LAME DEER, Mont. — Misty Pipe had about an hour before her shift began at the post office. She used that time to check in on a new mom who lives a few miles outside this town at the heart of the Northern Cheyenne Indian Reservation.
A mom of seven, Pipe is a doula on the reservation who supports new and expectant parents. She does that work free, around her day job. That’s because in this town of about 2,000 people, the closest hospital that delivers babies is 100 miles away.
“Women need this help,” Pipe said.
Doulas ready parents for childbirth, support their deliveries, and can be a steady presence in a baby’s first months. Studies link their work with lower rates of costly birth and postpartum complications — especially in hard-to-reach places like Lame Deer.
But that help can be scarce. As Pipe put it: “Doula doesn’t pay the bills around here.”
Things were supposed to change this year. Montana was set to join at least 25 other states that reimburse doulas through their Medicaid programs to ease gaps in care. Montana lawmakers approved the payments last year, authorizing up to $1,600 per pregnancy. Pipe hoped that money would give her the chance to leave her post office job one day to help more parents.
But the state Department of Public Health and Human Services postponed adding doula services to its Medicaid program in late March, citing a bu …