Dear Members of Congress,

I am a Certified Professional Midwife.  I provide healthcare for Tricare families in the Hampton Roads, Virginia area.  Families were thrilled that they would be able to have a doula covered by Tricare when it was announced earlier this year.

However, we all found out that if they are not in a Tricare authorized provider's care, they cannot get a covered doula.  Moreover, if they birth at a military hospital, they cannot get a doula covered by Tricare.

The intention of the act: "Pregnant servicemembers and military spouses are more likely to experience isolation during pregnancy or be without their partners during childbirth, making them uniquely positioned to maximize the benefits of doula support;"  (https://www.blumenthal.senate.gov/newsroom/press/release/supporting-military-families-blumenthal-and-gillibrand-introduce-legislation-to-expand-access-to-doulas-for-military-moms includes the members and spouses who birth with a Certified Professional Midwife (not covered by Tricare) or who birth at a military hospital.  Of all the members not to cover, the members who birth at a military hospital are not the ones to exclude.  They include those without the finances to pay for a doula privately.  They are isolated from emotional support.  They are without their partners.

Military families are vulnerable during their births with their service member deployed.  They often have no one there to support them. They need access to a birth team that is committed to and proven to provide best outcomes for pregnant and birthing people and their babies - all classes of midwives and doulas.

We can do better for our military families.

I have two asks, therefore:

• Cover all service members and their Tricare covered military spouses for doula coverage; and
• Add Certified Professional Midwives to the list of Tricare authorized providers.  We serve families across the country and they have to pay for these services on their own.  I have had the local MTF hospital send members to me when they were overbooked - MTFs cannot provide the volume of services needed - but without a way for the member to have that service covered. Besides doulas, if you look at the Midwives for MOMS act from Representatives Lucille Roybal-Allard (D-CA) and Jamie Herrera Beutler (R-WA), and original cosponsors, Katherine Clark (D-MA) and Ashley Hinson (R-IA) and Senators Ben Ray-Lujan (D-NM) and Lisa Murkowski (R-AK) (https://www.midwife.org/congress-introduces-legislation-to-grow-and-diversify-the-nation-s-midwifery-workforce you will see the importance of midwifery care - which should be expected by Tricare families.  Certified Nurse Midwives are currently the only classification of midwives who are Tricare authorized providers.  There are not enough Certified Nurse Midwives to provide midwifery care to service members and their families.  Certified Professional Midwives help fill that gap.

We, the petitioners, hope that you'll look at these discrepancies in Tricare doula and midwifery coverage.  If Congress truly wants the best outcomes for military families, it will make sure that all families have access to doulas and to midwives - Certified Nurse Midwives and Certified Professional Midwives.

We, the petitioners, thank you for your time.

Tammi L. McKinley, CPM, 

on behalf of U.S. Military Members and their families