West Virginia families deserve healthy and safe birthing outcomes, but moms and babies are currently facing significant health challenges. While much discussion is rightly focused on mortality rates, deaths are only the tip of the iceberg of infant and maternal health and well-being. Birthing complications, including pre-term births and caesarian sections, incur a significant cost to families and the state each year. Beyond a physical and mental toll, they also cost the state Medicaid program millions of dollars annually in more complicated births and lengthier hospital stays. These complications are often preventable. One way to improve all aspects of infant and maternal health is by widening access to doula care and midwifery.
Read the full fact sheet.
Doulas are trained birth workers who provide non-medical support throughout pregnancy, during childbirth, and after the end of pregnancy. They act as support for pregnant persons, ensuring that their questions are answered, their needs and desires are represented, and they feel comfortable and safe.
Meanwhile, certified professional midwives (CPMs) are health care providers trained to provide medical services during and after pregnancy and childbirth. They work alongside hospitals, and often doulas, to provide holistic care services to support healthy pregnancies.
Studies show that having a doula and/or midwife can improve pregnancy, birth, and post-birth outcomes. It can also mitigate racial and regional disparities in birthing outcomes across West Virginia, which has worse outcomes than the United States average.
As obstetrics and gynecology hospital units continue to close across the state, increasing access to caregivers like doulas and midwives becomes increasingly important. They can bring health care to families that may otherwise lack access for a myriad of reasons. In 2006, West Virginia had 35 obstetrics and gynecology hospital units across the state. In 2024, there were 20, with significant swaths of the state having no units at all. This has contributed to longer travel times to maternity care providers and delivery centers, which can be logistically challenging due to lack of transportation, child care, flexible work hours, and other factors. March of Dimes found that living in a maternal care desert decreases the likelihood of receiving prenatal care and increases the risk of a pre-term birth by 13 percent.
Providing doula coverage in Medicaid pays for itself multiple times over nearly immediately via reduced c-sections and pre-term births. The WVCBP’s analysis shows a cost-savings of 2.5 times the cost at any utilization level. For instance, if doulas assisted one in five Medicaid-covered pregnancies, West Virginia could save over $1 million annually while spending less than $400,000 and simultaneously improve birthing outcomes across the state.
West Virginia is one of just 12 states that do not have a path to licensure for Certified Professional Midwives (CPMs). Enacting legislation to give CPMs this path to licensure would increase access to maternal care throughout the state and strengthen the health workforce.
Studies show having a doula and/or midwife present throughout pregnancy and postpartum significantly improved birthing outcomes. These outcomes include fewer c-sections and pre-term births, as well as lower rates of postpartum depression and anxiety and higher rates of breastfeeding.
