Arkansas doulas await Medicaid coverage rollout, say delays leave mothers without support
Doulas say the legislation was a significant step forward, but the wait for implementation has been frustrating.
ARKANSAS, USA — As Arkansas works to implement Medicaid coverage for doula services, some doulas say the delay is preventing expectant mothers from accessing critical support during pregnancy and childbirth.
For community-based doula Cashel Robert, helping mothers navigate pregnancy, labor, and postpartum care is about ensuring they have someone in their corner.
Robert works with families to create birth plans, understand medical information, and advocate for themselves throughout the birthing process.
“Our governor, she signed the bill. She said that doulas should get paid through Medicaid, but it seems like there’s a bottleneck, and the problem with that is paperwork, bureaucracy,” Robert said.
Last year, Arkansas approved Medicaid coverage for doula services as part of a broader effort to improve maternal health outcomes. Supporters say doulas can help reduce barriers to care by providing education, emotional support, and advocacy before, during, and after birth.
While doulas say the legislation was a significant step forward, they say the wait for implementation has been frustrating.
“We cannot lose sight of the fact that this is only the first step, and every month that passes that we don’t have reimbursement active is a month that people are going without support,” said Whitney Hardie, owner of Bentonville Birth Services.
Hardie said delays in implementation mean some families who could benefit from doula care are still unable to access services through Medicaid.
She also expressed concerns about reimbursement rates under the proposed program.
“If the reimbursement rates are as low as they currently are, there are many doulas who will not be able to use this as a sustainable form of income,” Hardie said.
In a statement to 5NEWS, the Arkansas Department of Human Services said:
“We wanted to take the time to get our maternal health rule right, which means we have worked closely with and received feedback from key groups and partners, and reviewed numerous stakeholder comments. We have also engaged in multiple rounds of reviews and questions with the Centers for Medicare and Medicaid Services, primarily around rate setting regarding the Doula and lactation consulting rules. This is a necessary and ongoing process. We are investing significant resources into ensuring a successful program implementation, and we look forward to sharing updates in the near future.”
“It’s going to take time for us to get credentialed, it’s going to take time for DHS to process our paperwork, and you shouldn’t have all this red tape in order to proceed, because I’m going to help that mom. If a mom is giving birth right now, but I don’t get paid for six months, I’m still going to help that mom,” Robert said.
Both doulas said they are encouraged by the state’s efforts to expand maternal health resources but hope the process moves forward quickly so more Arkansas mothers can receive support during pregnancy and childbirth.