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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.39.01" title_num="10" subtitle_num="09" chapter_num="39" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Birthing parent” means the participant giving birth, who is receiving doula services throughout their pregnancy, including the prenatal, labor, and postpartum periods.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Certified doula” means a trained nonmedical professional who provides continuous physical, emotional, and informational support to the birthing parent throughout the prenatal and postpartum periods and who has received a certification as approved by the Program to perform doula services.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Department” means the Maryland Department of Health, the single State agency designated to administer the Maryland Medical Assistance Program under Title XIX of the Social Security Act, 42 U.S.C. §1396 et seq.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Doula services” means continuous physical, emotional, and informational support to the birthing parent throughout the prenatal and postpartum periods, provided by a certified doula, including:</text>
      <paragraph num="(a)">
        <text>Information about the childbirth process;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Emotional and physical support provided at perinatal visits and during labor and delivery, which may include:</text>
        <paragraph num="(i)">
          <text>Prenatal coaching;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Providing person-centered care that honors cultural and family traditions; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Teaching and advocating on behalf of the birthing parent during appointment visits, hospitalization, and delivery;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Provision of evidence-based information on general health practices pertaining to pregnancy, childbirth, postpartum care, newborn health, and family dynamics;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Provision of emotional support, physical comfort measures, and information to the birthing parent to enable the birthing parent to make informed decisions pertaining to childbirth and postpartum care, and other issues throughout the perinatal period;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Provision of support for the whole birth team including a birthing parent’s partner, family members, and other support persons;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Provision of evidence-based information on infant feeding;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Provision of general breastfeeding guidance and resources to supplement, but not in lieu of, the services of a lactation consultant;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Provision of infant soothing and coping skills for the new parents; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Facilitation of access to resources that can improve birth-related outcomes, including ongoing home visiting services, transportation, housing, alcohol, tobacco and drug cessation, WIC, SNAP, and intimate partner violence resources.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>“Home” means the birthing parent’s place of residence in a community setting.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Labor and delivery” means the period during which the fetus, membranes, umbilical cord, and placenta are expelled from the uterus through vaginal birth or through the surgical delivery by a cesarean section.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Medically necessary” means that the service or benefit is:</text>
      <paragraph num="(a)">
        <text>Directly related to diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative treatment of an illness, injury, disability, or health condition;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Consistent with current accepted standards of good medical practice;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The most cost-efficient service that can be provided without sacrificing effectiveness or access to care; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Not primarily for the convenience of the consumer, family, or provider.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>“Perinatal period” means the period that encompasses both the prenatal and postpartum periods.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Postpartum period” means the period that begins immediately after childbirth up to 180 days following childbirth.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Prenatal period” means the developmental period between conception and birth.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Program” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Provider” means an individual doula or an association, partnership, or incorporated or unincorporated group of doulas certified to provide doula services that, through an appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number.</text>
    </paragraph>
  </paragraph>
</regulation>