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Proposed Bill Would Encourage Doula Services

Legislation aims to reduce pregnancy-related deaths.

A bill that would allow for the Tennessee Department of Health to “collaborate with the bureau of TennCare in order to study existing doula certification programs” is headed to the House for consideration on April 18.

Senator London Lamar (D-Memphis) introduced Senate Bill 0394, and during a senate floor session on April 13, Lamar moved for third and final consideration of the bill. Lamar explained that as amended, it would rewrite the bill to “create a five-member doula services advisory committee.”

The text of the bill explains that the advisory committee will “advise the department of health by establishing core competencies and standards for the provision of doula services” in Tennessee. The bill also recommends reimbursement rates and fee schedules for TennCare reimbursement for doula services.

The amendment defines a doula as a “birth worker who provides childbirth education, advocacy, and physical, emotional, and nonmedical support for pregnant and postpartum women before, during, and after childbirth.”

“Doulas are vital members of the child birthing team and have proved to reduce the rates of maternal [and] infant mortality,” said Lamar.

A report from the Centers for Disease Control and Prevention (CDC) showed that the U.S. maternal mortality rate had increased 40 percent from 2020 to 2021.

The report also stated that the rates for Black women “were significantly higher than rates for White and Hispanic women.”

The 2021 Tennessee Maternal Mortality Rate Annual Report showed that “non-Hispanic Black women” are 3.9 times as likely to die from pregnancy-related causes compared to “non-Hispanic white women.”  President and CEO Jennifer Pepper of CHOICES: Center for Reproductive Health told the Flyer in March that both the maternal and infant mortality rate crisis in Tennessee is “dire, particularly for Black women.”

While efforts are being made to help reduce Tennessee’s mortality rate, there are other obstacles that stand in the way of this.

Mayoral candidate Michelle McKissack is urging Governor Bill Lee to provide emergency state funding for maternal health after a presentation by the Tennessee Department of Finance and Administration last week proposed that $19 million in state funds be used for programs that would have been covered by federal funds. 

According to a statement from McKissack’s office, Tennessee became ineligible for federal Title X funding as a result of “the state’s abortion ban and refusal to provide a full spectrum of reproductive health education that would include information about abortions.”

According to the U.S. Department of Health and Human services, “The HHS Office of Population Affairs (OPA) funds Title X family planning service grantees who support hundreds of subrecipients and thousands of service sites.” HHS defines family planning services as those that are related to “achieving pregnancy, preventing pregnancy, and assisting women, men, and couples with achieving their desired number and spacing of children.”

McKissack said that Lee has “floated the idea of amending the state budget to include $7.5 million in recurring funding for family planning for low-income women,” to replace the Title X grant, however McKissack is calling on elected officials to do more for women, who she refers to as “our most vulnerable population.”

This funding impacts birth control, pregnancy testing and basic infertility services for low-income individuals. According to McKissack, this will have a “deadly” impact on women and mothers in Memphis, especially Black women.

“Lack of access to quality maternal care, lack of access to family planning resources and education, and lack of access to reproductive care that includes abortions, is a trifecta for worsening the number of preventable pregnancy-related deaths in Memphis and statewide,” said  McKissack. “These deaths will primarily be Black women. This is unacceptable.”