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Welcome to The NICU Translated Podcast, where we break down the complex world of the NICU into clear, relatable insights for families and the professionals who support them. Hosted by Mary Farrelly—a certified NICU nurse, doula, and educator—this podcast is your go-to resource for navigating the NICU with confidence and compassion.
Whether you’re a doula looking to better support NICU families, a healthcare professional seeking deeper understanding, or a parent preparing for or living through a NICU journey, you’ll find actionable tips, evidence-based guidance, and heartfelt stories to inspire and empower you.
Each week, we’ll explore topics like:
-NICU 101: Terms, diagnoses, and medical equipment explained.
-Preemie care basics and developmental milestones.
-How to advocate for your NICU baby with confidence.
-Emotional and trauma-informed support for NICU families.
-Insights from NICU professionals and families who’ve been there.
With episodes featuring expert advice, list-style guides, and real-life interviews, The NICU Translated Podcast is here to equip you with the tools and knowledge to make the NICU journey less overwhelming and more empowering.
Subscribe now and join our community dedicated to bringing more joy and less trauma to the NICU experience—because the NICU is only the beginning.
Let’s navigate this journey together.
Mary Farrelly (00:00)
Insurance is something most families don't think much about.
until pregnancy, birth or a nake you say suddenly brings it to front and center. And when that happens, the system can feel overwhelming, confusing and incredibly isolating. My guest today, Pachet Bryant is the founder of MINE Maternity and has spent over a decade working in women's and maternal health as a benefits navigator, care coordinator, researcher and advocate. Through her work, she's seen firsthand how unclear insurance coverage can add stress to families during some of the most vulnerable moments of their lives and how powerful it can be when families are given clarity and true support. In this episode, we're talking about
how families can better access financial resources during pregnancy, postpartum, and the NICU, and how doulas can help bridge the gap in becoming insurance credential providers and expanding access to care.
Mary Farrelly (01:18)
Hi everybody and welcome back to this week's episode of the NICU Translated Podcast. I am so excited to talk to Pachet Bryant today. Welcome to the show!
Pachet (MINE Maternity) (01:26)
Thank you, it's lovely to be on.
Mary Farrelly (01:28)
So we're gonna kind of start at the very beginning so that people can get to know who you are, a little bit about your story to how you got to this place and what is the work that you do.
Pachet (MINE Maternity) (01:38)
Definitely, definitely. So hi everyone. My name is Pachet Bryant. I'm the founder of MINE maternity M-I-N-E. And I've actually been in the industry for 10 years now. So I started when I was in university, working with the Women's Resource Center. And then that molded specifically into maternity care when I was doing my senior thesis. And I just never left. As I call it, I went down a rabbit hole, and I never left the rabbit hole, and I have been addicted ever since.
But really I went from being a maternal health advocate to a care coordinator to a benefits navigator. And that's really where I've landed now is helping families as well as providers navigate insurance and benefits.
Mary Farrelly (02:17)
Most people that are listening to this, whether you're a family or a doula or a nurse or any type of care provider, I feel like insurance is the least understood aspect of maternity care and especially around advocacy and understanding even your rights and what you are entitled to as someone who's navigating the healthcare system. So let's kind of start with like a broad overview. What is something that you wish every
single person who is pregnant would know about interacting and navigating their own insurance and options around maternity care.
Pachet (MINE Maternity) (02:53)
Yes, I love this question. I would
say that people have a lot more power than they think they do when it comes to actually activating their insurance, getting things paid for them like hospital bills reduced or reevaluated, and even when it comes to getting access to care. So a lot of times what I come across, and this is what really got me in MINE maternity into this direction is
You know, you're, well, it's not covered by insurance, so I guess I can't access it. And that is not the case. So even within your insurance, there's such things as gap coverage. So insurance companies are reliant on actually having to agree to the coverage that they performed, even if there's no out of, know, in network coverage for you. That's the kind of the loophole they say, ⁓ well, we provided it. It's like, no, you didn't. You know, you didn't give me anyone that I can access.
But oftentimes people stop there to even just making sure that you're getting the care that you deserve. So people have a lot more power than they think they do.
Mary Farrelly (03:52)
Yeah, and I think, you know, when you think, especially we're both in the US and so I know there's probably some people listening abroad and this might specifics of this may not apply directly to you and you might be listening to me like, well, I'm so grateful that I don't have to all of the nuances. But I feel like, you know, when you think about health care, especially it's almost in the insurance company's interest to make things a little bit more complicated so that people do find these potential what feels like a roadblock or like an end of the tunnel.
Pachet (MINE Maternity) (04:05)
Yeah
Mary Farrelly (04:22)
Not knowing that there's maybe another secret door over here to be able to open and explore and navigate. So I feel like one of the biggest things is maximizing your usage of your insurance and holding these big type of companies accountable for those resources that are available to you. And I know every insurance is different, but I love that lens of being like, you have more power than you think you do.
Pachet (MINE Maternity) (04:46)
Absolutely,
and the thing is, like you said, that secret door, it truly is there, but they aren't responsible in their eyes to tell you what you are entitled to. So for instance, I can't tell you how many insurance check reports we do, and I say, hey, just so you know, you have doula coverage. And the families had no idea, because unfortunately, nobody, well, it's not in their best interest to, but nobody tells you,
You know, this is how you access your doula coverage. This is how you get to see a lactation consultant, a pelvic floor therapist, a nutritionist, all surrounding your pregnancy and postpartum experience.
Mary Farrelly (05:22)
Yeah, and I also want to acknowledge that this can feel really frustrating and overwhelming and you're like, I don't want to have to do all this extra work. But that's why people like you exist to help navigate this and feel like there's someone I think I said this to you the first time we met, but like that you're almost like an insurance type doula, like you're helping you're doula-ing them through this process of navigating help here. So we know that around maternity and postpartum benefits
Pachet (MINE Maternity) (05:41)
Yeah.
Mary Farrelly (05:51)
There's most people especially those that have low risk or quote-unquote normal postpartum and birth experiences. There's already things that we're navigating ⁓ and maybe more like Set up plans that are a little bit more straightforward, but when it comes to the NICU oftentimes this is this additional layer of intensity and overwhelm and so many families say to me that that Navigating insurance and finance is one of the most intense parts of their journey
and this is happening when they're already exhausted and scared. from, I guess, your perspective working with families, where do people feel the most lost? Like where does this kind of, when you're meeting people, where are at? Like what would be connecting with you?
Pachet (MINE Maternity) (06:19)
Mm-hmm.
Yes. Absolutely.
So we're a lot of families, like you said.
Whether or not you're going through the NICU experience, pregnancy, building a family can even be in cases of adoption and people trying to just build their family and trying to get them on the insurance. But especially when you're going through it physiologically, you're under so much stress. And so oftentimes people are coming to me with, I don't even know where to begin. And for maternity providers, oftentimes what we see is that, and this is, I can go into the history of this, but...
Mary Farrelly (07:01)
Mm-hmm. ⁓
Pachet (MINE Maternity) (07:08)
What we see is that they're often out of network providers because then, you know, Western medicine or the insurance world or the medical field didn't acknowledge these providers on their own for so long. A great example, doulas. We're just now getting to see them recognize providers within the scope starting 2025, but even things like lactation consultants, you know, they're having to work under somebody or they're not even recognized at all without having extra credentials. And by the way,
Lactation consultants are the expert. Like there is no other provider that has their training. So they shouldn't be required to have additional to anything other than what their specialty is. But again, won't go too deep into that. The reason I bring all that up is because reimbursement support is where I see a lot of need. Because there are a multitude of forms that you need oftentimes. And then
a portal or something to submit. So I see a lot of people saying, I don't know even where to start, but it's typically around the reimbursement area.
Mary Farrelly (08:11)
So what is typically the first place that people start? Like where is your first step? If someone is listening to this and they're like, okay, I wanna take an action today, I'm in the thick of it, or I'm helping to support a family that's navigating the NICU right now, what is typically your advice for like their first thing to do?
Pachet (MINE Maternity) (08:28)
Yes, the
first thing I would say to do is get what we call a summary of benefits, your SOB. And when you get that summary of benefits, because it's going to be a lot of information, but I really want you to focus on two areas specifically. Your deductible for in and out of network. So your deductible is how much you have to pay in for your policy to activate in a way. And then your out of pocket maximum. For NICU families, this is so, so crucial because it's telling you.
This is what I can expect to pay for the whole experience and then anything after that my insurance company should be responsible for 100%. If you're still getting bills, that could be a discrepancy in the system, but since you don't know it because you're not familiar and you're under stress, you're paying for things that you potentially shouldn't be paying for.
Mary Farrelly (09:16)
I know I feel that I feel that way all the time like am I being duped for this or do I have time to look into it? I don't know and and I feel like that's there's like that almost preying on a vulnerable family knowing that likely a lot of these families are not going to be taking that extra step in time, but really the bringing your power back especially in a NICU setting where you don't have a lot of autonomy and power at the bedside and throughout the experience anyways, this is potentially one aspect that can be
an outlet for bringing back some of that feeling of control and understanding and decreasing the overwhelm slightly by having clarity and a little bit more understanding. A lot of times in scarier topics or especially around money and insurance, people tend to be avoidant because it feels so overwhelming or uncomfortable. Guilty of it myself. I'm... my 2026 resolutions is to get
Pachet (MINE Maternity) (09:54)
Yes.
Mm-hmm.
Mary Farrelly (10:10)
like a very like in-depth grasp and understanding of all of my numbers and benefits and what what am I missing? So some of it is that like ostrich in the sand like la la la la la. This makes me uncomfortable. No one to do it. What other like nuances around NICU stays in general do you do find families come across or maybe benefits and eligibility specific to the
Pachet (MINE Maternity) (10:21)
I love that. Yes.
Mary Farrelly (10:38)
NICU stay but then as I say oftentimes to many families and providers the NICU doesn't end at discharge. Many babies are needing follow-up care from professionals that range from follow-up clinics to PT, OT, speech, IV, CLC, all the things. So what insights you have on that kind of the nuances of NICU insurance and support.
Pachet (MINE Maternity) (10:45)
Yes.
Mm-hmm.
Yes, absolutely.
So, and I love the ostrich in this sand topic. Before I answer that beautiful question, I want to just repeat what you said for the families out there. It will give you a sense of control. Mary is right in that. So it may seem overwhelming and daunting, but everything else is chaotic. This is one thing that you can control and give you a sense of.
Mary Farrelly (11:15)
Mm-hmm.
Pachet (MINE Maternity) (11:24)
maybe some immediate gratification or immediate solution. And so just wanted to highlight that because that definitely could bring some emotional peace and grounding. But now to your wonderful question. I would definitely say when it comes to NICU families is really partner, have a very strong relationship with your child's pediatrician and your own primary care doctor.
or your family doctor, have a very strong relationship with them because in the insurance world, your doctor oftentimes is your hugest advocate. So they'll be able to send what we call Letter of Medical Necessities, LMNs, that is able to get you to see specialists. And when it's signed off by a doctor, oftentimes the insurance company has to recognize it to some degree with what you're seeing.
Really having a strong relationship with that primary care provider for your family or your little one specifically is really crucial to get the specialty care that you deserve.
Mary Farrelly (12:24)
Yeah, that's something that when I'm working with families transitioning to home, sometimes I feel like choosing a pediatrician because they're so stuck in the weeds and the NICU becomes an afterthought. And they're like, you know, I Googled this person, they're right down the street or maybe they were really nice and they take care of my three year old who's otherwise well. The pediatrician becomes such a focal part of your post NICU experience, both in this in this instance where they potentially could become an advocate for you. But you're also needing to
Pachet (MINE Maternity) (12:48)
Thanks
Mary Farrelly (12:53)
that point person who really knows you, your story, and your baby and can follow you as a continuity of care. So not all pediatricians are created equal and not all are as familiar with helping families navigate maybe a slightly more medically complex child like a baby coming home with that's premature and has feeding issues or has needs for additional medical equipment or support. So you really want to do your due diligence and know that who you picked for the first three visits even though they're nice you can
Pachet (MINE Maternity) (12:56)
Yes.
This one.
Yes.
Mary Farrelly (13:22)
change too. Like you can break up with a provider and find some. Yes.
Pachet (MINE Maternity) (13:25)
Yes, you can fire your provider. People need to, you hired them. Okay, so
you can fire them. Yes, they do.
Mary Farrelly (13:31)
work for you. And there are
many, mean, depending on where you are in the world, this may be more difficult than others. Sometimes there are limits in who is physically near you, especially if you live in a more rural or isolated area. But there are always going to be some type of options. So I feel like especially like as like millennial people pleasers, we're really hesitant often to rock the boat or create conflict. it's not to be in like a negative way. Like you can be really nice and also be really
Pachet (MINE Maternity) (13:55)
Get over that. Yes.
Mary Farrelly (14:00)
firm
and having that perspective of like this, you're great but you're not, it's not you, me, sort of, break up.
Pachet (MINE Maternity) (14:09)
Yeah,
absolutely. And take advantage of telehealth. Really take, because if you can open yourself up to telehealth, one, oftentimes insurance company covered, a lot of times what we see is telehealth actually is at zero fees or zero co-pays or very minimal co-pays versus going in person. But it opens you up to maybe specialists that are in another state, ⁓ in another region where they're very familiar with the care that your child might need.
Mary Farrelly (14:32)
Mm-hmm.
Pachet (MINE Maternity) (14:37)
definitely something to consider.
Mary Farrelly (14:37)
That's it.
That's a great point too, especially since so many NICU families are hesitant to bring their baby physically places because of the increased risk of germ exposure and all the logistics that come with hiking an infant around who's tired and doesn't, you you're driving during nap time. So that is, I love that point that like telehealth is come so far too, especially since COVID when it was like forced to happen. some of the benefits I feel like of COVID is that's created like a much more robust ability
Pachet (MINE Maternity) (14:48)
yeah.
Mary Farrelly (15:07)
to get really excellent care without having to schlep yourself to a doctor's office.
Pachet (MINE Maternity) (15:11)
Yes. And
for those that you brought up amazing point though, in home care. Okay. So I'm going to, I'm going to give you some tidbits in the assurance world. All right. ⁓ Okay. So depending on the circumstances of your child's NICU experience,
Mary Farrelly (15:17)
in the room.
Yeah.
Pachet (MINE Maternity) (15:29)
or for providers, know, the person that you're caring for, the child that you're caring for, they definitely can qualify for disability. ⁓ Up until the point where, you know, maybe it's no longer applicable, but in that immediate NICU to post-NICU time period, typically what we see is they qualify for disability. What this means is if you go ahead and apply, you know, disability benefits to that child, it opens you up to in-home care. So being providers coming to your home caring for your child.
Mary Farrelly (15:37)
Mm-hmm.
Pachet (MINE Maternity) (15:58)
It opens you up to supplemental security income, SSI, so you can have some financial relief. It may open you up to Medicaid or CHIP programs, even, you know, independent if you're, the parents have commercial insurance. There's just a lot that comes along with.
having, know, setting yourself up when it comes to these things. So in-home care is absolutely an option, especially if it's a medical necessity and for oftentimes for NICU babies needing a stable environment, it is. So don't be shy to look into that and call your insurance policies to get somebody to come in-home.
Mary Farrelly (16:33)
I love that and that's something that people might hear disability insurance and they're like, well, you know, there's this like image in your head, well, we don't qualify for that. So I'm not even gonna read the paperwork. I'm not even gonna look at that. But oftentimes the NICU experience does open different pathways that would not have been there otherwise. And as you mentioned, they're not always going to be.
given to you as an opportunity. One thing that I've seen and I've talked to many different NICU families, usually the liaison in the NICU of insurance and managing this and navigating this in a unit experience is usually the unit social worker or sometimes the case manager, but they all have different backgrounds and experience and knowledge working specifically with NICU patients. So I've had people had two different social workers at the same hospital, sit down with them and they're like,
Pachet (MINE Maternity) (17:08)
Mm-hmm. ⁓
Mary Farrelly (17:23)
This person told me about this option, but then this person came three weeks later and told us about disability or going on 30 day Medicaid or all these other things like we had no idea that was an opportunity too, which is very frustrating as a family, but some of that is like being able to take that as we said the power back in the understanding from a logistical perspective and this is kind of from my own curiosity one of the roles that I assume is and help train others to do is
Pachet (MINE Maternity) (17:34)
Yeah, of course.
Mary Farrelly (17:50)
as a NICU doula, so someone who's helping families navigate the physical, emotional, and practical needs of a NICU stay. One of the burdens of having a NICU parent, and something that a lot of NICU families have said is like, don't want to be an insurance benefit manager. I want to be a parent. I want to be able to just be present in the NICU and be there with my baby. How much of that as a person can you delegate to someone else? Have a doula call insurance on your behalf. Have someone else help you fill out the
Pachet (MINE Maternity) (18:05)
Yeah.
Mary Farrelly (18:18)
paperwork and then obviously you review it and sign it. What is the practicality around having someone else help you navigate this?
Pachet (MINE Maternity) (18:26)
a lot. I created
my whole company ⁓ based off of this. yeah, absolutely. So you can have someone be legally, like an authorized signature, authorized representative to at least complete some of the paperwork process. So that's something that my attorney does for reimbursements or insurance or whatever. But yeah, absolutely. Even your doula, if well, you guys have to establish that relationship and make sure that they're qualified to do this, of course. ⁓ But.
Mary Farrelly (18:29)
Yes!
Mm-hmm. Mm-hmm.
Pachet (MINE Maternity) (18:52)
Absolutely, you can have someone like a benefit navigator or your your doula take that off of your hands a thousand percent just be sure that you're a little bit a part of the process because as They always say with anything if one person leaves the other person should at least know what's going on You know, so if one handles the bills in your family The other should at least know the login information to get the bills in case you know for any reason Yeah
Mary Farrelly (19:04)
Thank
Yep.
I love that.
sometimes it's like just, yeah, I'll go, I'll sit on hold for you. Like I'll sit and wait for the next available representative on your behalf. Like what a gift of time you can, you can give to a family is just having part of the mental load of a NICU stay be offloaded to somebody like yourself who can truly help get you that coverage that you need, but also not totally offloading to the point that you, if you ever, like you said, need to assume that role too. You need to be able to have at least
Pachet (MINE Maternity) (19:30)
That, yes.
Yes.
Mary Farrelly (19:46)
of a fluent understanding or moderately fluent understanding of what's going on too. So if you were
Pachet (MINE Maternity) (19:49)
Yeah.
Absolutely.
Mary Farrelly (19:56)
meeting someone, I guess, let's kind of talk a little bit more about just general insurance knowledge and preparation. So say you have a, like I have birth clients too, they pee on their stick and they're pregnant. What is the very first thing that you wish that they would do?
Pachet (MINE Maternity) (20:11)
Okay.
The very first thing that I wish they would do is take a look what's actually existing currently between three different entities. So one, what's your insurance policy when it comes to maternity care? Because I am going to be very honest when I say I've seen policies where maternity care is not part of the coverage. I myself actually escaped a policy like that prior to my pregnancy because I knew I wanted to get pregnant.
but I almost chose a policy that did not have maternity care. So that would have been detrimental, very expensive as well. So insurance is number one.
Mary Farrelly (20:44)
world.
Pachet (MINE Maternity) (20:49)
Two is take a look to see if you have any FSA or HSA accounts. So these are healthcare savings accounts, flexible spending accounts, aka what they are is money that you took from your check and put into a bucket for you to utilize later. Oftentimes they're employer based or insurance based. But that's saved money that you have for you to utilize on your benefits. And it's a tax benefit as well ⁓ when it comes to just your income. But won't go into the details on that, but there are multiple benefits.
The third would be take a look at your employee assistant programs. So oftentimes what I find, and this is one component we add it to our insurance check reports because it goes so missed, but is that what happens is when you get the job and they're trying to get you, know, they say, hey, we have this and this and that, and you're so excited. And then once, you know, you...
been there for a year or two years or however long you're there, you forget about these benefits that you have. So I have discovered $15,000, $40,000, $90,000 worth of employee assistant benefits that were maternity specific, that somebody was just going to leave on the table unused and it's a use it or lose it. So I would definitely say take a look at those three and then understand what your maternity leave looks like. Because if you need to start saving now,
Mary Farrelly (21:44)
Mm-hmm.
Yes. ⁓
Pachet (MINE Maternity) (22:06)
You at least know how many months until you're going to go on leave. You you need to start setting money aside if you don't live in a state where, you know, there's a lot of support financially, like California is a good example.
Mary Farrelly (22:18)
As you were saying that about like knowing what your benefits were, I have a very vivid image of me like having the HR folder just like sitting on my desk that I got from my job and it just like, it's all in there. I know that there's all these pamphlets and flyers and things and it just sat and like literally would gain dust.
Pachet (MINE Maternity) (22:35)
Yeah, because it can be overwhelming.
Mary Farrelly (22:38)
Right, right. I'm glad to see this today,
so I'll figure this out another
Mary Farrelly (22:45)
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Mary Farrelly (23:28)
sometimes people do have these other programs. And Employee Assistance especially is so underutilized, especially when I've seen around mental health benefits too, because for NICU families, the experience can be financially incredibly challenging.
Pachet (MINE Maternity) (23:38)
Yes.
Mary Farrelly (23:44)
by having a hospitalization and an ICU stay and that along with being postpartum all the other things can lead to mental health intensity, much higher rate of having perinatal mood and anxiety disorders, clinical PTSD. So let's touch a little bit about, I mean, again, if this is something that you're less familiar with, like what is your understanding about mental health benefits and how families can potentially navigate that and advocate for their needs as well? What's the best step for a family who's recognizing?
Pachet (MINE Maternity) (23:50)
boy.
Mary Farrelly (24:13)
that they need more professional support but not sure how to access that financially.
Pachet (MINE Maternity) (24:13)
Mm-hmm.
Absolutely. mental health thankfully, within our country especially, has been recognized from multiple areas. One, preventative care. So oftentimes it is free because they've already done the research on the long lasting effects and more so for the insurance companies, the economical, the financial loss effects. Just putting it out there, right? I see the world as, you know, as
Mary Farrelly (24:35)
This is... I don't know why.
Pachet (MINE Maternity) (24:42)
from my perspective, but ⁓ oftentimes it is free. And so, but I want you to understand is that when it comes to mental health, there's so much more than just what your insurance offers. So, so much more, especially with maternal healthcare and then especially with NICU experiences, because that's even a specialty area. So there are amazing nonprofits out there, which I would actually recommend starting with. Amazing nonprofits who offer free support that's
actually their specialty is maybe, you know, perinatal or postnatal or the NICU experience. So for instance, PSI, postpartum international, yeah, they are wonderful in that they have so many specialty group sessions and therapists to help you and even peer counseling.
Mary Farrelly (25:30)
Yeah, sometimes you can feel like you need, you know, there's like one image in your mind of what a therapist is and what mental health support looks like, but it really is, especially with this type of unique experience that the NICU is, like sometimes that peer support is so, so, so powerful too. To, in addition to PSI and having your state local chapter, two places that the nonprofits that I like to send families to for NICU specific care, what we're talking about it, are Project NICU and Hand to Hold, both have
Pachet (MINE Maternity) (25:58)
Yes.
Mary Farrelly (25:59)
free,
different kind of flavor of it, but free mental health support specifically for families. Navigating the NICU experience for individual care and then also similar to PSI have group and ⁓ really support group type care that is not just for the person that gave birth to, for partners and siblings and other people that are helping also to navigate that experience.
Pachet (MINE Maternity) (26:14)
Yes.
yeah.
you know,
let's talk about that actually, but before I do want to, another great one for those that maybe are within the black community would be Alliance for Black NICU Families. There are definitely chapters if you need someone that's more, know, fitting your cultural backgrounds, there probably are some for the Asian and Pacific Islander communities, Latina and Latino communities, so definitely see if that helps with your familiarity as well as recognizing your cultural nuance. ⁓
Mary Farrelly (26:33)
Yes.
Pachet (MINE Maternity) (26:50)
The mental health of partners. ⁓ I think we really, I love that we want to touch on that because it's so easy for us to think about the mental health of the mother, especially with her going through postpartum and then the mental health or the needs of the baby. But definitely partners, I think goes a lot of times under utilized or under recognized. So everybody deserves care. And I hope that there are partners out there listening to this podcast.
Mary Farrelly (26:53)
you
Mm-hmm.
Pachet (MINE Maternity) (27:17)
You know, yes, you are a pillar and I appreciate this, you know, the strength that you're providing those two, but definitely know that you also deserve to have someone to lean on too.
Mary Farrelly (27:27)
Yeah, and the way to become that stronger pillar is to exercise and grow your own strength. And that often comes by having protected time for growing your mental health.
grit, resilience, all the things that comes along with having those like vulnerable conversations. Because one thing we talk about with NICU Doula's work in trauma-informed care is the idea of like emotional constipation, right? Eventually like, don't talk about it, it's always there, it's gonna back up and back up and back up. And oftentimes it comes out in ways that are very unexpected and very yucky, like rather than letting things out in small controlled ways.
Pachet (MINE Maternity) (27:40)
person.
yeah.
Yeah, that's gonna work.
Definitely.
Mary Farrelly (28:07)
It is an accurate image too as well.
Pachet (MINE Maternity) (28:09)
And
one thing that I'm thinking of that, like the little bits of relief, if, you know, I don't have time to work a job and take care of my family and see my baby in the NICU, because you know, sometimes people don't get time off to be able to see their baby. They have to still juggle or they'll lose their livelihood, which is just heartbreaking. But then take a look at smaller steps. So apps.
Mary Farrelly (28:24)
Yes.
Mm-hmm.
Pachet (MINE Maternity) (28:35)
A lot of times insurance companies are offering these mindfulness apps, Calm, Headspace, to allow some mental health relief. The peer groups, as Mary was talking about. Getting just one person who understands what you're going through or hiring a NICU doula who can say, I am here for you. What do you need emotionally as a family and as an individual? So there might be smaller steps to take before just going to a full session if that's not realistic.
Mary Farrelly (29:03)
Mm-hmm.
And I love that you mentioned that too. Likely that's another one of those hidden benefits. Your employee assistance or maybe your insurance will give you a year of headspace or calm for free. And there's those again, those hidden resources that you don't know about unless you go looking for them sometimes. So there's one of my favorite lines is like everything is figure outable. And it definitely, even when you're in the intense and the like, you're like, I don't know how we're going to figure this out. Everything is figure outable.
Pachet (MINE Maternity) (29:13)
Yes. Yeah.
Mary Farrelly (29:31)
but it's just one small action, one next step every day. And eventually you'll look back and be like, we did it, we got through this. Whether it's navigating insurance, going through the mental health journey, supporting a clinically complex newborn at home, you get through it one, literally one foot in front of the other, but knowing that there's people helping you along the way. Hold your hand while we navigate this together.
Pachet (MINE Maternity) (29:43)
you
So,
Yes,
a village is so important like a village is just generally needed when bringing about a family and figuring out things and nuances But especially if you're going through a NICU experience, you know, you've got to have that You got to have your village You got to your people
Mary Farrelly (30:12)
It's gonna have your people,
One of the things you touched on that I wanted to kind of go into a little bit is the navigating leave and what that looks like in general for maternity benefits, but especially around a NICU stay, ⁓ especially those slightly longer NICU stays. Like as a NICU nurse, some babies that are in the NICU for four hours, some are there for four days, four weeks, four months. We've had families that are there for a year or more. So what is your experience?
in helping new families navigate their leave.
Pachet (MINE Maternity) (30:46)
Definitely.
So when it comes to leave, it's really important to understand two areas. So if there's a, you know, your state, if there are state benefits and leave support, and then if there are federal leave support programs in place or whatnot. The reason why this is so important is because for instance, in California, you know, you can have
a disability leave which provides the financial support and then you can have an extended leave, Family Leave Act which allows for you to take unpaid time off but at least you have job protection. And so, but then I've worked with folks because we service nationwide who are in states, unfortunately Florida is a great example this, where a lot of times we're trying to actually negotiate with the employer to have them somehow keep their job during their stay because
Mary Farrelly (31:19)
you.
Peace.
Pachet (MINE Maternity) (31:35)
it's not protected. in a lot of cases where if they don't meet certain criteria in Florida, they definitely don't have any protective leave. And then it's light to begin with. So I would say that it's really important to understand what your options are and to do it independently of whatever your employer tells you, which might sound...
that sounds like more work, but your employer would tell you things that will benefit the company. Well if you look for it yourself or work with a company like mine or ⁓ even amazing consulting companies, know, California Maternity Leave Act or company, then they can help you recognize truly what your benefits are from an unbiased point of view.
Mary Farrelly (32:20)
Yeah, that is so interesting. variety of options, especially internationally, state by state. I did want to highlight because we're recording this in January of twenty twenty six. You may be listening to it after that. There is some momentum specifically in the United States around legislative change specific to NICU family leave. So that's very exciting. There was just two different bills enacted, one in Colorado and one in Illinois that offer
Pachet (MINE Maternity) (32:36)
and...
Yep. Yep.
Mary Farrelly (32:47)
recognize that the NICU postpartum experience is very different than a typical postpartum experience. no matter what, we probably need some better parental leave nationwide and a lot of work to be done. But just recognizing that oftentimes what I see at the bedside, as you alluded to, is people are returning to work. So they're leaving their baby for hours and hours a day. They're coming back after eight, nine, 10 hour work day and then spending time with their baby. Or some are trying to work at
Pachet (MINE Maternity) (32:57)
Yes.
Okay.
Mary Farrelly (33:15)
bedside while the same time that they are navigating. Some, this is often to quote unquote save up their leave so that when their baby does go home from the NICU they don't immediately have to go to daycare the next day. They can spend some time at home bonding, connecting, navigating that incredibly intense transition as well. So the fact that there is some momentum happening is hopeful. I have a lot more hope that this is going to continue to be
Pachet (MINE Maternity) (33:16)
Yep.
Yep.
Okay.
Yes.
Mary Farrelly (33:42)
recognized for the important difference that it really is.
Pachet (MINE Maternity) (33:46)
Yes, I was
so excited when I saw this. I was like, I have to tell it, Mary, and we have to really talk about this. Because I am a very hopeful person. Even, you know, I've been in the field again for 10 years now, and I have seen the transition and I've seen the growth of us acknowledging what the experience truly is. And it's an experience that requires time.
Mary Farrelly (33:56)
Mm-hmm.
Mm-hmm.
Pachet (MINE Maternity) (34:10)
That's the biggest
component of what we need. So for NICU families, the most thing you guys need is as much support and time as you can possibly get to get back on your feet. ⁓ And so with these two bills passing or being proposed to pass for even more states, it's going to be a nice domino effect of saying, wow, we really do recognize that NICU families need an extended time period. And it's not just, you know, a lot of times people think maternally of, you're drinking, these are,
Mary Farrelly (34:19)
Mm-hmm.
Pachet (MINE Maternity) (34:38)
tell me, but you're drinking cocktails and you're going to the beach and having playdanks. It's just, I've heard it all from people who are not in it. And it's not the case, but especially for a family going through, you know, a heightened medical situation, you guys just need time. And so that's, that's the hopeful part about this.
Mary Farrelly (34:46)
Mm-hmm.
Mm-hmm.
Yeah, I'm...
Cautiously optimistic that there's going to be real momentum. mean for better or for worse sometimes there's a little bit of peer pressure like from in like like, you know, okay now, I don't know what these two states have it now We have we have to follow suit or we're gonna like look a certain way or or the good peer pressure Someone with integrating you do a work sometimes like this hospital down the street has it I know families are asking about it now we can open the door so sometimes it's that momentum and I feel like the the rock has been gently pushed and
Pachet (MINE Maternity) (35:14)
Yeah. Yeah!
it is.
Mary Farrelly (35:27)
now slowly starting to roll. ⁓
Pachet (MINE Maternity) (35:29)
Absolutely, I mean
it worked for doula services, right? Being recognized within Medicaid environments and now it's being recognized into commercial insurance plans. It works with childcare. Look at New Mexico, what they did with their universal childcare. Now New York just stated about childcare benefits. you know, I believe in the momentum. Go peer pressure.
Mary Farrelly (35:46)
Mm-hmm.
Love you.
Yeah, and
keep talking about it too. The more that we have these conversations, the more that people get mad, but in a good way about what's missing and how it really harms babies and families and the real harm that happens when there's not these types of systems built in place. ⁓ The more change that we can have and NICU parents are some of the fiercest voices they've had to practice advocacy so hard throughout their entire NICU journey and beyond.
Pachet (MINE Maternity) (35:56)
Yes.
Yes.
Absolutely.
Mary Farrelly (36:20)
they are professionals and they are ready to rumble. watch out. NICU families are coming to session. Let's see it. And I'm here to cheerlead them and support them and continue to build out new systems of true actual family centered care and support. ⁓ So let's, we talked a little bit about doulas. Let's talk a bit about how doulas fit in with insurance.
Pachet (MINE Maternity) (36:23)
Watch out, makers. Yes, they are.
percent.
Mary Farrelly (36:46)
How can families access doulas through their insurance? And as a doula who might be listening, what might they need to consider or how can they start their journey to becoming a credentialed provider? Not provider, someone who accepts insurance.
Pachet (MINE Maternity) (36:47)
Yeah.
Definitely. Okay, so we're gonna do it twofold because it's different experiences and different, you know, different stories. So let's talk about the families first. You wanna first call in, check in somehow, get an insurance check or pour whoever, know, however you wanna do it, but confirm that you have doula coverage first. So what we're seeing is that insurance companies, especially in states where it's starting to become more mandated or pressured on insurance companies,
Mary Farrelly (37:29)
Thank
Pachet (MINE Maternity) (37:29)
to have
doula services covered. But what we see is that it's available in the Medicaid, so the government insurance side, but it's also available in the commercial side of insurance. So definitely check into your policy and see if you have dual coverage. Once you find out that you do have doula coverage, that is where you just want to make sure if you have to use their directory or can you choose your own. Really, really, really key part. I cannot stress this enough.
Mary Farrelly (37:50)
Thank you.
Pachet (MINE Maternity) (37:54)
⁓ Because I want to make sure that you're not paying out of pocket and then potentially not getting reimbursed. I want you to get reimbursed or and oftentimes the doula can bill on your behalf so you're not even having to worry about the financial aspects of things. So check your policy, see if you even have doula coverage. Second, confirm if you need to be in network with them or can you choose your own, choose your own doula.
Mary Farrelly (38:00)
Thank
Mm-hmm.
Pachet (MINE Maternity) (38:19)
And
oftentimes, like I said, the partnership with your primary care provider is so important because oftentimes what we see is that you need a letter of medical necessity, an LMN, aka like a doctor referral, but to say, yes, I believe my patient needs a doula for X, Y, and they'll state the reasons. Doctors are very familiar with this, don't be stressed about it, but it is important for insurance coverage, almost actually a necessity itself.
Mary Farrelly (38:30)
Mm-hmm. Mm-hmm.
That's really interesting.
Pachet (MINE Maternity) (38:46)
So that's the
family side of things. Any question though, or any caveat? ⁓
Mary Farrelly (38:50)
No, well, I'm thinking too, like for my own,
like having the NICU experience, like needing, I'm sure OBs and are very familiar with how to write these letters, but it may be some place that I need to explore in how to help neonatologists and pediatricians be able to potentially write letters of necessity for NICU doula parent support and integrating that too. So you got my wheel spinning as you're talking about it.
Pachet (MINE Maternity) (39:00)
Mm-hmm.
Yes, and we will talk way more about
it because I am so on the path of what you're talking about, 1,000%, because they do count as primary care providers. So absolutely, let's take a look into that. But one thing I want families to know, and I'm so glad I remember this before, while I'm on the podcast and not Monday quarterbacking. But oftentimes what I see is people say, oh, well, I'm no longer pregnant, so I lost my benefit, or I already gave birth, so I can't get a labor and delivery.
Mary Farrelly (39:30)
You
Pachet (MINE Maternity) (39:39)
you know, doula, please recognize that oftentimes this doula benefit is 12 month period. So if you haven't activated your doula, you know, benefits at any point and you're still, you know, maybe four months or you're home with your NICU baby or whatever it may be, please do not just say, oh, I don't have any benefits anymore because that is not how it works. So you, well, oftentimes what I suggest folks is when they find out later is that
Mary Farrelly (39:40)
Mm-hmm.
Pachet (MINE Maternity) (40:08)
If you're going back to work, that transition, ooh, a doula can help you with that transition, even if you work from home or maybe sometimes, especially if you work from home, actually. But that 12-month period is really important to recognize that you can still activate your benefits. And then for NICU families, when you get home, like you said,
You got all this support while your baby's in the hospital. People checking in on you and this and, hi mama, hi papa, hi dada, know, whatever they call you. But they always have like some kind of name that they try to do to make you feel better. And so, but then you go home, you know, where's the team? Where's the checkup? Where are the reports? know, where are the calls? Like it might be a huge shift, which can lead to an internal chemical shift. So a doula would be a really great time to activate that benefit as well.
Mary Farrelly (40:35)
It's true.
Mm-hmm.
Pachet (MINE Maternity) (40:56)
And especially for net like like I said medical necessities you can actually oftentimes get nine more postpartum sessions Yes to support your case because 1,000 % you'll qualify so Really? Yeah, and that's in addition to the 11th that kind of tend to be standard So really really you know take a look and if you need help MINE maternity
Mary Farrelly (41:14)
Fascinating.
huh.
Pachet (MINE Maternity) (41:24)
Call your insurance. Talk to Mary. Mary might call me, but still, talk to Mary. We're working together anyways. You know, get her, you get both of us. And vice versa. But anyway, so that's the family side. For our doulas, you beautiful, beautiful souls with healing hands. I love what I do because I get to help people like you. I swear to it. But when it comes to the process,
Mary Farrelly (41:28)
We're gonna hear the sound together.
Pachet (MINE Maternity) (41:47)
and this is if you want to work with employer assistant programs, that's the carrots and the mavens, the progenies, or if you want to work with insurance companies, it's starting to become, especially in 2026, mandatory for you to be a Medi-Cal approved doula. It will very much, sorry, Medicaid, Medicaid, because Medicaid is a general term for any state that you're in. Medi-Cal is specifically for California, but I'll say Medicaid nationwide program. So Medicaid.
Mary Farrelly (42:02)
you
Pachet (MINE Maternity) (42:14)
approved doula ⁓ in your state. What this means is it doesn't mean you have to work with Medi-Cal members, but what it means is so far is that it's a stamp of approval that the other entities are looking for. And then once you have that stamp of approval, then you can go and have a contract directly with the insurance company themselves.
Mary Farrelly (42:35)
What is the best way, say you are now a Medicaid approved doula, what is the best way for them to learn how to appropriately help their clients navigate the insurance exchange and insurance benefits? Is it recommended to go through like a third party system? Is there ⁓ a way that they can feel more confident in how to do that type of billing work? That's a little different than having contracts and paying via Venmo sort of exchange.
Pachet (MINE Maternity) (42:38)
Great.
Yes.
Yes, yes,
this is different. So this is another reason why MINE Maternity was created, is to help with that whole step with the credentialing process, the billing support. But even, and we offer a lot of free resources and I'm always a chat away. So please, if you're like, ⁓ I can't afford it, I'm just now starting, but you have questions, please Instagram message us or email us on the website. But outside of that scope, I would say,
Mary Farrelly (43:07)
Mm-hmm.
Mm-hmm.
Pachet (MINE Maternity) (43:28)
rely on your doula community. There are doula hubs being created to support with billing needs or at least billing questions. It might not be direct billing support, but billing questions, credentialing questions, see what type of hub is available. So for instance, in California, there's the LA Doula Hub, which I highly recommend folks at least get connected with to see what resources are available. And then if you need more direct support or more hand-holding support, well, that's where companies like mine can really help.
Mary Farrelly (43:33)
Mm-hmm.
I love that you're helping. As you said, your work is indirectly causing so many positive ripples in both individuals' lives and on such a massive collective way because knowledge is power and being able to connect people with the real resources and support that are out there. I feel like that sometimes can happen in the doula world is you're like, you know that there's people out there that need you. You know that you have this skill set that you can offer these families, but sometimes it's hard
Pachet (MINE Maternity) (44:04)
thank you.
Yes.
Yes.
Mary Farrelly (44:24)
to bring these two like orbs that are bopping around together but that's really where your work like shines like you're you're the dot connector you're bringing that magic together so that real healing real transformation and real support can happen and my my passion is to have NICU families, NICU babies, not just survive the Niki experience but to truly thrive like have that feeling of like this yes this was hard there are aspects of the NICU that are always going to be hard they can't take that away but we can make it so much better than
Pachet (MINE Maternity) (44:51)
⁓ huh, ⁓ huh.
Mary Farrelly (44:54)
what it currently is for so, so many families all around the world. So I'm just so grateful that you who you are and you're able to share your knowledge and experience both with people on an individual level and coming here today and sharing about your work and what you do. So people are looking, they're like, yes, I want to know more. Where can everybody find you and get connected with what you have to offer?
Pachet (MINE Maternity) (45:11)
Thank you.
Yeah, definitely. So our website is www.mine.com. Our Instagram and YouTube handle is MineMaternity. And then our email address is info at MineMaternity.com. And we're just an email or a direct message away.
Mary Farrelly (45:37)
That's amazing. And so one last, I guess, follow up ending kind of summary questions. So to the family who feels super overwhelmed right now by insurance and bills and uncertainty and all the things, what's one thing you want them to know about their worth, their options? Like, what's one grounding thing that you can say as they're feeling like this guy is falling? What would be your worst to them?
Pachet (MINE Maternity) (45:42)
Ooh. Yay.
You deserve to be heard. You deserve to be heard. whether that is financially heard, whether that is resource-hered, you need, you know, government support, need, you know, family support, you need village support, whatever it is, you deserve to be heard. And I need you to really own that feeling and that self-confidence when it's maybe at a time of a low for you, because your self-worth will give you the courage to reach out and say, I do need help.
whether that's from your neighbor who has sugar or from a pediatrician that's a telehealth appointment away. But just know that.
Mary Farrelly (46:37)
I love that. you
deserve to be heard and it's true sometimes we do we can feel like sometimes in the NICU community especially I'll see you know like my NICU stay wasn't that bad or it's not as bad as this other person or they deserve more help because XYZ is happy. No like everybody deserves to be heard everybody deserves to be supported everybody's story is important and your worth is not measurable everybody is worthy. so thank you so much for being here today and sharing your knowledge and expertise
Pachet (MINE Maternity) (47:01)
Absolutely. Thank you, Pat.
Mary Farrelly (47:06)
I'm just so grateful that our paths crossed when they did. And thank you again for being on the show.
Pachet (MINE Maternity) (47:09)
Yes.
Thank you for having me. Good luck, everybody.