Doula Medicaid Project

About the Doula Medicaid Project

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The National Health Law Program’s Doula Medicaid Project seeks to improve health outcomes for pregnant Medicaid enrollees by ensuring that all pregnant individuals enrolled in Medicaid who want access to a doula, will have one.

Low-income women are at the highest risk of poor birth outcomes in the United States, and women of color are especially vulnerable. According to the Centers for Disease Control, Black mothers die at three to four times the rate of non-Hispanic white mothers during the maternal period, one of the widest of all racial disparities in women’s health. The search for solutions to stem this long-standing crisis in maternal health is increasingly urgent. Doula care is among the most promising approaches to combating such racial disparities. Numerous studies demonstrate that doulas can help reduce the impacts of racism and racial bias in health care on pregnant women of color by providing individually tailored, culturally appropriate, and patient centered care and advocacy. Women receiving doula care have also been found to have improved health outcomes for both themselves and their infants, including higher breastfeeding initiation rates, fewer low-birth weight babies, and lower rates of cesarean sections.

We are lawyers, researchers, and policy advocates. We are not doulas. As such, we seek to do all our work in partnership with and with the guidance of community doula groups, doula collectives, and individual doulas, especially Black doulas and Black-led doula groups, as well as doulas and doula groups serving low-income clients.

To achieve the goal of Medicaid coverage of doula care, we are engaged in advocacy work on various fronts, including:

• Working with doulas and other stakeholders to identify and overcome barriers to creating a sustainable and equitable Medicaid coverage of doula care program, including workforce issues, payment and billing challenges, and fair reimbursement rates;
• Working with doulas, Medicaid enrollees, policy advocates, and researchers to educate legislators and other stakeholders about the importance of expanding Medicaid coverage of doula care;
• Information-gathering and -sharing with the number of states around the country who have proposed legislation providing for Medicaid coverage of doula care;
• Advocating for state legislation providing for a Medicaid coverage of doula care program, initially in California and then subsequently promoted as a model strategy in other states; and
• Helping to develop programs for full spectrum doula support for Medicaid enrollees, including doula support for prenatal care, labor/delivery, postpartum care, miscarriage management, and abortion.