Are postpartum doulas covered by insurance?
If you are passionate about providing postpartum support, the experience is undeniably rewarding. You’re making a positive impact during one of the most vulnerable, sensitive and meaningful transitions in a person’s life. It’s a feeling like no other!
However, there are some downsides to being a postpartum care professional in a world that doesn’t value postpartum support. Unsurprisingly, postpartum experiences in our culture aren’t all sunshine and rainbows. As a postpartum professional, taking care of your mental and physical health is essential. You need firm support for your own life and household so you can tend to your clients without burning out.
One of the biggest downsides is the lack of publicly funded employment opportunities. Most of our graduates start their own businesses and are paid privately by their clients. If you’ve never started a business, this can feel quite daunting, but the good news is we teach business and marketing skills inside Newborn Mothers Postpartum Education and Care Training.
It takes time to establish a reliable income; however, in the long run, the flexibility of running your own business can be very rewarding. Many of our students now earn more money than they did in their previous careers, but there is no such thing as an overnight success! It takes persistence and determination.
What kind of insurance is required for providing postpartum support?
Most people who work with parents and newborns have Professional Indemnity and Public Liability insurance to cover them from risks at work.
Public Liability insurance covers you for any injury or property damage in connection to your business. For example, a client might trip and fall at a new mothers group you’re running. Or—if you’re a birthworker—you might drop a client's camera into the birth pool. Public Liability insurance covers you for those types of incidents. This kind of insurance is often required to hire venues like community halls. This can be useful if you plan to offer pre-natal classes, mothers circles, breastfeeding support groups or similar gatherings.
Professional Indemnity insurance protects you against the risks associated with providing information to clients. Doulas and other postpartum care providers do not carry out clinical tasks or give medical advice, however, there’s a chance a client might misunderstand your role or misinterpret the information they’ve been given and blame you for an unwanted outcome. This is when Professional Liability insurance can protect you.
Even if you never need it, Professional Indemnity and Public Liability insurance can give you peace of mind in running your business and working with clients.
Can clients claim doula fees on insurance, or is there any public funding for doula support?
If you’re considering becoming a doula—or Postpartum Education and Care Professional—one of the biggest questions you might have is whether or not insurance will cover the fees for your clients.
Over the past decade, birthworkers and postpartum care professionals have grown in popularity in Australia and other parts of the world. They are becoming more recognised in popular culture and by medical professionals. However, there is little public funding or private health insurance coverage available for people to access this kind of essential support.
A postpartum support professional can be a significant financial investment for some families. While there is a robust body of evidence to support the value of good postpartum care, it’s often regarded as a luxury in our culture.
Some clients may ask you whether their private health insurance or public health funding will cover any, if not all, of your cost. Let’s look at answering that question for the United States, Canada and Australia.
If you have more information on funding where you live, please leave us a comment—we would love to know about your experience with this issue.
United States
In the US, doulas are not generally covered by commercial insurance. There may be exceptions, but claims must be submitted to insurance companies, and it typically involves jumping through many hoops to get any type of reimbursement.
This article provides a great breakdown of how people can file an insurance claim for a doula. Some doulas have experience filing claims and can help their clients with this logistical task. If they are part of an agency, they may have a process in place for this.
Since commercial insurance typically won’t cover the cost of a postpartum care professional, new parents may be able to use their Health Savings Account (HSA) or Flexible Spending Account (FSA).
As of 2020, Minnesota, New Jersey, Indiana and Oregon mandate coverage of doula services through the government-funded program Medicaid. The Doula Medicaid Project is an ongoing effort to ensure birth-giving persons on Medicaid can get doula services covered (if they choose to have one). This is because doulas are considered to provide health benefits, and having one in the delivery room has been proven to decrease complications.
Doulas in the US can also now register a National Provider Identification (NPI) number so clients can submit claims to their insurance along with a doula-specific Current Procedural Terminology (CPT) code. Not many people have had luck with getting postpartum support services covered, but if they do, it’s under a reimbursement, so your client will have to pay you in full for services first.
Canada
In Canada, doulas aren’t covered under commercial insurance, but doula groups and agencies are working towards getting their services recognised as necessary for birthing persons.
Some people will have extended health insurance/benefits through their work, and within these benefits, they may have funding for a doula. Birthing families may have a health spending account to pull from or money for a doula specifically - they just need to check with their extended health plan.
Perinatal Support Worker (PNSW) is a new training qualification that has been gaining some recognition and funding. The PNSW program is an accredited, advanced program that covers the period from fertility to postpartum and into the first year of a newborn's life. The PNSW's unique education and training allow them to support persons who are experiencing a wide range of circumstances such as disability, medically high risk, socially high risk, perinatal bereavement, mental health issues and more. It should be noted that PNSWs can be covered by private health insurance if the client has coverage for a Personal Support Worker and if their healthcare professional is willing to complete the paperwork.
Australia
In Australia, doulas, birthworkers, and postpartum support professionals aren’t covered under any type of private health insurance. They are also not covered under Medicare, the main form of public health coverage in Australia.
There are a few funded doula programs in specific geographic locations and in niches, including philanthropically funded Birth for Humankind for refugees in Melbourne. It is also possible that people with disabilities may be able to have their doula care covered by NDIS funding. There is an acclaimed Mothercarer, post-natal support service available through Lyell McEwin Hospital in South Australia.
If you feel disappointed by the lack of funding for postpartum care where you live, please write to your elected representative and contact your private health insurance fund.
What about tax deductions?
In some parts of the world, perinatal care can be claimed as a tax deduction. In Ontario, Canada, for example, postpartum support is in the same category for tax purposes as childcare, which is tax deductible. Expectant parents may wish to talk to their accountant to see what tax deductions are available. Depending on the area you serve, this could be something you suggest to your birth or postpartum clients.
Should I have a contract with my clients?
To put it simply, yes! All doulas, birthworkers and postpartum care providers of any kind should have a contract with their clients. It’s essential to have a paper trail to ensure that the client receives the services asked for, the professional is paid for them, and both parties clearly understand the scope of the role.
Never cut and paste a contract or any other legal document from someone else’s website, as it may not be relevant to you, your country, or your services. Copying and pasting a legal document could even be an infringement of copyright law. Even if this type of plagiarism is not intended maliciously, it is still against the law and may leave you exposed if you haven't fully understood the implications of the legal documents you have copied.
Getting legal advice is highly recommended, but if you’re really keen to write your contract yourself, make sure you do it in your own words.
Newborn Mothers have worked with lawyer Michelle Whitehead to create a DIY template contract that you purchase here. You can also find other useful legal documents such as Website Terms & Conditions and Privacy Policy available as DIY packs. This is an affiliate link and I will earn a small commission when you use it to purchase.
Finally, make sure you have read and understood your entire contract front to back and back to front before sending it to a client. Encourage your clients to read the entire thing so everyone is on the same page.
Are doulas and postpartum professionals required to be vaccinated?
Given that non-medical postpartum support is not a regulated industry, doulas are not generally required to be vaccinated. There are some exceptions, like certain doula agencies or some niche-funded programs.
Even though it’s not required, vaccination against COVID-19 is recommended, along with vaccination against other diseases that pose a significant risk to pregnant women and new babies, including chicken pox and whooping cough. If you are unsure of what vaccinations are worth getting, find out what midwives in your local area must do and use this as a guide.
You can still offer your services to pregnant and postpartum families if you are not vaccinated. However, you should be clear about this with your clients. Being upfront helps your clients make informed choices and ensures everyone is on the same page.
Keep in mind other consequences of not being vaccinated; for example, if you plan to visit hospitals, this may be more difficult depending on the regulations they have in place.
Are doulas welcome in hospitals?
COVID-19 affected the allowance of doulas into hospital rooms, and at times, hospitals forced birthing people to choose between having their doula or partner in the delivery room. There are quite a few first-hand reports about how distressing and isolating this was for birthing and postpartum families. Thankfully, most of these pandemic-related restrictions were lifted after a few months. Nowadays, it may depend on the hospital and the specific risks and restrictions where you live.
Some public hospitals welcome birth doulas and postpartum professionals as long as they practice within their scope. Doctors and midwives can be quite appreciative of the extra support doulas provide. In other areas, doulas may experience obstacles to supporting their clients in hospitals or medical settings. It may be worthwhile researching how the hospitals in your local area typically regard doulas.
Changing the experience of postpartum
Newborn Mothers Postpartum Education and Care Training is for anyone who feels called to work with new families during the life-changing transformation of becoming parents. The World Health Organisation has acknowledged that the postnatal period is a critical life phase for mothers and newborn babies; however, it’s also the most neglected period when it comes to quality care.
Our ultimate wish with our Postpartum Education and Care Training is to provide the tools and skills you need to support families while developing the business know-how you need. Many Newborn Mothers graduates have gone on to create fulfilling and sustainable careers—you can listen to their stories here.
If you would like to change the way birth givers experience the transition to parenthood, learn more about our evidence-based training here.
I have partnered with my lawyer Michelle Whitehead to create a DIY legal template for you to customise with your details. It contains all of the basics from the Client Service Agreement, including disclaimers, payment terms, dispute resolution, refunds, and much, much more.
Here is my affiliate link for Michelle Whitehead’s DIY legal documents for doulas.
https://www.carefreecounsel.com/product/doula-agreement/?ref=71
Go to Legals > DIY Legal Docs > Doula Agreement.
