Bill Overview
Title: To require the Secretary of Veterans Affairs to conduct a study on the feasability and advisability of furnishing doula services to certain veterans, and for other purposes.
Description: This bill requires the Department of Veterans Affairs (VA) to study the feasibility and advisability of furnishing doula services to pregnant or formerly pregnant veterans (with respect to postpartum care) who are enrolled in the VA health care system.
Sponsors: Rep. Lawrence, Brenda L. [D-MI-14]
Target Audience
Population: Pregnant or postpartum veterans in the VA health care system
Estimated Size: 11492
- The bill targets pregnant or formerly pregnant veterans within the VA health care system.
- There are approximately 2 million female veterans in the US.
- The VA health care system enrolled about 383,092 female veterans as of 2021.
- A significant proportion of these are of childbearing age, considering the demographics of military service.
- Doula services are typically relevant for individuals undergoing pregnancy and postpartum recovery.
- In 2019, it was reported that an estimated 1 in 10 of all living U.S. veterans are women, showing a potentially large group eligible for care.
Reasoning
- The target population is pregnant or formerly pregnant veterans enrolled in the VA health care system.
- Based on available data, approximately 11,492 female veterans are considered current pregnancy or postpartum cases within the VA healthcare system.
- The budget of $2,000,000 USD in Year 1 allows for the initiation of services, which may include hiring and training doulas, setting up necessary infrastructure, and beginning service delivery.
- Due to budget constraints, initial years may see limited scaled service, focusing on high-need areas or patients first.
- The cost of doula services varies but generally ranges from $800 to $2,500 per birth in various US regions.
- Given this, if each doula service is estimated at $1,500, initial budget would potentially cover approximately 1,333 cases in the first year.
- Feedback and demand will guide budget allocation in subsequent years, gradually increasing the reach to the full target over time or adjusting focus based on feedback and effectiveness.
- In interviews, it's important to capture both directly impacted individuals who are female veterans of childbearing age, and those who may indirectly feel the policy's impacts, such as healthcare providers, veteran families, or male veterans.
- We'll also include perspectives of individuals within veteran communities who may foresee potential indirect benefits or have opinions on resource allocation.
Simulated Interviews
Veteran (San Diego, CA)
Age: 31 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Having a doula during my pregnancy would have been valuable, especially as a single parent with no family nearby.
- VA resources for postpartum care are limited, so additional support would be greatly beneficial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Veteran (Houston, TX)
Age: 28 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- Doula services could ease the stress of my first pregnancy, especially navigating the VA system.
- It's a progressive step if implemented well, but I worry about whether it's truly accessible to all who need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Advocate for Veterans Rights (Raleigh, NC)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could highlight gaps in current health care offerings for female veterans.
- Evaluating its effectiveness could lead to greater healthcare reforms for veterans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
VA Healthcare Administrator (Phoenix, AZ)
Age: 40 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- The policy is a step in the right direction for improving service offerings for female veterans.
- Anticipated challenges in logistics and initial budget constraints.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 7 |
Veteran (Seattle, WA)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 7/20
Statement of Opinion:
- I like the idea of doula services; it gives me more confidence planning a family.
- It depends on how accessible and covered these services will be.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Nurse in VA hospital (Chicago, IL)
Age: 27 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 5/20
Statement of Opinion:
- I've seen the difference doulas can make in births and postpartum care.
- This policy can hugely benefit veteran families if implemented well.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 5 | 6 |
| Year 20 | 5 | 6 |
Policymaker (Washington, D.C.)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 9/20
Statement of Opinion:
- This policy could be a valuable pilot project in expanding holistic care for veterans.
- Ensuring continuous funding and implementation will be key challenges.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
VA Patient Navigator (Denver, CO)
Age: 38 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 8/20
Statement of Opinion:
- Doulas could be incredibly beneficial during transition periods for new mothers.
- Resource allocation is always a challenge; hope this gets properly funded.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Active duty preparing for transition to civilian life (Boston, MA)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 7/20
Statement of Opinion:
- Concerned about balancing new motherhood with transitioning from service.
- Doula services could greatly ease the strain.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran support group leader (New York, NY)
Age: 45 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 6/20
Statement of Opinion:
- Veteran mothers face unique challenges; a policy like this is overdue.
- Sustainable funding and expansion will determine long term success.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $2000000 (Low: $1500000, High: $3000000)
Year 2: $2000000 (Low: $1500000, High: $3000000)
Year 3: $0 (Low: $0, High: $0)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The primary expense stems from contracting personnel for the study.
- Data management and processing are likely to require technological investment.
- Possible travel and logistics costs for on-site assessments or consultations