California Doula Pilots Lessons Learned Project

From 2019 to 2022, there have been at least ten doula pilot programs in California with a primary focus on addressing racial health disparities, and in particular on providing free doula services to either Black pregnant and birthing people or Medicaid enrollees.

To our knowledge, it is the largest number of doula pilot programs of this nature that have taken place than in any other state. The counties that have had doula pilots are Alameda (two), Contra Costa (two), Fresno (two), Los Angeles (two), Riverside (two), Sacramento, San Bernardino (two), and San Francisco. Three of the doula pilot programs were initiated by Medicaid managed care plans: Anthem, HealthNet, and Inland Empire Health Plan.

Beautifully illustrated rendition of our "Doulas Know Best"

Image by visual scribe Ashanti Gardner

From October to November 2021, the National Health Law Program’s Doula Medicaid Project embarked on an information gathering project, conducting interviews with doulas, funders, and/or administrative staff involved with each of these ten doula pilot programs. Overall, we found that the programs share remarkable consistency across some broader themes. At the same time, on a more granular level, the doula pilots have been quite distinct from one another, with different funding structures, scope of care provided, recruitment plans, training requirements, etc.
On January 26, 2022, the Doula Medicaid Project held a panel discussion with representatives from six of the interviewed doula pilot programs. This California Doula Pilots Lessons Learned Project builds on our work and findings from our May 2020 report, Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California.
What follows are a set of publications and resources that we have created from our interviews, conversations, and panel discussion. We hope that in compiling and sharing out this information, the experience and expertise of those involved in these doula pilots can help to inform the rollout and implementation of California’s statewide doula Medicaid benefit. We also hope that this information can be helpful for doulas and advocates in other states across the country who are setting up similar doula pilot programs or expansions of doula care in their own regions.
If you have any questions or comments, or would like more information, please contact NHeLP Senior Attorney Amy Chen at [email protected].

Publications

Summaries of California Doula Pilot Programs: This publication contains the compiled summaries of the doula pilot programs that were interviewed as part of this project. The information collected includes the scope of services, reimbursement rate, geographical area served, and many other details on each of the interviewed programs.

Challenges Reported by California Doula Pilot Programs: This publication details the common challenges encountered during set-up, launch, and implementation as reported in interviews with the doula pilot programs. Learn more about the challenges they faced, including funding, COVID-19, administrative burdens, data collection, relationships with hospitals and providers, and much more.

Lessons Learned from California Doula Pilot Programs: This publication is a very topline summary of the panel discussion that took place on Wednesday, January 26, 2022. The goal of the panel discussion was to hear from the doulas and program administrators who launched, implemented, and led innovative doula pilot programs across the state.

Panel Discussion & Related Resources

[WATCH] Doulas Know Best – Lessons Learned from California’s Doula Pilot Programs Panel Discussion: Watch a recording of our virtual panel discussion on lessons learned from California’s doula pilot programs. Hear directly from the doulas and program administrators who launched, implemented, and led innovative doula pilot programs across the state.

[WATCH] Time-lapse of Visual Recording by Ashanti Gardner: This is a time-lapse of a visual recording done by visual scribe Ashanti Gardner for the National Health Law Program’s Doula Medicaid Project panel discussion, “Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs.”

Q&A from Doulas Know Best – Lessons Learned from California’s Doula Pilot Programs: This document lists the question and answers from the panel discussion titled Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs. These questions were submitted during the panel discussion and during registration for the panel. The answers are a combined effort of NHeLP staff, panel presenters, and attendees.

[View] Visual Recording of Panel Discussion by visual scribe Ashanti Gardner

Acknowledgments

We would like to thank Marna Armstead, Priya Batra, Natalie Berbick, Shene Bowie-Hussey, Mika Cade, Deidre Coutsoumpos, Aman Dhuncy, Linda Jones, Maryam Karim, Mildred King, Gifty Kwofie, Sheryl Lane, Lauren McCollins, Samsarah Morgan, Nicole Morris, Curley Palmer, Khefri Riley, Michelle Sanders, Kristin Schlater, Elizabeth Sneed-Berrie, Shana Spinks, and Trúc Tang for taking the time to speak with us for this project. We would also like to thank visual scribe Ashanti Gardner and our graphic designer Amanda Epperson.
We also want to recognize each and every one of the doula pilot programs we spoke with, for embarking on this work to improve health outcomes for Black pregnant and birthing people in the state. Your programs make a tangible positive difference in the lives of each person and family who receives these services. We know that doula care is life-changing and life-saving, and we hope this project honors your efforts.
This project was funded by the California Health Care Foundation, which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

Additional Doula Health Policy Resources

Learn more about our Doula Medicaid Project