Ohio officials recently created a pathway for doulas to become state certified so they can be reimbursed through Medicaid for their services.
It's a part of an effort to decrease infant and maternal deaths in the state.
But the doulas who advise the Ohio Board of Nursing on policies say that instead of taking their concerns seriously, the state is taking away their power and influence.
Doulas advocate for people during pregnancy, birth and postpartum care.
Evidence shows doulas improve outcomes for babies and moms, and are a part of a slate of efforts the state has made in the past few years to improve mortality rates.
But members of Ohio's Doula Advisory Board say there have been issues since the state rolled out the certification process last year. And instead of listening, state officials instead made moves to limit the doulas' power.
"You guys keep asking us like, 'well, what can we do, what more can we do,' you can actually listen to us," said Jamaica Gilliam, a doula in the Cincinnati area.
Doulas convened at a meeting of the advisory group last week in a conference room at the Rhodes Tower in downtown Columbus.
In addition to a dozen or so other observers and participants, the room was filled with at least a dozen doulas, almost all of whom were women.
Someone convinced lawmakers to change the law and call the board a group, while taking away its ability to elect its own leader and set its own agenda.
Joe Quackenbush, the only man in the group, will be the group chairman. He was appointed to the position by the Ohio Board of Nursing. Quakenbush has no experience as a doula.
The group originally elected maternal health advocate Marie McClausland to be board chair.
Nursing board spokesman Dean Heid said the change in leadership was made for "consistency," but didn't confirm if the change was made at the request of the nursing board.
At the same time the board changed leadership, lawmakers also changed the wording of what it means to be an Ohio-certified doula, a change that the advisory group fought for and asked the nursing board to get changed.
WOSU has requested information from the Ohio Board of Nursing about how the suggested changes made it to lawmakers’ desks.
Marlene Anielski, executive director of The Ohio Board of Nursing, argues the advisory group expects too much power.
"We have the advisory group and they have been educated as to what their role is. I think that not all members perhaps understand that they are an advisory role, and I think they also don't understand that we don't control the legislature," she said.
Gilliam said many doulas don't believe the board of nursing is even the proper board to certify doulas, since doulas don't provide medical services.
"You have something that is very clinical that is overseeing something that is not very clinical," Gilliam said.
Though advisory groups have little power, this group has had successes, like getting changes made to the application process to become certified by the state as a doula to make it more user friendly. But there are still issues with the application that haven't been resolved.
Some of the members say they raise issues at group meetings that take a long time to get resolved or go ignored.
And the group made a discovery at their latest meeting. Doulas that have been certified and billing Medicaid since October when the program kicked off, have yet to be paid anything from the state. It revealed a statewide Medicaid claims payment problem. But the doulas weren't aware why their claims were being rejected.
"I have concerns, but we're still not there, that there's still things that have been discussed and talked about and haven't been addressed," said group member Erica Paulson. "And then...and we start this meeting of this year with a new chair. These are the problems. They're actually things that you do have control over, that you are intentionally doing, and that are holding us back in our efforts."
