More help is coming to maternity wards across Massachusetts and on the Island as access to doulas grows.
MassHealth, the state-run insurance program, began to cover doula services this spring, allowing more pregnant people on the Vineyard to have additional emotional, physical and informational support throughout their pregnancy from the trained nonmedical professionals. Gov. Maura Healey on Friday also signed legislation that requires MassHealth to cover doula services for pregnant people up to 12 months postpartum.
The services, which have been linked to fewer c-sections and preterm births, have been out of reach for many, and state officials hope this can cut down disparities.
“Often, doulas have been an out-of-pocket luxury,” said Maria Thibodeau, a Vineyard doula certified with MassHealth. “Doulas increase equity and produce more positive birth outcomes.”
Services provided by doulas have also been shown to help reduce health disparities for families of color and low-income families, according to studies published in the American Journal of Public Health and the Maternal and Child Health Journal.
Fallon Aiello, a doula on the Island who trained in New York, said that interest in doulas is growing as knowledge about the role spreads.
“People are wanting support, are realizing that there’s support out there…and are a little bit fearful of the process of birth,” Ms. Aiello said. “Our country runs really high in morbidity rates for pregnancy, for birth – especially for women of color. I think more and more women are fearful of moving into the hospital system to have their baby when they’re hearing about women dying in birth.”
MassHealth’s new coverage allowed Island residents Maria and Jan Hulka to get doula services here on the Vineyard. The couple first met Ms. Thibodeau at a program hosted by Martha’s Vineyard Community Services for expectant parents.
“Before, we were talking about how nice it would be to be in touch with somebody to learn more about how to do things properly, how to get ready,” said Mr. Hulka.
Ms. Hulka added that having a doula was important because the couple did not have a familial network to support them in the lead up to the birth of their son Oliver.
“I don’t have my family here anywhere near to me,” she said. “Jan doesn’t have his family here, so it would be a great thing for us to be supported on this big day.”
The Hulkas decided to hire Ms. Thibodeau to help them prepare for the birth of their first child after meeting her and learning that her services were covered by MassHealth.
Ms. Thibodeau began to meet with Ms. Hulka in the lead up to the birth and they worked together to come up with a birth plan.
“It was really nice because she really wanted to know me and what’s important for me and who I am, so she could prepare herself better for the date of our son’s arrival,” Ms. Hulka said.
For many doulas on the Island, their work in the lead up to a birth is focused on education.
Polina Whitfield, who specializes in postpartum care, said it can be difficult to navigate pregnancy and birth without a familial network.
“When I arrived here 21 years ago, and I got pregnant, I didn’t have any family,” Ms. Whitfield said. “I was pretty fluent [in English], but I didn’t know anyone, and it was hard. I needed the help that I’m actually now providing for moms. I understand the need for someone to be there for you, especially with the postpartum work.”
Ms. Whitfield added that she is most often called to provide night nurse duties because sleep deprivation is one of the worst aspects of the postpartum period.
Ms. Aiello, who is working to get certified with MassHealth, teaches childbirth education classes and prenatal yoga in addition to being a doula. She said that the classes she teaches for expectant parents and her one-on-one work provide tools for parents to give them agency.
“My hope is that parents feel empowered to advocate for themselves,” said Ms. Aiello. “I’m teaching them information, giving them resources…giving them choices that letting them know what the process could look like so that they can make the best, informed decision for themselves.”
When Ms. Hulka went into labor, Ms. Thibodeau was the first person she called. Ms. Hulka and her husband then met their doula at the Martha’s Vineyard Hospital.
Ms. Hulka said that the time spent planning with Ms. Thibodeau ensured that she had the support she and her husband needed during labor.
“She was not going with those fancy phrases…affirmations or stuff like that, I’m not really that kind of person, but she knew that what’s important for me is to gently remind me by touch or by breathing with me,” Ms. Hulka said. “She really helped me whenever I forgot to breathe. And I remember her hands, like okay, you can squeeze me no matter how hard.”
Mr. Hulka added that Ms. Thibodeau brought a transcutaneous electrical nerve stimulation (TENS) unit to help his wife with labor pains. The couple practiced with the machine at home ahead of time so they were ready when a strong contraction began.
In addition to bringing equipment and helping create a birth plan, doulas can also speak up for their patient during birth.
“I advocate for them in labor, when women are in a state of intense sensation,” Ms. Aiello said. “I’m not expecting them to speak up and it’s oftentimes my voice that is heard.”
The doulas on the Island often work together and they came together to help the Hulkas following the birth of their son.
“When we were released from the hospital, we didn’t have much formula. It was the end of the day, and I didn’t know how to get more,” said Ms. Hulka. “We just spread the word through the doulas…they grabbed a couple bags of frozen milk…the network of doulas was really helpful.”
Ms. Hulka added that doulas came to her house to help her improve her breastfeeding technique.
Ms. Thibodeau said that’s just part of the job.
“Having a baby is profoundly complicated,” Ms. Thibodeau said. “There’s nothing anyone can say that really fully prepares you for how life changing having a child is.”
