Ohio Doulas Face Certification Hurdles Amid Medicaid Challenges

Tensions are rising in Ohio between doulas and the state Board of Nursing as the certification of doulas for Medicaid reimbursement becomes increasingly contentious. With over 60,000 births annually in Ohio covered by Medicaid, the demand for doulas—who research indicates can significantly lower risks for mothers and infants—has never been higher.

However, there is a major hurdle: only 132 doulas in the state are certified to receive Medicaid payments. Dr. Marie McCausland, chair of the state’s Doula Advisory Group, highlights the pressing need for more doulas, stating, ‘To meet the demand, about 3,000 need to be certified.’

Dr. McCausland criticized the existing certification process, describing it as ‘top-down and exclusionary.’ She expressed concerns about a recent legislative change that stripped doulas of leadership roles within the advisory group, a decision she claims was made without sufficient collaboration.

‘Day one, the first meeting, they already had almost all the rules written,’ said McCausland. ‘They sent it to us and we were supposed to start there, versus any sort of collaborative writing of the rules.’

In a statement, the Ohio Board of Nursing defended the leadership change, asserting it was necessary to maintain consistency across professions. Yet, McCausland raised alarms that even doulas serving families without Medicaid coverage are being turned away due to the lack of new certification.

Guillermo Bervejillo from Children’s Defense Fund Ohio remarked on the state’s focus on improving doula access, stating, ‘Gov. DeWine made it a priority to reduce infant mortality, especially among Black children. However, the Board of Nursing may be undermining that effort.’

Concerns about representation have also emerged; McCausland noted that Black voices on the advisory group have often been overlooked, with some even omitted from official documentation. In response, the group has taken action to ensure accurate records.

‘Doulas are happy to come into hospital systems and work with doctors and nurses,’ said McCausland. ‘We want to be able to work as a team for our clients’ success.’ The Board of Nursing has stated its commitment to maternal health and continues to refine the certification process for doulas.