[Congressional Record Volume 168, Number 183 (Tuesday, November 29, 2022)]
[House]
[Pages H8600-H8602]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 DELIVERING OPTIMALLY URGENT LABOR ACCESS FOR VETERANS AFFAIRS ACT OF 
                                  2022

  Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2521) to require the Secretary of Veterans Affairs to 
establish a pilot program to furnish doula services to veterans, as 
amended.

[[Page H8601]]

  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2521

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Delivering Optimally Urgent 
     Labor Access for Veterans Affairs Act of 2022'' or the 
     ``DOULA for VA Act of 2022''.

     SEC. 2. FEASIBILITY AND ADVISABILITY STUDY ON DOULA SUPPORT 
                   FOR VETERANS.

       (a) Study.--The Secretary of Veterans Affairs shall carry 
     out a study on the feasibility and advisability of furnishing 
     doula services to covered vetearns. Such study shall include 
     an analysis of--
       (1) measures taken by other Federal, State, and local 
     entities to ensure the appropriate certification of doulas; 
     and
       (2) the extent to which such measures, or similar measures, 
     may be adequate for purposes of such furnishment.
       (b) Report.--Not later than 18 months after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the House of 
     Representatives and the Senate a report on the findings of 
     the study under subsection (a) that shall include a 
     determination by the Secretary as to whether furnishing doula 
     services to covered veterans is feasible and advisable.
       (c) Covered Veteran Defined.--In this section, the term 
     ``covered veteran'' means a pregnant veteran or a formerly 
     pregnant veteran (with respect to doula services to be 
     furnished post-partum) who is enrolled in the patient 
     enrollment system of the Department of Veterans Affairs under 
     section 1705 of title 38, United States Code.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Illinois (Mr. Bost) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material on H.R. 2521, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 2521, as amended, the DOULA 
for VA Act of 2022. This bill, authored and long championed by 
Congresswoman Brenda Lawrence, would bring VA closer to providing the 
full scope of reproductive healthcare that our veterans and their 
newborns deserve. This bill would require VA conduct a feasibility and 
advisability study to determine whether to provide pregnant veterans 
access to doula support services.
  The United States has a maternal mortality crisis, and our veterans 
are not protected from it. In fact, they are disproportionately more 
likely to experience severe maternal mental health outcomes than their 
civilian counterparts.
  There is a growing body of research that shows that doula care is an 
effective tool in mitigating pre and postpartum mental health crises 
and can be a factor in reducing childbirth complications. The VA must 
investigate the ability to provide such holistic and effective care.
  Mr. Speaker, I wholeheartedly support this bill. I encourage all my 
colleagues to join me in supporting Mrs. Lawrence's critical and 
commonsense legislation, and I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 2521, the Delivering 
Optimally Urgent Labor Access for Veterans Affairs Act of 2022, or the 
DOULA for VA Act of 2022.
  Women are now our fastest growing group within the veteran community. 
More than 2 million women veterans live in the U.S. today. Many of them 
are within childbearing age.
  In the last few years, the use of maternal services within the VHA 
has increased by 44 percent. The DOULA for VA Act would require VA to 
conduct a study to provide doula services for pregnant veterans 
enrolled in the VA healthcare system.
  Mr. Speaker, a doula is a trained companion who provides physical and 
emotional support to women before, during, and after childbirth. They 
also offer guidance and educational support for new mothers. However, 
doulas are not medically trained professionals, and there are no 
certifying or licensing standards for doulas, which is why it is 
imperative that doulas meet the minimum quality and safety standards 
set forth by the VA.
  This bill will provide VA and Congress with valuable insight into the 
trade, and I ask all of my colleagues to support H.R. 2521.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
Michigan (Mrs. Lawrence), the author of H.R. 2521 and my good friend, 
who serves on the Appropriations Committee and the Oversight and Reform 
Committee.
  Mrs. LAWRENCE. Mr. Speaker, I thank the chairman for his dedication 
and the efforts of his entire team in bringing this bill to the floor. 
I also thank the ranking member for his support of this bill.
  Mr. Speaker, I rise today in support of my bill, the DOULA for VA 
Act.
  Maternal mortality in the United States is a public health crisis. 
While maternal mortality rates have declined globally over the past 
three decades, the United States' maternal mortality rates have 
climbed.
  As we work to address this serious public health issue, we have a 
responsibility to make sure that our pregnant veterans are included in 
the conversation. This is because veterans who have experienced 
pregnancy disproportionately experience mental health afflictions such 
as post-traumatic stress disorder and anxiety.
  Studies have found that pregnant veterans were twice as likely to 
have a diagnosis of depression, anxiety, and stress disorder, and more 
than those who had not experienced a pregnancy.
  We must provide veterans who have served our country optimal maternal 
and mental health care that takes into consideration their veteran-
specific experiences.
  Doulas have a proven positive effect on the health outcome of the 
mother and child. As the use of doula services continue to grow, we 
must look at ways to expand maternal health services for our women in 
the VA.
  Mr. Speaker, I thank the bipartisan Congressional Caucus for Women's 
Issues for supporting this effort, the House leadership and their 
hardworking staff, and the amazing committee staff for working to 
advance this bill to the floor. I urge my colleagues to support it.
  Mr. BOST. Mr. Speaker, in closing, I encourage all my colleagues to 
support the bill, and I yield back the balance of my time.
  Mr. TAKANO. Mr. Speaker, I again ask my colleagues to join me in 
passing H.R. 2521, as amended. With a heavy heart, I take this moment 
to pay tribute to the gentlewoman from Michigan (Mrs. Lawrence). She 
has joined us on Veterans Affairs' codels and done factfinding on 
behalf of the committee for the betterment of our veterans. I thank her 
for that, and I wish her the best of the new opportunities that she 
will encounter after she leaves this body.
  Mr. Speaker, I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 2521, DOULA 
for VA Act of 2021--to require the Secretary of Veterans Affairs to 
establish a pilot program to furnish doula services to veterans.
  Doulas provide emotional and physical support to pregnant people 
during pregnancy, childbirth, and postpartum. A doula will assist 
during birth by providing a positive and safe birthing experience.
  Studies show that when doulas are present in the birthing process 
labors are shorter, it is less likely that a C-section will be needed, 
there are less requests for pain medication, and there is a more 
positive childbirth experience.
  In 2013, the Journal of Perinatal Education conducted a study which 
found that expectant mothers matched with a doula had better birth 
outcomes than did mothers who gave birth without involvement of a 
doula.
  Doulas work to develop birthing plans, help the parent understand 
labor and delivery procedures, communicate preferences to the medical 
staff, and teach relaxation and breathing skills, along with many other 
non-clinical tasks that improve the birthing experience.
  Currently, Veterans Affairs benefits do not cover doulas.
  Improving the childbirth experience should be a priority for us all. 
Veterans and their family members deserve to have positive birthing 
experiences, just as all Amencans do.

[[Page H8602]]

  Maternal mortality is an issue that continues to plague the United 
States health care system. In 2020, 861 women died of maternal causes 
in the United States. In the U.S., two-thirds of those pregnancy-
related deaths are preventable and for every pregnancy-related death, 
there are 70 pregnancy-related near-death experiences. It's extremely 
important that we remove barriers in health care that may be 
contributing to these deaths.
  Maternal mortality is caused by several issues such as cardiovascular 
problems, high blood pressure, blood clots, and complications of labor 
and delivery.
  One step to removing health care barriers is to provide more services 
such as doulas who can advocate for the parent and provide positive 
birthing experiences.
  From 2010 through 2015, the use of maternity services from the 
Veterans Health Administration increased by 44 percent.
  If doula services are improving care for the general public, then 
veterans should be provided with the opportunity to utilize doula 
services as well.
  A study in 2010 found that veterans returning from Operation Enduring 
Freedom and Operation Iraqi Freedom who experienced pregnancy were 
twice as likely to have a diagnosis of depression, anxiety, 
posttraumatic stress disorder, bipolar disorder, or schizophrenia as 
compared to those who had not experienced a pregnancy.
  H.R. 2521, Doula for VA Act of 2021 is important because we should be 
working to improve the lives of women and children in the United 
States. This bill directly impacts the health of veterans and their 
families.
  I know that this bill is important to my constituents in Houston. 
Over 282,000 Veterans live in the Houston area, and almost 25,000 
Veterans in Houston are women. Improving the birthing experience for 
these women is a top priority to me.
  I encourage my colleagues to join me in supporting this critical bill 
that will direct the Department of Veterans Affairs to establish a 
pilot program to furnish doula services to veterans.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 2521, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mrs. LAWRENCE. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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