About the Doula Medicaid Project

The National Health Law Program (NHeLP)’s Doula Medicaid Project seeks to improve health outcomes and address inequities in maternal health by ensuring that all pregnant, postpartum, and post-pregnancy people who want access to a doula can have one. Our starting point in this work is expanding access to sustainable, equitable, and inclusive programs for Medicaid coverage for doula care.

People with low incomes in the United States are at a higher risk of poor birth outcomes, and pregnant and birthing people of color, especially Black and Indigenous/Native American pregnant and birthing people, are especially vulnerable. Doula care is one promising approach to combating inequities in maternal health. Pregnant and birthing people receiving doula care are more likely to have improved health outcomes for both themselves and their infants, including fewer low birth weight babies, lower rates of cesarean births, and higher breastfeeding initiation rates. Doulas can also help reduce the impacts of racism and racial bias in health care on pregnant people of color by providing individually tailored, culturally appropriate, and client-centered care and advocacy.

NHeLP supports and advocates for full spectrum doula care, which we define as doula care for all the ways in which a pregnancy can end, including doula care for prenatal, labor/delivery, and the postpartum period, as well as doula care for abortion, miscarriage, and stillbirth.

Illustrator M Jay Smith created the lovely artwork which is the centering image for the Doula Medicaid Project. Watch a short time-lapse video of the creation of the design and read Smith’s artist statement here.

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

  • Working with doulas and other stakeholders across the country to provide technical assistance, information sharing, and other support as they propose policies, pass legislation, and implement programs for Medicaid and private insurance coverage for doula care in their states and regions;
  • Educating agencies, legislators, and other stakeholders about the importance of expanding coverage of full spectrum doula care;
  • Lifting up best practices from our advocacy work to achieve sustainable, equitable, and inclusive programs for Medicaid and private insurance coverage of doula care;
  • Creating and publishing resources including fact sheets, reports, issue briefs, and other materials relevant to expanding access to doula care; and
  • Maintaining multiple listservs to share state and regional updates, resources, events, and other topics relevant to expanding access to doula care.

At NHeLP, 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-based 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.

 

Note on language:  The word “doula” comes from the ancient Greek word for “female servant” or “female slave.” Over time, the term evolved to its modern meaning of a trained professional who provides non-clinical physical, emotional, and informational support during the perinatal period. Doula work has also expanded to include the full spectrum of pregnancy outcomes (e.g., birth, abortion, adoption, miscarriage, stillbirth, and perinatal loss), as well as services to women, men, transgender, and gender non-conforming people. After consideration, NHeLP will continue to use the terms “doula” and “full spectrum doula” in our Doula Medicaid Project work, while also noting alternative terms (e.g., birthworkers, full spectrum support advocates, etc.) in parentheses. Read our issue brief, NHeLP’s Framing and Language in the Doula Medicaid Project, to learn about our process for arriving at this decision.

Doula Medicaid Project Listservs

The Doula Medicaid Project maintains a number of listservs pertaining to expanding access to doula care. To join one or more of these listservs, please fill out this form

  • National Doula Medicaid Listserv exists to share information, resources, and updates around current state, regional, and federal efforts around expanding access to doula care, including Medicaid coverage for doula care. NHeLP’s Doula Medicaid Project sends out monthly email newsletters to the listserv with updates, resources, and events. Access an archive of these monthly email newsletters.
  • California Coverage for Doula Care Listserv exists to share information, resources, and updates around efforts to expand access to doula care in California. 
  • California Doula Access Listserv is an advocacy-based working group for those actively working to troubleshoot and improve California’s doula Medi-Cal benefit. This listserv is solely for doulas and advocates.

Current Efforts at Expanding Access to Doula Care

We are tracking current state and federal efforts at expanding access to doula care, including states that have proposed, passed, and/or are implementing legislative or administrative efforts related to Medicaid coverage for doula care. We have compiled our information in two charts, which you can access below. We hope these charts are helpful resources for doulas, advocates, researchers, legislators, and other stakeholders working on this issue. We are doing our best to update them on an ongoing basis. If you have any corrections, comments, or questions, please contact NHeLP Senior Attorney Amy Chen at [email protected].

 

Doula Medicaid Resource Library

Our Resource Library collects publications, articles, and other resources from across the country pertaining to expanding access to doula care. You can filter the resources by organization, region (i.e. national, state, or territory), and topic. You can also utilize the built-in search function for keywords or phrases. We hope to continue adding to and updating this Resource Library.

RESOURCEAUTHOR
ORGANIZATIONDATE (YEAR/MONTH)REGIONTOPIC(S)
California Doula Medi-Cal Benefit: FAQ for AdvocatesAmy ChenNational Health Law Program2023/04CA
Summaries of California Doula Pilot ProgramsAlexis Robles-Fradet and Amy ChenNational Health Law Program2022/03CA
Challenges Reported by California Doula Pilot ProgramsAmy Chen and Alexis Robles-FradetNational Health Law Program2022/03CABenefits; Workforce; Hospital/Med Providers; Reimbursement
Lessons Learned from California Doula Pilot ProgramsAmy Chen and Alexis Robles-FradetNational Health Law Program2022/03CABenefits; Workforce; Hospital/Med Providers; Reimbursement
Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs Panel DiscussionAmy Chen and Alexis Robles-FradetNational Health Law Program2022/03CABenefits; Workforce; Hospital/Med Providers; Reimbursement
Doulas Know Best: Time-lapse of Visual Recording by Ashanti GardnerAshanti GardnerNational Health Law Program2022/02CA
Visual Recording by visual scribe Ashanti GardnerAshanti GardnerNational Health Law Program2022/03CA
Q&A from Doulas Know Best: Lessons Learned from California’s Doula Pilot ProgramsAmy Chen and Alexis Robles-FradetNational Health Law Program2022/03CABenefits; Workforce; Hospital/Med Providers; Reimbursement
Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in CaliforniaHelen Arega, Amy Chen, Alexis Robles-FradetNational Health Law Program2020/05CABenefits; Workforce; Hospital/Med Providers; Reimbursement
What is a Doula?Alexis Robles-FradetNational Health Law Program2020/04CA
How Can Doulas Help Address Racial Disparities in Care?Alexis Robles-FradetNational Health Law Program2020/04CABenefits; Health Equity/Disparities
Medi-Cal Enrollees Deserve Doula Care; Doulas Deserve a Living WageAlexis Robles-FradetNational Health Law Program2020/04CABenefits; Reimbursement
Timeline of Birth Work in the U.S. and California Alexis Robles-FradetNational Health Law Program2020/05CA
Recommendations from the Doula ReportAmy Chen and Alexis Robles-FradetNational Health Law Program2020/05CABenefits; Workforce; Hospital/Med Providers; Reimbursement
Supporting Mothers and Saving Lives: Creating a Medi-Cal Coverage Program for Doula Care in CaliforniaNational Health Law Program2019/04CA
The LGBTQ+ Community Deserves Access to Inclusive and Affirming Doula CareAlexis Robles-FradetNational Health Law Program2023/05U.S.Benefits; Health Equity/Disparities
Doula Medicaid Training and Certification Requirements: Summary of Current State Approaches and Recommendations for ImprovementAmy Chen and Kate RohdeNational Health Law Program2023/03U.S.Workforce
Private Insurance Coverage of Doula Care: A Growing Movement to Expand AccessAmy Chen and Kate RohdeNational Health Law Program2023/03U.S.Reimbursement
Current State of Doula Medicaid Implementation Efforts in November 2022Amy ChenNational Health Law Program2022/11U.S.
Medicaid Coverage for Doula Services: A conversation with Averjill Rockwood and Amy Chen Averjill Rockwood and Amy ChenMaternal Health Learning and Innovation Center2022/11U.S.Benefits; Workforce; Reimbursement
Doula Care Improves Health Outcomes, Reduces Racial Disparities and Cuts CostAlexis Robles-Fradet and Mara GreenwaldNational Health Law Program2022/08U.S.Benefits; Cost/Benefit; Health Equity/Disparities
Medi-Cal Coverage for Doula Care Requires Sustainable and Equitable Reimbursement to be SuccessfulAmy Chen and Allison BerquistNational Health Law Program2022/05U.S.Reimbursement
Medicaid Coverage for Doula Care: 2021 State RoundupAlexis Robles-FradetNational Health Law Program2021/12U.S.
Medicaid Coverage for Doula Care: State Implementation EffortsAlexis Robles-FradetNational Health Law Program2021/12U.S.
Issue Brief: A Guide to Proposed and Enacted Legislation for Medicaid Coverage for Doula CareAlexis Robles-FradetNational Health Law Program2019/08U.S.
Women are Dying in Childbirth: Doulas are Part of the SolutionAlexis Robles-FradetNational Health Law Program2019/08U.S.Benefits; Maternal Mortality
Legislative Proposals Addressing Maternal MortalityDaniel YoungNational Health Law Program2019/08U.S.Maternal Mortality; Health Equity/Disparities
Guest interview for Good Birth For All Podcast about Medicaid coverage of doula careAmy ChenGood Birth for All Network2019/02U.S.Benefits; Workforce; Reimbursement
2017-2018 Federal Legislative Proposals Relating to Maternal and Infant Health and MortalityAmy Chen, Dhara Patel, Nicole StrombomNational Health Law Program2019/01U.S.Maternal Mortality; Health Equity/Disparities
The Doula Difference: State and Federal Bills Aim at Reducing Maternal Health Disparities through Doula ServicesDhara PatelNational Health Law Program2019/03U.S.Benefits; Maternal Mortality; Health Equity/Disparities
State and Federal Legislative Proposals Relating to Doula CareAmy Chen and Dhara PatelNational Health Law Program2019/02U.S.
Routes to Success for Medicaid Coverage of Doula CareAmy ChenNational Health Law Program; California Preterm Birth Initiative2018/12U.S.Benefits; Workforce; Reimbursement
Raising the Bar for Maternal Health Equity and ExcellenceNational Partnership for Women & Families2023/03U.S.Workforce; Hospital/Med Providers
Changing the Narrative: The Doula Medicaid Reimbursement StorybookHealthConnect One2023/04U.S.Workforce; Reimbursement
Getting Doulas Paid Policy Brief: Advancing Community-Based Doula Models In Medicaid Reimbursement ConversationsHealthConnect One; SisterWeb; BirthMatters; Accompany Doula Care; Ancient Song Doula Services2023/02U.S.Workforce; Reimbursement
Birth Worker Burnout: Exploring Integrative Approaches to Nurturing a Healthy Doula WorkforceMama Glow Foundation2023/01U.S.Workforce
Doula Care and Maternal Health: An Evidence ReviewKathleen Knocke, Andre Chappel, Sarah Sugar, Nancy De Lew, Benjamin D. SommersAssistant Secretary for Planning and Education2022/12U.S.Benefits; Workforce; Health Equity/Disparities
Covering Doula Services Under Medicaid: Design and Implementation Considerations for Promoting Access and Health EquityPriti Khanal, Anna Benyo, Karla Silverman, Alexandra MaulCenter for Health Care Strategies 2022/12U.S.; MD; NJ; OR; RI; VA; DCBenefits; Workforce; Reimbursement
“Our Communities Hold the Solutions”: The Importance of Full-Spectrum Doulas to Reproductive Health and JusticeNational Partnership for Women & Families2022/10U.S.Benefits
Improving Our Maternity Care Now Through Doula SupportNational Partnership for Women & Families; HealthConnect One; Tewa Women United; National Health Law Program2022/09U.S.Benefits; Maternal Mortality
It Takes A Village: Pathways for Achieving Access to Doula Services for Medicaid EnrolleesSarah Hart Georgetown Journal on Poverty Law & Policy2022/06U.S.
Community Doula Research Project LearningsUC Berkeley Sexual Health and Reproductive Equity Program2022/04U.S.Workforce
The State of Doula CareThe Washington Post2021/03U.S.; MN; ORBenefits; Workforce; Reimbursement; Maternal Mortality
Improving Our Maternity Care Now: Four Care Models Decisionmakers Must Implement for Healthier Moms and BabiesCarol Sakala, Sinsi Hernández-Cancio, Sarah Coombs, Ndome Essoka, Erin MackayNational Partnership for Women & Families2020/09U.S.Maternal Mortality; Health Equity/Disparities
Four State Strategies to Employ Doulas to Improve Maternal Health and Birth Outcomes in MedicaidTaylor Platt, Neva KayeThe National Academy for State Health Policy2020/07U.S.; IN; MN; NE; ORBenefits; Cost/Benefit
Community-Based Doulas and Midwives: Key to Addressing the U.S. Maternal Health CrisisNora EllmannCenter for American Progress2020/04U.S.Benefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality
Expanding Access to Doula Care: Birth Equity & Economic Justice in New MexicoTewa Women United2020/03NMBenefits; Workforce; Reimbursement; Health Equity/Disparities
Creating Policy for Equitable Doula AccessHealthConnect One2019/10U.S.Benefits; Workforce; Reimbursement; Maternal Mortality
Summary of Doula Town Halls and Doula Survey in MassachusettsMarch of Dimes2019/05MABenefits; Cost/Benefit; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality
Eliminating Racial Disparities in Maternal and Infant Mortality: A Comprehensive Policy BlueprintJamila Taylor, Cristina Novoa, Katie Hamm, Shilpa Phadke Center for American Progress2019/05U.S.Maternal Mortality; Health Equity/Disparities
Tackling Maternal Health Disparities: A Look at Four Local Organizations with Innovative ApproachesNational Partnership for Women & Families2019/04U.S.; FL; DC; NM; TXMaternal Mortality; Health Equity/Disparities
Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities Asteir Bey, Aimee Brill, Chanel Porchia-Albert, Melissa Gradilla, Nan Strauss Ancient Song Doula Services; Village Birth International; Every Mother Counts2019/03U.S.; NYBenefits; Cost/Benefit; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities
Toolkit for Advancing the Human Right to Safe and Respectful Maternal Health CareBlack Mamas Matter Alliance2016/06U.S.Maternal Mortality; Health Equity/Disparities
Sustainable Funding for Doula ProgramsHealthConnect One2017/06U.S.Workforce; Reimbursement
Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant HealthNational Partnership for Women & Families; Childbirth Connection; Choices in Childbirth2016/01U.S.Benefits; Cost/Benefit; Health Equity/Disparities
Doulas in Medicaid: Case Study FindingsMACPAC (Medicaid and CHIP Payment and Access Commission)2023/11U.S.; FL; MN; NJ; OR; RIWorkforce; Reimbursement
Key Learnings from the Doula and Perinatal Community Health Worker in Medicaid Learning SeriesEvery Mother Counts; Institute for Medicaid Innovation2023/10U.S.Workforce; Hospital/Med Providers; Reimbursement
Healthy Babies and Parents: How States Can Leverage Doulas to Improve OutcomesThe Prenatal-to-3 Policy Impact Center2023/10U.S.Benefits; Workforce; Reimbursement
Doulas as Reproductive Justice Actors in the Climate CrisisHuman Rights Watch, et al.Human Rights Watch2023/11U.S.Benefits; Workforce; Maternal Mortality; Health Equity/Disparities
Hear Her Campaign American Indian and Alaska Native (AIAN) PeopleOffice of Minority Health; CDC (Centers for Disease Control and Prevention) 2022/11U.S.Maternal Mortality; Health Equity/Disparities
Black Women’s Maternal Health Solutions: A Multifaceted Approach to Addressing Persistent and Dire Health InequitiesNational Partnership for Women & Families2023/11U.S.Maternal Mortality; Health Equity/Disparities
March of Dimes Annual State Report CardsMarch of Dimes2023/11U.S.Maternal Mortality; Health Equity/Disparities
Advancing Maternal Health with Data EquityAssociation of State and Territorial Health Officials2023/10U.S.Maternal Mortality; Health Equity/Disparities
Building a New Way Forward: The White House Blueprint for Addressing the Maternal Health CrisisMaternal Health Learning and Innovation Center; The Reilly Group; Postpartum Support International’s Mind the Gap2023/09U.S.Maternal Mortality; Health Equity/Disparities
Advancing Healthy Births - An Equity Plan for Michigan Families & Communities for 2024-2028Michigan Department of Health and Human Services2023/10MIHealth Equity/Disparities
Building Your Perinatal Care TeamRH Impact2023/11U.S.Workforce; Hospital/Med Providers
The California Black Birth Justice Agenda: Unifying the Vision for Systemic ChangeCalifornia Coalition for Black Birth Justice2023/10CAWorkforce; Maternal Mortality; Health Equity/Disparities
The Connecticut Doula Integration ToolkitPrimary Maternity Care2023/08CTWorkforce; Hospital/Med Providers
Coverage of Community-Based Doula Care: A Summary of Initial Stakeholder Convenings with Kansas DoulasKansas Birth Justice Society2023/09KSWorkforce; Reimbursement
Next Steps for Doula Services in New York State: Medicaid Benefit Design and ReimbursementSamra G. BroukNew York State Senator Samra Brouk2023/07NYBenefits; Workforce; Reimbursement; Maternal Mortality
Centering Black Mothers in CaliforniaCalifornia Department of Public Health2023/09CAMaternal Mortality; Health Equity/Disparities
Summary: “An extra layer my best self”: Healthcare provider perspectives on doula careReiley Reed, et al.SisterWeb2023/06U.S.; CAWorkforce; Hospital/Med Providers
Aligning Pregnancy-Related Medicaid Coverage Extensions and Medicaid Doula Coverage to Improve Maternal HealthNatasha Rappazzo and Amy ChenNational Health Law Program2023/08U.S.Benefits; Maternal Mortality
Utilizing Doula Care to Support Substance Use Disorder in the Postpartum PeriodMaria Gabriela Ruiz, Ramya DronamrajuThe Association of State and Territorial Health Officials2023/06U.S.Benefits; Maternal Mortality; Health Equity/Disparities
Opportunities to Advance Medicaid Coverage for Doula SupportAfton Bloom2023/08U.S.Benefits; Workforce; Hospital/Med Providers; Reimbursement
Medical Billing Must-Have ToolsKadria MarchPost & Claim2023/08U.S.
Tackling The Maternal And Infant Health Crisis: A Governor’s PlaybookThe National Governors Association2023/07U.S.Maternal Mortality; Health Equity/Disparities
Increasing Access, Quality, and Equity in Postpartum Care in Medicaid and CHIP: A Toolkit for State Medicaid and CHIP AgenciesCenters for Medicare & Medicaid Services2023/08U.S.Maternal Mortality; Health Equity/Disparities
Where You Live Matters: Maternity Care Deserts and the Crisis of Access and EquityMarch of Dimes2023/08U.S.Maternal Mortality; Health Equity/Disparities
Fact Sheet: Black Women, Birthing People, and Maternal Mental HealthThe Maternal Mental Health Leadership Alliance2023/07U.S.Maternal Mortality; Health Equity/Disparities
New Jersey Doula ToolkitNew Jersey Doula Learning Collaborative2022/10NJWorkforce
Maternal and Child Health Data HubHealthy Mothers, Healthy Babies Coalition of Georgia2023/08GAMaternal Mortality; Health Equity/Disparities
Champion Dyad Initiative (CDI)SisterWeb2023/08CAHospital/Med Providers
Tricare Childbirth and Breastfeeding Demonstration Survey ResultsThe Military Birth Resource Network & Postpartum Coalition2023/08U.S.Benefits; Workforce; Reimbursement
How the Federal Government Can Make Funding Accessible to Maternal Health Community-Based OrganizationsThe Century Foundation2023/07U.S.Workforce; Hospital/Med Providers
Forecasting and Sustainability Tool for Community Doula Organizations (Doula FAST)Rutgers School of Public Health; Burke Foundation; HealthConnect One; Children’s Home Society of New Jersey2023/03U.S.Workforce
Community-Based Doulas: A Proven Solution to Improve Perinatal OutcomesPrenatal-to-3 Policy Impact Center2023/04U.S.Benefits
HHS Celebrates the Role of Doulas in Improving Maternal Health OutcomesThe Department of Health and Human Services2023/05U.S.Benefits; Workforce; Maternal Mortality; Health Equity/Disparities
Re-Imagining Policy: In Pursuit of Black Reproductive Justice: 2023 Black Reproductive Justice Policy AgendaIn Our Own Voice: National Black Women’s Reproductive Justice Agenda; Interfaith Voices for Reproductive Justice; SisterLove, Inc2023/06U.S.Maternal Mortality; Health Equity/Disparities
"An extra layer of pressure to be my best self”: Healthcare provider perspectives on how doulas foster accountability and bridge gaps in pregnancy-related careReiley Reed, et al.UC Berkeley Sexual Health and Reproductive Equity Program2023/06U.S.; CAWorkforce; Hospital/Med Providers
Expanding and Diversifying the Doula Workforce: Challenges and Opportunities of Increasing Insurance CoverageMathilde RouxThe U.S. Department of Labor2023/05U.S.Workforce; Reimbursement
Facing high death rates, Black expectant parents seek out Black doulasJustin Wm. MoyerThe Washington Post2023/05U.S.Benefits; Maternal Mortality
Medicaid Doula Pilot Findings and Looking ForwardHealthy Mothers, Healthy Babies Coalition of Georgia2023/05GABenefits; Workforce; Health Equity/Disparities
Black Mamas Matter: In Policy and PracticeBlack Mamas Matter Alliance2023/04U.S.Workforce; Maternal Mortality; Health Equity/Disparities
Understanding Barriers and Facilitators to Payer Investment in Doula CareCassondra Marshall, Ashley Nguyen, Clara Yang, Anu Manchikanti GómezUC Berkeley Sexual Health and Reproductive Equity Program2023/05CABenefits; Workforce; Reimbursement; Health Equity/Disparities
Giving Birth in America: Arkansas Screening and Advocacy GuideEvery Mother Counts2023/07ARMaternal Mortality; Health Equity/Disparities
What, When, and How Long? Doula Time Use in a Community Doula Program in San Francisco, CaliforniaJennet Arcara, et al.2023/03U.S.; CAWorkforce; Reimbursement
Private Insurance Coverage of Doula Care: A Growing Movement to Expand AccessAmy Chen and Kate RohdeNational Health Law Program2023/03U.S.Benefits
Doula Medicaid Training and Certification Requirements: Summary of Current State Approaches and Recommendations for ImprovementAmy Chen and Kate RohdeNational Health Law Program2023/03U.S.Workforce
Identifying and Understanding Ways to Address the Impact of Racism on Patient Safety in Health Care SettingsLucy B. Schulson, Angela D. Thomas, Jeannette Tsuei, Jason Michel EtchegarayRAND Corporation; MedStar2023/03U.S.Health Equity/Disparities
Bonnie Boswell Reports: Saving MomsBonnie BoswellPBS2023/02U.S.Maternal Mortality; Health Equity/Disparities
EnRICH webinar: Partnering with Community Doulas in Research: Agenda Setting and Program EvaluationsHealth Resources & Services Administration2023/02U.S.Workforce
EnRICH webinar: Medicaid Coverage of Doula ServicesHealth Resources & Services Administration2023/09U.S.; CA; MABenefits; Cost/Benefit; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities
EnRICH webinar: Impact of Community Doulas on Reducing Health Disparities in Maternal and Child Health PopulationsHealth Resources & Services Administration2022/10U.S.Benefits; Cost/Benefit; Maternal Mortality; Health Equity/Disparities
Doulas Work on the Front Lines of the Climate CrisisHannah Docter-LoebYes! Magazine2022/12U.S.; FLBenefits; Workforce; Maternal Mortality; Health Equity/Disparities
Is This the Answer to Reducing the Black Maternal Mortality Rate?Sam Delgado, Libby RaineyMore Perfect Union2023/02U.S.Benefits; Health Equity/Disparities
Advocating for Birthworkers in ColoradoElephant Circle; Soul 2 Soul Sisters2022/12COBenefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality; Health Equity/Disparities
Birth Worker Burnout: Exploring Integrative Approaches to Nurturing a Healthy Doula WorkforceMama Glow Foundation2022/10U.S.Workforce; Hospital/Med Providers; Reimbursement
‘I Don’t Want to Die’: Fighting Maternal Mortality Among Black WomenErica K GreenThe New York Times2023/01MOBenefits; Maternal Mortality
Doula Care and Maternal Health: An Evidence ReviewKathleen Knocke, Andre Chappel, Sarah Sugar, Nancy De Lew, Benjamin D. SommersAssistant Secretary for Planning and Education2022/12U.S.Benefits; Workforce; Reimbursement
2019 State Doula BillsAlexis Robles-FradetNational Health Law Program2019/12U.S.
2020 State Doula BillsAlexis Robles-FradetNational Health Law Program2020/12U.S.
2021 State Doula BillsAlexis Robles-FradetNational Health Law Program2021/12U.S.
2019 Federal Doula BillsAlexis Robles-FradetNational Health Law Program2019/12U.S.
2020 Federal Doula BillsAlexis Robles-FradetNational Health Law Program2020/12U.S.
How birth doulas help clients adapt to changes in circumstances, clinical care, and client preferences during labor.Amram, N. L., Klein, M. C., Mok, H., Simkin, P., Lindstrom, K., & Grant, JThe Journal of Perinatal Education2014/03U.S.Benefits; Workforce; Hospital/Med Providers
Impact of doulas on healthy birth outcomesGruber, K. J., Cupito, S. H., & Dobson, C. F.The Journal of Perinatal Education2013/12U.S.Benefits
Continuous support for women during childbirthBohren, M.A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A.Cochrane Database of Systematic Reviews2017/07U.S.Benefits
Perceptions and experiences of labour companionship: a qualitative evidence synthesisBohren, M. A., Berger, B. O., Munthe‐Kaas, H., & Tunçalp, Ö.Cochrane Database of Systematic Reviews2019/03U.S.Benefits
Continuous support for women during childbirthHodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C.Cochrane Database of Systematic Reviews2013/07U.S.Benefits
Continuous emotional support during labor in a US hospital: a randomized controlled trialKennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C.JAMA1991/05U.S.Benefits
Disrupting the pathways of social determinants of health: doula support during pregnancy and childbirthKozhimannil, K. B., Vogelsang, C. A., Hardeman, R. R., & Prasad, S.The Journal of the American Board of Family Medicine2016/05U.S.Benefits
Use of nonmedical methods of labor induction and pain management among US womenKozhimannil, K. B., Johnson, P. J., Attanasio, L. B., Gjerdingen, D. K., & McGovern, P. M.BIRTH2013/12U.S.Benefits
Potential benefits of increased access to doula support during childbirthKozhimannil, K. B., Attanasio, L. B., Jou, J., Joarnt, L. K., Johnson, P. J., & Gjerdingen, D. K.The American Journal of Managed Care2017/08U.S.Benefits
A hospital-based doula program and childbirth outcomes in an urban, multicultural settingMottl-Santiago, J., Walker, C., Ewan, J., Vragovic, O., Winder, S., & Stubblefield, P.Maternal and Child Health Journal 2007/07U.S.Benefits
Outcomes of care for 1,892 doula-supported adolescent births in the United States: The DONA international data project, 2000 to 2013Everson, C. L., Cheyney, M., & Bovbjerg, M. L.The Journal of Perinatal Education2018/06U.S.Benefits
Improving birth and breastfeeding outcomes among low resource women in Alabama by including doulas in the interprofessional birth care teamThurston, L. A. F., Abrams, D., Dreher, A., Ostrowski, S. R., & Wright, J. C.Journal of Interprofessional Education & Practice2019/07U.S.; ALBenefits
The Cost‐Effectiveness of Professional Doula Care for a Woman's First Two Births: A Decision Analysis ModelGreiner, K. S., et al.Journal of Midwifery & Women's Health2019/07U.S.Benefits; Cost/Benefit
Coverage for doula services: how state Medicaid programs can address concerns about maternity care costs and qualityKozhimannil, K. B., & Hardeman, R. R.BIRTH2017/07U.S.Benefits; Cost/Benefit
Modeling the cost‐effectiveness of doula care associated with reductions in preterm birth and cesarean deliveryKozhimannil, K. B., et al.BIRTH2016/03U.S.Benefits; Cost/Benefit
Potential benefits of increased access to doula support during childbirthKozhimannil, K. B., Attanasio, L. B., Jou, J., Joarnt, L. K., Johnson, P. J., & Gjerdingen, D. K.The American Journal of Managed Care2017/08U.S.Benefits
Doula care, birth outcomes, and costs among Medicaid beneficiariesKozhimannil, K. B., Hardeman, R. R., Attanasio, L. B., Blauer-Peterson, C., & O’brien, M.American Journal of Public Health2013/04U.S.Benefits; Cost/Benefit
An economic model of the benefits of professional doula labor support in Wisconsin births.Chapple, W., Gilliland, A., Li, D., Shier, E., & Wright, E.Wisconsin Medical Journal2013/04U.S.; WIBenefits; Cost/Benefit
Supporting birthing people and supporting doulas: the impact of the COVID-19 pandemic on a Community-Based Doula Organization in San FranciscoNguyen A, Arteaga S, Mystic M-I, Cuentos A, Armstead M, Arcara J, Jackson AV, Marshall C, Gomez AMHealth Equity2023/06U.S.; CABenefits; Workforce; Hospital/Med Providers
“An extra layer of pressure to be my best self”: Healthcare provider perspectives on how doulas foster accountability and bridge gaps in pregnancy-related careReed R*, Nguyen A, Armstead M, Cuentos A, Mystic M, Arcara J, Jackson AV, Marshall C, Gomez AMSSM - Qualitative Research in Health2023/06U.S.; CABenefits; Workforce; Hospital/Med Providers
"They're gonna be there to advocate for me so I'm not by myself": A qualitative analysis of Black women's motivations for seeking and experiences with community doula care.Arteaga S, Hubbard E, Arcara J, Cuentos A. Armstead M, Jackson A, Gomez AM, Marshall C.Women Birth2023/05U.S.; CABenefits; Health Equity/Disparities
Barriers and Facilitators to the Implementation of a Community Doula Program for Black and Pacific Islander Pregnant People in San Francisco: Findings from a Partnered Process EvaluationMarshall C, Arteaga S, Arcara J, Cuentos A, Armstead M, Jackson A, Gómez AM.Maternal and Child Health Journal 2022/01U.S.; CAWorkforce; Hospital/Med Providers
“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula CareGómez AM, Arteaga S, Arcara J, Cuentos A, Armstead M, Mehra R, Logan RG, Jackson AV, Marshall CJInternational Journal of Environmental Research and Public Health2021/10U.S.; CAWorkforce; Reimbursement
Partnering with Community Doulas to Improve Maternal and Infant Health Equity in California: Findings from the Community Doula Research ProjectMarshall C, et al. UC Berkeley Sexual Health and Reproductive Equity Program2022/07U.S.; CABenefits; Workforce
“I want to be able to serve those communities. [But] I know that my price tag is probably not what they can afford”: A Mixed Methods Study of Doula Care Access in GeorgiaElizabeth A. Mosley, et al.Perspectives on Sexual and Reproductive Health2023/08U.S.; GAWorkforce; Reimbursement; Health Equity/Disparities
“Doulas shouldn’t be considered visitors, we should be considered a part of [the]team”: Doula Care in Georgia during the COVID-19 PandemicDaria Turner, et al.Sexual and Reproductive Health Matters2022/11U.S.; GAWorkforce; Hospital/Med Providers
“I can be pro-abortion and pro-birth”: Opportunities and Challenges for Full Spectrum Care Among Doulas in GeorgiaLindsey A, Narasimhan S, Sayyad A, Turner D and Mosley EAFrontiers in Global Women's Health2023/01U.S.; GABenefits; Workforce; Health Equity/Disparities
“We Really are Seeing Racism in the Hospitals”: Racial Identity, Racism, and Doula Care for Diverse Populations in GeorgiaSayyad A, et al.PLoS ONE2023/06U.S.; GABenefits; Workforce; Health Equity/Disparities
Evidence and guidelines for trauma-informed doula careElizabeth A. Mosley, Rhonda K. LanningMidwifery2020/04U.S.; GABenefits; Workforce
Report to the General Assembly Manisha JuthaniConnecticut Department of Public Health2021/02CTWorkforce
Expanding doula support services in MassachusettsThe Betsy Lehman Center for Patient Safety2022/01MABenefits; Workforce; Reimbursement
Policy recommendations that support community-based doula sustainabilityMichigan Community-Based Doula SummitBlack Mothers' Breastfeeding Association2022/04MIWorkforce; Reimbursement
SWOT AnalysisMichigan Community-Based Doula SummitBlack Mothers' Breastfeeding Association2022/03MIWorkforce; Hospital/Med Providers; Reimbursement
Medicaid Coverage of Doula Services in Minnesota: Preliminary findings from the first year Katy B. Kozhimannil, Carrie A. Vogelsang, Rachel R HardemanInterim Report to the Minnesota Department of Human Services2015/07MNWorkforce; Hospital/Med Providers; Reimbursement
Doula Series FootnotesAshley Nguyen, Rachel Ryan, & Sarah Lipo2021/03U.S.; MN; ORBenefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality; Health Equity/Disparities
Tennessee Doulas: Practical and Policy RecommendationsElena Ferguson, Heather AllisonHealthy and Free Tennessee2022/10TNWorkforce; Hospital/Med Providers; Reimbursement
Report of the Virginia Medicaid Benefit for Community Doula Services Work Group 2020/12VABenefits; Workforce; Reimbursement
Methods to secure doula reimbursement approval from CMS Washington State Health Care Authority2020/12WABenefits; Workforce
Washington State Medicaid reimbursement: Survey of Birth DoulasAshley Nguyen2020/07WAWorkforce; Reimbursement
Next Steps for Doula Services in New York State: Medicaid Benefit Design and ReimbursementSenator Samra G. Brouk2023/07NYBenefits; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities
Leveraging Medicaid Policy to Advance Doula CareSashoy Patterson, Taylor Williams, Angie SnyderMaternal Health Learning and Innovation Center2023/12U.S.Benefits; Workforce; Reimbursement; Health Equity/Disparities
White House Blueprint for Addressing the Maternal Health CrisisBiden-Harris Administration2022/06U.S.Maternal Mortality; Health Equity/Disparities
Maternity Care Action PlanCenters for Medicare & Medicaid Services2022/07U.S.Maternal Mortality; Health Equity/Disparities
Letter for hospitals on the benefits of doula care, including Toolkit for Integrating Doulas into the Birth Care TeamPooja MittalHealth Net2023/06CABenefits; Workforce; Hospital/Med Providers
Template: Doula Observation Agreement with Community Health SystemShantay Davies-BalchBlack Wellness & Prosperity Center2023/09CAWorkforce; Hospital/Med Providers
Roadmap to Doula Care for Medicaid ClientsOregon Doula Association2015/01U.S.; ORWorkforce
A Cost-Benefit Analysis of Doula Care from a Public Health FrameworkAriel Eastburn, Erin Hubbard, and Ashley MitchellBixby Center for Global Reproductive Health2024/01U.S.Benefits; Cost/Benefit
Memo: For-Profit Companies’ Involvement in Doula Care (available by request to [email protected])José RodríguezNational Health Law Program2023/07U.S.Workforce
Memo: Theories of Liability for Doula Actions (available by request to [email protected])National Health Law Program2024/01U.S.Workforce
Medi-Cal Doula Benefit Enrollment: Resource GuideFrontline Doulas2023/06CAWorkforce
Medi-Cal Doula Benefit Enrollment: FAQFrontline Doulas2023/06CAWorkforce
Association Between Doula Use on a Digital Health Platform and Birth OutcomesSmriti Karwa, et al.Obstetrics & Gynecology2024/02U.S.Benefits; Hospital/Med Providers
Doula Pilot Program: Findings from Focus Groups of Doulas and Clients in Buffalo New York State Department of Health2023/09NYBenefits; Workforce
A Blueprint for Improving Maternal and Infant Health Outcomes Under MedicaidInstitute for Medicaid Innovation2024/01U.S. Workforce; Health Equity/Disparities; Hospital/Med Providers
Building Capacity for Research on Community Doula Care: A Stakeholder-Engaged Process in CaliforniaMarshall C, et al2024/01U.S.; CAWorkforce; Health Equity/Disparities
Doulas and the Birthing JourneyElizabeth MontgomeryArkansas Center for Health Improvement2024/01ARBenefits
Medicaid Reimbursement Guide for the Doula Services BenefitNew York Coalition for Doula Access2024/02NYWorkforce; Reimbursement
Doula Access Through Medicaid Managed Care Improves Maternal HealthElevance Health2024/02U.S.Benefits; Workforce
Realizing the Transformational Potential of Maternity Care Payment Reform Analysis and RecommendationsCarol Sakala and Megan BurnsNational Partnership for Women & Families2024/02U.S.Workforce; Reimbursement; Health Equity/Disparities
Doula Medicaid Project: February 2024 State RoundupAmy ChenNational Health Law Program2024/02U.S.Reimbursement
NHeLP’s Framing and Language in the Doula Medicaid ProjectMichelle YiuNational Health Law Program2024/03U.S.Workforce
Medi-Cal Birthworker Resource HubDiversity Uplifts, Inc.2024/02CAWorkforce; Reimbursement
Best Practices for Hospital-Doula RelationsHoda Shawky, et al.2024/03U.S.; CAHospital/Med Providers
Healthy Environment for a Healthy Start: Promoting Environmental Justice for Equitable Birth OutcomesMarch of Dimes2024/04U.S.Benefits; Workforce; Maternal Mortality; Health Equity/Disparities
Doula Care to Improve Outcomes and Reduce Disparities in NebraskaShannon Haines, et al.Nebraska Perinatal Quality Improvement Collaborative2024/04NEBenefits; Maternal Mortality; Health Equity/Disparities
Advancing Health Equity for Childbearing Families in Oregon: Results of a Statewide DoulaWorkforce Needs AssessmentCourtney Everson, et al.Oregon Doula Association2018/09ORWorkforce; Hospital/Med Providers; Reimbursement
Five Facts About Black Women’s Experiences in Health CareShannon Schumacher, et al.Kaiser Family Foundation2024/05U.S.Health Equity/Disparities

 

Meet the Team

Meet the Legal and Policy Experts working on NHeLP’s Doula Medicaid Project:

 

Amy Chen
View Amy Chen's Profile

Amy Chen

Senior Attorney

Area(s) of Expertise: Sexual and reproductive health, pregnancy coverage, maternal health, expanding access to doula care, Medicaid coverage for doula…

Alexis Robles-Fradet
View Alexis Robles-Fradet's Profile

Alexis Robles-Fradet

Policy Analyst

Area(s) of Expertise: Medi-Cal, Medicaid, Reproductive and Sexual Health, Behavioral Health, Health Equity, EHBsAlexis Robles-Fradet is a Health Policy…