Being a mom isn’t easy, especially for servicemembers or the partners of those who serve, who are more likely to give birth without their partner around. Thankfully, a new pilot program from TRICARE may help provide these moms with the support that they need before, during, and after the birth of a child.
Starting January 1, 2022, expecting mothers who use TRICARE in the U.S. will have access to the services of a doula and/or lactation consultant as part of a five-year pilot program to examine whether these birthing and breastfeeding consultants can help improve the health outcomes of new moms and babies in the TRICARE program.
Prior to 2022, TRICARE covered all medically-necessary prenatal care (with limitations), medically-necessary services during labor and delivery, and a minimum of two postpartum visits. So, this is a huge step for TRICARE in adding services that are not considered “medically-necessary,” but can pay off when it comes to the mental health of postpartum military moms.
What Is a Doula?
The word “doula” is rooted in ancient Greek, meaning “a woman who serves.” Today, “doula” refers to “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible,” according to DONA International.
Some services a doula may offer include physical comfort (touch, massage, positioning, and breathing assistance); emotional reassurance; facilitating communication between you and the hospital staff; guidance and support for loved ones; assistance with breastfeeding; and physical and emotional support for other reproductive experiences, such as miscarriage, stillbirth, abortion or the postpartum period. These services can be provided during a home birth or in a hospital delivery room.
In some cases, the use of a doula during labor and delivery has been associated with:
- A decreased use of pain relief medication during labor
- A decreased incidence of C-sections
- A decrease in the length of labor
- A decrease in negative childbirth experiences
In addition to critical support doulas provide during labor and delivery, doulas also provide services during the three months immediately following birth, referred to as the “fourth trimester,” a time which accounts for more than half (52%) of pregnancy-related deaths in the U.S. So, there’s a big expectation that the addition of these services under TRICARE could potentially impact outcomes for both the parent giving birth and the infant.
What Does a Postpartum Doula Do?
Each doula’s services vary, and postpartum doulas assist with a range of support and assistance for each member of the household, but especially for you and your newborn baby.
If you’re developing a plan with your postpartum doula, keep in mind the following services and how they may help you in the weeks and months after baby arrives:
- Newborn care: bathing, soothing, diapering
- Breastfeeding support: encouragement, positioning, pumping
- Overnight care: help with newborn care while parents sleep
- Light housekeeping: meal preparation, baby laundry, errands
- Education: babywearing, feeding cues, soothing techniques, and general newborn care
- Maternal care: emotional wellbeing, physical recovery, overall wellness (hydration, rest, nutrition)
- Sibling care: childcare of older children in the household
- Referrals: referrals to local pediatricians, new parent and breastfeeding groups, classes, and therapists
Looking at this list might make any expecting mom think, “Why doesn’t every new mom have a doula?” Well, postpartum doulas can cost anywhere from $20-50 per hour, which can be a hurdle for new parents — especially those living on a single income.
With the new Childbirth and Breastfeeding Support Demonstration, TRICARE will cover up to six visits by a certified labor doula (CLD) services before or after giving birth for pregnant beneficiaries who are at least 20 weeks and under the care of a TRICARE-authorized provider (for example, obstetrician, certified nurse midwife, etc.), as well as one continuous labor support encounter during the birth event.
Finding a TRICARE-Authorized Doula or Lactation Consultant
TRICARE will be updating their network directory to include certified labor doulas, lactation counselors and lactation consultants. Beneficiaries and providers can visit https://tricare.mil/ or contact TRICARE with questions about how to locate participating providers.
Some Limitations of the Program
There are some limitations to the new TRICARE pilot program:
- The doula must be certified by one of five organizations: BirthWorks International; Doulas of North America International; Childbirth and Postpartum Professional Association; International Childbirth Education Association; and toLabor.
- The lactation consultant must be certified by the International Board of Lactation Consultant Examiners or certified as an advanced consultant by the Academy of Lactation Policy and Practice.
- The new benefit does not cover those seen at military treatment facilities.
- The program excludes those who use the U.S. Family Health Plan or Continued Health Care Benefit Program.
- The new program will not be offered to Tricare beneficiaries overseas until Jan. 1, 2025
View the published notice by the Department of Defense (DoD) Defense Health Agency, Establishing a TRICARE Childbirth and Breastfeeding Support Demonstration, for full details.
If you had easier access to, or coverage for, a doula during and after childbirth, would you select doula or lactation support? Let us know in the comments!