested in the pregnancy or my services. I’m not sure if he is avoiding me or if there is something deeper. Thoughts?

Ladies, there are a few things to consider here.

First, let’s face it. Even those of us facing our first pregnancy, completely in the dark about what is going to happen, we are lightyears ahead of our male partners (unless they are obstetricians!)! We are “accustomed” to “the weirdness of womanhood” and all that entails (i.e. menstrual cycles, feminine products, bras, make up, concealers, body shapers, hair extensions, etc…) So yeah, a high risk pregnancy with bed rest is just one more adjustment we’ll make. We will do like we always do-make the necessary shifts and accommodations and make it happen! Men don’t accommodate as easily or as readily to change as we do. So we have to be patient as they “catch up” to us.

Second, the idea of actually being present during childbirth totally skeeves some men out! Oh yeah, they are all about “gettin’ with us in the moment” but getting down and dirty with something (actually someone) coming out of their “pleasure palace” really messes with some men’s minds. In hindsight, I really pushed for my then husband to be present at my daughter’s birth. And when she came out not breathing and then I hemorrhage, it nearly took him out! I should have listened when he told me he wasn’t up for being in the delivery room and chosen another, more capable childbirth support and advocate. Ladies, some men are not up for childbirth. It doesn’t mean that they don’t love us or support us, they just can’t be present at such a raw, visceral event. We must hear them and respect their limitations. (FYI I had my sister come in with me when I had my son. Much better experience!!!)

So Mamas, Find out where your man is on the spectrum. Is he all in, ready to be of utmost assistance? Is he totally freaked out and secretely signing up to become a merchant marine? Or is he somewhere in between and really just needs to process all that is happening and about to happen to someone he loves dearly, and is petrified that he has caused to have to go through unspeakable pain?

Ladies, do we ever really ask our guys what they think about what we are going through? In our book, From Mamas to Mamas: The Essential Guide to Surviving Bedrest, One dad shared poignantly about his experience when his wife went on hospital bed rest saying, “It felt like she had died and suddenly I had all this responsibility heaped on me.” It is so easy to get caught up in what we are going through; after all, we are the ones who are growing and changing and we are the ones who are enduring the brunt of this experience. But you and your partner are a team and he is going through this experience, too. And many men don’t say anything because they feel like they have no right to “complain” given all that we are going through. I want to reiterate, you and your partner are a team! This pregnancy isn’t just happening to you, but also your partner and any children you already have. Everyone’s thoughts and feelings need to be considered and attended to so that everyone’s needs are met and the wee one you are carrying will come into a cohesive, loving family.

Happy Father’s Day to all the dads out there! We love you and thank you for your love and support! We’d love to hear from you. Share your experience regarding your wife’s pregnancy and bed rest, labor and deliver (if applicable) in our comments section below.

Get your copy of From Mamas to Mamas: The Essential Guide to Surviving Bedrest Today!

Mamas on Bedrest: Who should be at your side when you deliver?

June 11th, 2014

Greetings Mamas!

Mamas, “Who should be at your side when you deliver?”

Current wisdom is that it should be the baby’s father. But what if the baby’s father is unavailable? The birth of your baby is one of the most monumental moments of your life! You need to be completely comfortable, able to freely express yourself and receive nothing but support. You must choose a birth partner who is not only completely supportive of how you are birthing, but they must be able to advocate on your behalf if you are unable to advocate for yourself. With those parameters in mind, who will be at their birth of your baby as YOUR support? Share who you chose to be in the delivery room with you and why in the comments section below.