Kristen Subach says she was “mentally unprepared” for giving birth when expecting her first child. When she sought guidance from a health care professional, the Rehoboth Beach mother says she felt “brushed off.” Then someone introduced her to the idea of a doula—a nonmedical support person—and Subach and her husband immediately knew that’s what they needed.
Doulas provide education, resources, and assistance throughout pregnancy, birthing, and early postpartum. As of January 1, 2024, Delaware requires Medicaid and all insurance providers to offer coverage for doula services.
“Doulas are advocates who give families extra support and a voice,” explains state Sen. Marie Pinkney, a co-sponsor of the legislation. She sees it as helping to lower Delaware’s maternal mortality and morbidity rates, particularly in disproportionately affected minority populations.
To be covered under Medicaid, doulas must be certified. Certification includes training in lactation support, childbirth education, nonmedical comfort measures, prenatal care, labor techniques, and postpartum assistance.
Subach’s doula helped create a birth plan, attended prenatal courses with Subach, and stayed by her side through more than 24 hours of labor. She provided massages for pain relief, encouraged position changes for pushing, advocated with medical personnel, and even guided Subach through an episiotomy procedure.
“She was just the person I needed,” says Subach, noting that her doula provided support for her entire family. “She took charge and made everything seamless.”
Families working with doulas should inform their hospital and care team. With the growing number of doulas in Delaware, many hospitals are evaluating procedures on the role doulas play.
Beebe Healthcare in Lewes, for example, is developing a policy. In the interim, the facility affirms medical decisions rest with physicians and nurses, while recognizing doulas as part of the patient’s care team, rather than a visitor.
Doulas bring a different level of professionalism, adds Erica Allen, a doula and the executive director of the Do Care Doula Foundation, a Dover-based nonprofit that trains doulas and offers free or low-cost services for those in need. While Allen says she is pleased that the number of doulas in Delaware has grown dramatically, she advises clients to do their research before hiring. “Not all doulas are created equal,” she cautions.
Allen recommends interviewing several candidates, reviewing training certifications, and asking about backgrounds and services. “Get a feel for [whom] you’d like to work with,” she advises.
Subach agrees. “There are plenty of awkward moments during childbirth,” she says. “It’s important to choose someone you’re completely comfortable with.”
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