BILLINGS — A bill that would increase access to doulas across the state is close to becoming Montana law.
Senate Bill 319 has passed the Montana Senate and is pending in the House.
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SB 319 aims to expand access to doula care by increasing the accessibility to certification programs, as well as having the services covered by Medicaid, so low-income families aren't paying out of pocket.
That certification program would be through the Department of Labor and Industry.
The bill defines a doula as "a trained, nonmedical professional who provides continuous physical, emotional, and informational support to a pregnant woman during the antepartum or intrapartum period or during the period up to 1 year postpartum."
Doulas are similar to midwives and labor and delivery nurses but focus more on support than medical care.
"We're there to help the birth partners, the birthing person, and help them have that birth that they have been wanting," said doula and founder of Tiny Miracles Doula Services, Jamie Canning.
Canning has been a certified doula for 13 years.
She says she supports expanding access to doula care for lower-income families, but she expresses concern for the statewide certification program, as different doula agencies practice different methods.
"I think (my concern) is just being told how to do your own practice. We all have our strengths and what we like to do. Some like body work, some like oils, and some like hands-on stuff," Canning said Friday.
For instance, Tiny Miracles Doula Services incorporates the body-ready method and hypnobirthing.
While Canning is on the fence and is unsure of the bill's effect on her agency, Amy Stiffarm, a mother and Native American Initiatives Director for Healthy Mothers, Healthy Babies Montana, supports SB 319.
"There is so much potential (in the bill) for good work and for good things to happen in our community when we're talking about reintegrating Indigenous doulas," said Stiffarm on a virtual interview Friday.
Stiffarm, both in her position with the nonprofit and as an Indigenous woman from the Fort Belknap reservation, sees the bill helping Indigenous expecting mothers in the state.
"When I think of Indigenous doulas, I think of the revitalization of these cultural teachings, this cultural knowledge, this language, our Indigenous language about birth, parenting, pregnancy, and postpartum," she said.
The bill aims to support Indigenous expecting families by providing services in accordance with the Indian Health Care Improvement Act, which is a part of the Affordable Care Act.
Providing assistance for Indigenous women was a goal of the bill's sponsor, state Sen. Cora Neumann, a Democrat from the Bozeman area, as she works as the chief community officer for the Native American Development Corporation.
"One of the things that we see throughout healthcare in Native American communities is the connection to culture and connection to traditional practice, and ceremony, is medicine," Neumann said on a virtual interview Wednesday.
Neumann said the culture regarding doulas has changed in the last 20 years in Montana and is growing in demand.
"I do think it's growing and gaining popularity... Maternal mortality rates are high here and complications around childbirth are actually increasing in the United States," she said.
If SB 319 is passed, it would take effect Jan. 1, 2026.
