More on this page: "Becoming a Doula", "Insurance for Services", and "Medicaid Bill for Doula Care"


HOW TO FIND A DOULA

Maternal Health & Community Doula Programs, Student Doulas, and Hospital & OB/GYN Doula Programs

There are many wonderful doulas in northern NJ and we believe there exist a good client doula match for everyone and enjoy helping people find that match. There are many ways to find a doula and we are happy to help get you started.

For general referrals, there are many doula agencies cropping up that act as a referral for smaller groups of doulas (google "doula agency" + your county or town).

For a larger referral base, we recommend looking on DoulaMatch.net. For student doulas you can look on doulamatch and the profile will indicate if they in the process of earning their certification. You can also email us at nnjdoulanet @ gmail to have your info sent to their student referral list.

Word of mouth is always a great way too! We will keep you posted on a larger doula referral, just for northern NJ, currently being created by our doula colleagues. 

There are several organizations offering doula services as part of a social service or a program for which may qualify or simply live in the right area. Here are the ones we know of:

Maternal Health & Community Doula Programs:

Update: Governor Murphy’s Administration has NJ Agencies Awarded $4.7 Million to Improve Black Infant, Maternal Mortality, so watch for doula training programs happening throughout the state.

  • The Partnership for Maternal & Child Health of Northern NJ offers The Community Health Worker (CHW), which is a program of Improving Pregnancy Outcomes (IPO) Initiative funded by New Jersey Department of Health. The Partnership operates CHW programs in Hudson, Union and Passaic Counties. The CHW can help prenatally and postpartum. They do not offer birth doula services.

  • SPAN IPO Community Doula Project offers labor support, home visits pre and postpartum, education and referrals. The project targets the Essex County communities, Newark, Irvington, East Orange and Orange. To learn more about their doula services, pls email Rachel Ruel at rruel@spannj.org or visit their Sister to Sister Community Doulas of Essex County, NJ Facebook page at https://www.facebook.com/Birthiswhatwedo

  • The Leaguers Head Start/ Early Head Start program services pregnant women and their families through weekly 90 minute home visits and bi-weekly group socialization events. They offer doula referrals. For more information see their Pregnant Services Program.

  • Birth Haven offers shelter, support, and education for homeless, pregnant women and girls in Newton, NJ area. Their services include helping the mother obtain a doula (from doulas Birth Haven has existing relationships).

Student Doulas:

  • To find a student doula in northern NJ, you can email us at nnjdoulanet @ gmail as we have a running list of student doulas seeking qualifying births, or contact local DONA trainers for names. A few trainers are: Laura DePasquale and Dorothy Haines for DONA and Kimberleigh Weiss-Lewit for BAI. Also, you can ask in FB or WhatsApp mommmy groups.

Hospital & OB/GYN Programs:

  • If you are lucky to live near Valley Ridgewood, you can take advantage of their hospital doula program. Also, Morristown Memorial Center has a couple of doulas on staff (we are awaiting verification if they are only for clinic patients). Rates and terms vary, so be sure to know what you are signing up for. Also, several OB/GYN & Midwifery offices have doulas on-staff, such as Wombkeepers in Montclair, and Integrative Obstretrics in Jersey City, and Midwives of NJ (the latter being a combined role of Midwife's Assistant/Doula/Photographer). A doula by definition is supposed to be working for the client and not the provider, so having your provider supply the doula poses a fundamental conflict. Also the staff doula might only meet you at the hospital, and not the home, so take care researching the right type of doula for your birth.

Good luck researching and finding your perfect doula! 


HOW TO BECOME A DOULA

Plus a look at the underlying problem with umbrella certifying organizations

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There are literally over 90 certifying organizations listed on doulamatch - dozens of them available right here in NJ . There are many things to consider when starting out, such as: what communities do you want to serve, what services do you want to offer and what are your priorities, do you prefer online learning or in-person workshops, how much do you want to invest, what will your doula network be? A great way to start is to start researching avenues, chat with other birth professionals you know, and start saving time and money.

Currently one does not need to be certified in NJ to work as a doula. Some cannot get certified due to limited resources or some choose not get certified because they do not wish to be bound by the agreements of a certifying organization. This can become a point of conflict if a doula wishes to work at certain locations or if NJ receives the medicaid waiver is passed for doula services in NJ.

For example, the new Our Birthing Center in Morristown states it only accepts DONA certified birth doula affiliates. This is an example of how people in power, either at birth centers, hospitals, or in government, desire that safety net of saying they only accept doulas of X experience from the oldest, biggest certifying doula organization in the country.

This one-size fits all approach has the potential to significantly reduce the benefit of the medicaid waiver bill (if it goes thru) on the communities that could use it most! The reason being is that many doulas are not certified by DONA, especially doulas living and working in communities of color. To give an example of this, the Essex County Community Doula Program bases their training on the Ancient Song Doula Services Training, which is a program customized and independently developed by Chanel L. Porchia-Albert and Patricia Thomas of Ancient Song, i.e. not affiliated with an umbrella organization such as DONA or Bradley or Cappa.

If the Medicaid waiver goes thru, many of the women who the Community Program serves are insured via Medicaid and could greatly benefit from taking advantage of the waiver, however they would not be able to because most of the doulas in the program are certified thru Ancient Song Doula Services, a program that may not be "nationally recognized".

What can be done? Carefully consider these factors when choosing a doula path. Also... write your representatives and let them know the value of having a diversity of doula certifications and that a one-size fits all approach when it comes to doula care does not work and can in fact work against what they are trying to do - to have healthy moms and babies and improve pregnancy outcomes! 

Once you've considered all the above and if you choose to get certified - some of the organizations NNJ doulas have been more commonly certified thru are: Ancient Song Doula Services, CAPPA, Doula TrainingsInternational, ProDoula, DONA, Birth Arts International. Good luck!

List of Doula Trainings offered in usa:

(Expand for full-view)

Insurance Coverage for Doula Services

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Clients often ask if I can provide them with a receipt that they can submit to insurance. Yes, I can, but  you will want a back-up plan. Doulas are not automatically covered by insurance although many people feel they should be. Choices in Childbirth (CiC) put out a big report on this topic earlier this year, Overdue! Insurance Coverage of Doula Care. Warning: it's complicated. In the report they say,  “Private insurance plans should include services of a trained doula as a covered service, and state legislatures should pass legislation mandating private insurance coverage of doula services, as they have done for a broad range of services." Even in states where there are programs and the insurance companies are supposed to reimburse (the only states being Oregon and Minnesota), it is not a slam-dunk, “At this time, few doulas, if any, have actually received reimbursement in either Oregon or Minnesota.”
 
So some people try to get covered with some effort. For this, the doula needs to provide an itemized receipt. The theory is that there are insurance companies that cover support services that fall into a second tier of health options such as therapeutic massage, gym memberships, breast pumps, lactation consultants and doulas, and typically the companies require the insured to provide paperwork and receipts. As an example of how to submit, DONA offers this DONA 3rd party reimbursement manual, but keep in mind it needs updating as it still includes CPT code, which I will go into below: http://www.dona.org/PDF/3PRSampleLetter.pdf.  As doulas, we can provide a detailed receipt including our National Provider Identification(NPI#) and a description of services. As per describing services - I have not heard of the insurance companies being impressed with doulas describingrelaxation and pain-coping techniques or that doulas are preventivemedicine and statistically reduce the need for expensive surgeries and epidural anesthesia. The companies seem to better respond to tangible services they are familiar with, such as childbirth education and breastfeeding support.

Anecdotally, I have heard of a doulas being reimbursed when the provider signs a letter of medical necessity, including a medical code, indicating labor support increases the chances of the patient having an unmedicated birth with no pain management (I guess if it's doctor's orders then it is taken more seriously). What is this secret code you ask? Midwives and Doctors can offer CPT code 99499, since they are medical, but since doulas are not medical we cannot offer this same code. Per DONA, “As of this date, there is no national CPT (current procedural terminology) code for doulas.” So doulas cannot sign-off on this type of letter/receipt because doulas are not medical therefore we do not have a diagnosis code. Having a provider sign-off on our services is not realistic option for most of us since we are hired by the client and not by the provider, but there are offices in my home turf of northern NJ that have doulas on staff, such as Wombkeepers and Midwives of NJ.

So what are the options? Some clients have been able to use their Health Savings Account (HSA) accounts and Flexible Spending Accounts  (FSA), that can reimburse an individual or help one pay for eligible health care expenses not covered by one's health plan. Typically, the amount designated from your paycheck, that you put into your FSA, is taken out pre-tax. You will still need a receipt with NPI# and description of services for this purpose.

In closing... The insurance piece is going to take some time. Feel free to get involved by raising awareness via the CiC report or by contacting the rep at your doula organization who handles insurance questions. Personally, I don't recommend clients invest too much time with insurance. As for women who cannot afford a doula - recommend saving, offer a payment plan, request money for doula-savings at their baby shower/registry, ask a doula to barter services. Also, there are always student doula training and attending births, as they work towards their certification. To find these doulas just look on doulamatch and see how much they charge – rates often correlate with experience.

What is your experience with insurance reimbursement for doulas and what are creative ways you've heard of how people afford a doula? How do you respond when people ask if you provide insurance? I hope to read your response.
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If you are interested to read the full report, visit Choices in Childbirth's Toolkit Overdue Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health http://choicesinchildbirth.org/our-work/advocacy-policy/doulacoverage/.


Doula Medicaid Bill in NJ (Medicaid Coverage for Doula Care)

There's been lots of buzz around the newly introduced NJ Doula Medicaid bill, so we wanted to collect all the information we know so far and share it with you. 

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The name: MEDICAID COVERAGE FOR DOULA CARE 

https://legiscan.com/NJ/bill/A1662/2018

Number: Assembly Bill 1662, NJ

Introduced: January 9, 2018

Introduced by (Sponsored by) Representative: Eliana Marin, Rep 29th District

"This bill provides for the expansion of the State Medicaid program to include coverage for doula care.  A doula is a trained professional who provides physical, emotional, and educational support, but not medical care, to mothers before, during, and after childbirth.  Research has demonstrated that support from a doula is associated with lower caesarian section rates, fewer obstetric interventions, fewer complications, decreased use of pain medication, shorter labor hours, and higher scores on the APGAR test (which indicates how well the baby is doing outside the womb)."

According to NJ Spotlight 

"Maternal mortality is also a priority for Democrats in the state Senate, including Sen. Joe Vitale, (D-Middlesex), the longtime health committee chairman, who has pledged to hold hearings on the issue and the racial disparities in death rates, which are significant."

"Vitale joined Sen. Teresa Ruiz (D-Essex) in December to introduce legislation to create a panel of experts, armed with subpoena power, which would go beyond the existing review process. A companion version has been sponsored by Assemblywoman Pamela Lampitt (D-Camden), Assemblyman Rag Mukherji (D-Hudson), and Assemblywoman Valerie Vainieri Huttle (D-Bergen), who has led other efforts to improve maternity care.

Other supporters of maternal health were present at a recent East Orange WIC Black History Month Event celebrating Breastfeeding, including New Jersey's First Lady Tammy Murphy and Acting Commissioner of the Department of Health Dr. Shereef Elnahal. 

What can you do help? Write letters.

The bill was just recently introduced, so it has a way to go before it becomes law.

Find out more about how a bill becomes law in NJ http://www.njleg.state.nj.us/legislativepub/legprocess.asp

Write a letter to your assembly person, the folks who will sponsor the bill. Be sure to read the above section about, How to Become a Doula in Northern NJ (and the underlying problem with Umbrella Certifying Organizations), to emphasize the deterrents of only allowing one certification.

First find out your Legislative district & Assembly person here: http://www.njleg.state.nj.us/districts/districtnumbers.asp

Consider writing an actual paper letter with information about the benefits of doulas or letter written from the heart based on your perspective or experience and passion. It is important we help push it through by showing support for the bill. It is also important for your former clients to write letters, so that the general public is also represented. Consider hosting a letter writing party with some of your birthworker colleagues.

It would be a really wonderful start if this bill can get passed. Providing a medicaid waiver for doula services to medicaid enrolled parents would be a great start to increasing equity and access in maternal health care. Please share with us what steps you are taking so others get inspired and can possibly reach out to you.