Changes in the current health insurance marketplace are likely coming. Here's our summary of what is currently offered under the Affordable Care Act for pregnancy and the postpartum period, and what changes will likely occur under the new administration.
Breastfeeding benefits under ObamaCare:
1. Health insurance must cover the cost of a breast pump.
2. Breastfeeding support and counseling must be covered by health insurance before and after birth, and must be covered for the duration of breastfeeding.
3. The ACA amended the Fair Labor Standards Act to protect breastfeeding moms who need to pump at work. The ACA required that employers with at least 50 employees must allow the time and a space--"other than a bathroom, that is shielded from view and free from intrusion by coworkers and the public"--for a mother to express breast milk for the first year after the birth of her baby. The law only applies to hourly wage employees, not salaried workers.
What might change:
1. Before the current healthcare laws, pregnancy could be classified as a pre-existing condition, and therefore maternity care and childbirth coverage could be denied by insurers. Currently, maternity care and childbirth must be covered by all insurance plans, even if the pregnancy began before coverage started.
2. The birth of a baby means that you are eligible for a special enrollment period, meaning you can enroll your newborn in a health insurance plan at any time and coverage will begin from the date of birth, rather than having to wait for the open enrollment period.
3. Medicaid expanded under the Affordable Care Act, making it accessible for a broader range of incomes and circumstances. Under Medicaid, a long list of prenatal and postpartum care is available without cost to the individual, including: birth control and family planning services, screening for gestational diabetes, HIV and sexually transmitted infection screening and counseling, interpersonal violence screening, and breastfeeding support.
4. The ACA put limits on out-of-pocket expenses, meaning that high-risk pregnancies and infants who need hospitalization and intensive care are less likely to create insurmountable cost burdens for families.
5. Lower- to moderate- income families are eligible for premium tax credits if they do not qualify for Medicaid or for coverage through an employer and they have coverage under a qualified health plan. Under the ACA, if a woman becomes pregnant and is therefore eligible for Medicaid coverage, she will not lose her premium tax credit.
What might change:
1. All qualified health plans must include family planning and contraceptive care at no cost to the individual.
What might change:
Other benefits specific to women that might change:
1. Well-woman check-ups, and preventative screenings for breast cancer and cervical cancer must be covered with no cost-sharing (no deductible, co-pay, etc.)
2. "Gender rating" (charging women higher premiums than men for their health insurance) is prohibited under the ACA.
3. Mental health benefits, including treatment of postpartum mood disorders such as postpartum depression and anxiety, postpartum OCD, and PTSD, are included in "essential health benefits" and must be covered by qualified health plans. Previous mental health issues cannot be grounds for denying coverage, and for most plans there can be no caps on the number of covered visits for psychotherapy.
Maternal health matters to us all. Let us hope that the majority of American women have access to quality affordable healthcare, including maternity care, childbirth coverage, routine preventative screenings, and mental healthcare in the future.
--written by Rachel Brinker
One of the wondrous--and sometimes terrifying--things about birth is that so much of it is completely out of our control.
Sometimes a birth goes exactly how the parents wish for it to go, and sometimes it doesn't. One of the most common struggles we hear as postpartum doulas is that of women who wanted a natural birth but ended up with interventions, medication, or a cesarean. Because they didn't have the "natural" birth they wanted, they feel like they failed somehow. Friends and family will often say, "Well, you and the baby are healthy, that's all that matters."
It's not all that matters. How you feel about your birth has huge impacts on your identity as a mother, and going through a traumatic birth experiences puts you at greater risk for postpartum mood issues.
This failure felt by some women who wanted a "natural" birth but missed out on that experience is something that sometimes gets dismissed and brushed aside in the homebirth and natural birth communities. In order to be seen as legitimate, the focus has been on the benefits of "physiologic" birth (birth without medication or interventions), on the beautiful potential of such a birth, and on the dangers associated with medical interventions. Too often, there has been a one-sided message from the natural birth community, and an us vs. them mentality. When there are just two teams, the Uses and the Thems, there are lots of postpartum women stuck somewhere in the middle--supporting the choice to have a natural birth or a homebirth, but having had some interventions in their own birth--not knowing why they feel like they've suddenly been kicked off the team.
The message that one kind of birth is better than another kind of birth is hurting women.
Many women are left feeling like they failed if their birth didn't match the "natural birth" ideal they were hoping for. This podcast episode from The Longest Shortest Time includes an interview on this very issue with the matriarch of the natural birth movement herself, Ina May Gaskin.
Ina says, "You're not alone if you experienced a lot of pain and you felt like you failed. I mean, there's so many women that feel that way. Maybe it was because of expectations that were on the unrealistic side...That it [a natural birth] would be possible because you did everything right, everything the book told you, and then you still had pain, and you feel like you weren't correctly advised, you know, you were misled somehow."
It impacts women's postpartum experience when they receive the message that if a certain outcome--like an induction, a homebirth transfer, cesarean, use of an epidural, a perineal tear, interventions for your baby, etc.--happens, then they have somehow failed at birth. Ina May herself admits that the messaging of the natural birth community may be contributing to this common feeling of failure. We hope this message shifts and opens up space for ALL women to celebrate their birth experience rather than judge it as a good/natural birth or a failed/medical birth.
No matter what happens during your pregnancy, labor, and postpartum period, here's the bottom line:
Birth is a process, something you move through, largely without control, not something you attain. Birth is not something that you can fail. Your birth was its own process, unique to you and your circumstances.
You were strong. You were amazing. You had reasons for making the decisions you did.
If you hoped for a birth free from all interventions but ended up with, say, an epidural and a cesarean birth, it's ok to feel conflicting emotions about that. It's ok to be disappointed, it's ok to ask questions and process your feelings about what happened. You may also feel relieved, overjoyed, and frankly just tired and glad it's over. All of it is ok and valid.
You were brave. You were beautiful. You were powerful.
You gave birth!
--Written by Rachael Sudhalter
I talked it over with my husband, and we took the leap...we did it. Our first one! There were bumps and bruises, things didn't always go as planned. We went along, making it up as we went, consulting those who had gone before us. It seemed to make our life more seamless, Our new addition fit in perfectly.
Then we had the talk--should we have a second one? Would it work? Could we handle it? We talked it over again with our son. Our family and friends encouraged us and supported us along the way. It would be double the pressure, double the noise, double the work. Could a second one blend into our already busy family? Would it simplify things or make it harder?
We decided. Yes, we want another one.
Our second one came. We now had two! Twice the pressure! Twice the fun! I don't know how we lived so long with just one.
One was great, two was FANTASTIC!
It's been two months now, and I can't imagine my life without them. They fit so nicely in our family.
My husband, son, and I are in love!
Yes, we are the proud owners of TWO Instant Pots.
If you haven't heard of them, check them out. It makes meal preparation with a family SO much easier. Hardboiled eggs in 12 min total. Frozen chicken on your plate in an hour. Rice, 15 min. I heard you can do cheesecake in it, too.
And the BEST part is you don't have to stand there and watch the stove. It is a pressure cooker and crockpot all in one. Dump in ingredients, turn on the right setting, and walk away.
Family life is busy and there is not always time to cook a wholesome meal. The Instant Pot has made it more feasible for my family to eat nutritiously. Having a baby can create some big changes in the way you plan and prepare your meals. As your postpartum doula, I can show you many tips and tricks if you are floundering with meal planning. And if you are an Instant Pot owner, I'll make my favorite recipe for you!
(There are no affiliate links in this post--I just love the Instant Pot!)
Are you a birth professional of excellence?
We are now accepting Letters of Intent to join our team in 2017.
Proud Mama Support Services is growing into a full-service doula agency! We are looking for compassionate and professional birth doulas, postpartum doulas, newborn care specialists, lactation professionals, childbirth and parenting educators, and placenta services specialists to join the Proud Mama Support Services team. We are committed to providing communities in the Willamette Valley with top-quality perinatal support, and elevating the role of doulas and other birth support professionals in the eyes of the public, medical professionals, and doulas themselves. We are looking for the right doulas and birth support professionals who share this vision to join our team.
What we offer birth services professionals:
What we are looking for:
Download the Call for Letters of Intent below for complete details of how to apply.
The deadline to apply is February 1, 2017. Offers will be made by February 20, 2017. Questions can be directed to firstname.lastname@example.org