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CT to cover doulas, breastfeeding support for pregnant Medicaid patients by next summer

As the national maternal mortality rate continues to rise, the state is stepping up its Medicaid program to protect and care for its pregnant patients.

In a program beginning next summer, pregnant women under HUSKY, Connecticut’s Medicaid program, will be able to get covered help from doulas and breastfeeding specialists, according to the state Department of Human Services.

Coverage has already opened for pregnant patients. In April, those who are pregnant and meet the income requirements began to qualify for antenatal care regardless of their immigration status, opening care to approximately 1,400 patients per year. Nearly 600 people have already signed up, Commissioner Deidre Gifford told a news conference earlier this month.


“As an obstetrician-gynecologist, I know first-hand the critical importance of early and regular prenatal care for a healthy pregnancy outcome,” Gifford said.

Eligible HUSKY members also began to receive more postpartum coverage. Initially just two months long, the program expanded to 12 months starting in April.

Authorities are adding these services to help new mothers and try to prevent pregnancy-related deaths. Although rare, these deaths occur, and disproportionately among black patients or patients on Medicaid, according to Connecticut Maternal Mortality Review Committee data.

“This is a situation that needs to be addressed urgently,” Gifford said.

Of the roughly 35,000 births Connecticut sees per year, HUSKY Health covers about 14,000 each year, according to DSS spokesman David Dearborn.

The Report of the Connecticut Maternal Mortality Review Committee 62 pregnancy-related deaths from 2015 to 2019, or deaths occurring during pregnancy or within one year of termination of pregnancy, regardless of cause. It could mean complications during pregnancy or an unrelated car accident.

The state Department of Public Health said data on maternity-related deaths in 2020 and 2021 were not yet ready for release.

Black patients and patients who had Medicaid for insurance were overrepresented in these deaths. Despite accounting for just 13.1% of live births, black patients accounted for 27% of pregnancy-related deaths, according to the report. Medicaid patients accounted for 37% of live births but 68% of deaths.

Of those 62 deaths, 25, or about 40%, were directly related to pregnancy or “causally related to pregnancy or its management”, the committee said in a report. This means the deaths were caused by complications, postpartum depression ending in suicide, unrelated conditions aggravated by pregnancy such as cancer or other related conditions.

Some 33 of them were unrelated to pregnancy, but occurred during pregnancy or within a year of termination, and four were undetermined.

The committee determined that 45 of the 62 deaths were preventable, 22 of which were pregnancy-related.

Nationally, centers for disease control and prevention reported more than 2,200 maternal deaths from 2018 to 2020. And blacks, Native Americans, and Alaska Natives are two to three times more likely to die from pregnancy-related causes than whites.

The maternal mortality rate has also increased nationwide in recent years; going from 17.4 maternal deaths per 100,000 births to 23.8 per 100,000 in 2020. It went from 658 in 2018, to 754 in 2019 to 861 in 2020.

Nearly two-thirds of pregnancy-related deaths are preventable, according to the CDC.

By summer 2023, the Department of Social Services is implementing a maternity package that will incorporate doulas and breastfeeding support. With the bundle, Gifford hopes to address “birth disparities and outcomes, with a particular focus on women of color and those with substance use disorders.” »

Cynthia Hayes, doula practitioner and lactation consultant, says doulas are birthing professionals. Although not medical professionals, “we are here simply to support the biological parent before birth, during childbirth and also after childbirth,” she told a conference of hurry.

Doulas will be able to help reduce C-section rates and help new mothers breastfeed and support families in the way they need, Hayes added.

The maternity package will be similar to what state employees receive, but with doulas, according to Dearborn.

The Department of Public Health is also working to get doulas certified as independent providers in the state. However, DSS does not need the certification to use doulas in the bundle, Dearborn said.

To further support postpartum patients, starting this fall, the agency is piloting a program to further support postpartum patients. Gifford called it a universal home visiting and community health worker program, and it will start in Bridgeport.

This means that every family will have access to a home visit from a qualified registered nurse to help mothers and babies after delivery. These nurses will screen for domestic violence, substance use disorders and depression, as well as check on the baby’s health and development and provide education and support to families. This program can also refer patients who need additional support to other programs.

For more information about these programs, or if you have any questions or concerns about your pregnancy or your child’s development, call 211 or visit CDI.211CT.org.