Doula Medicaid Project
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.
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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.
RESOURCE | AUTHOR | ORGANIZATION | DATE (YEAR/MONTH) | REGION | TOPIC(S) |
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California Doula Medi-Cal Benefit: FAQ for Advocates | Amy Chen | National Health Law Program | 2023/04 | CA | |
Summaries of California Doula Pilot Programs | Alexis Robles-Fradet and Amy Chen | National Health Law Program | 2022/03 | CA | |
Challenges Reported by California Doula Pilot Programs | Amy Chen and Alexis Robles-Fradet | National Health Law Program | 2022/03 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
Lessons Learned from California Doula Pilot Programs | Amy Chen and Alexis Robles-Fradet | National Health Law Program | 2022/03 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs Panel Discussion | Amy Chen and Alexis Robles-Fradet | National Health Law Program | 2022/03 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
Doulas Know Best: Time-lapse of Visual Recording by Ashanti Gardner | Ashanti Gardner | National Health Law Program | 2022/02 | CA | |
Visual Recording by visual scribe Ashanti Gardner | Ashanti Gardner | National Health Law Program | 2022/03 | CA | |
Q&A from Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs | Amy Chen and Alexis Robles-Fradet | National Health Law Program | 2022/03 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California | Helen Arega, Amy Chen, Alexis Robles-Fradet | National Health Law Program | 2020/05 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
What is a Doula? | Alexis Robles-Fradet | National Health Law Program | 2020/04 | CA | |
How Can Doulas Help Address Racial Disparities in Care? | Alexis Robles-Fradet | National Health Law Program | 2020/04 | CA | Benefits; Health Equity/Disparities |
Medi-Cal Enrollees Deserve Doula Care; Doulas Deserve a Living Wage | Alexis Robles-Fradet | National Health Law Program | 2020/04 | CA | Benefits; Reimbursement |
Timeline of Birth Work in the U.S. and California | Alexis Robles-Fradet | National Health Law Program | 2020/05 | CA | |
Recommendations from the Doula Report | Amy Chen and Alexis Robles-Fradet | National Health Law Program | 2020/05 | CA | Benefits; Workforce; Hospital/Med Providers; Reimbursement |
Supporting Mothers and Saving Lives: Creating a Medi-Cal Coverage Program for Doula Care in California | National Health Law Program | 2019/04 | CA | ||
The LGBTQ+ Community Deserves Access to Inclusive and Affirming Doula Care | Alexis Robles-Fradet | National Health Law Program | 2023/05 | U.S. | Benefits; Health Equity/Disparities |
Doula Medicaid Training and Certification Requirements: Summary of Current State Approaches and Recommendations for Improvement | Amy Chen and Kate Rohde | National Health Law Program | 2023/03 | U.S. | Workforce |
Private Insurance Coverage of Doula Care: A Growing Movement to Expand Access | Amy Chen and Kate Rohde | National Health Law Program | 2023/03 | U.S. | Reimbursement |
Current State of Doula Medicaid Implementation Efforts in November 2022 | Amy Chen | National Health Law Program | 2022/11 | U.S. | |
Medicaid Coverage for Doula Services: A conversation with Averjill Rockwood and Amy Chen | Averjill Rockwood and Amy Chen | Maternal Health Learning and Innovation Center | 2022/11 | U.S. | Benefits; Workforce; Reimbursement |
Doula Care Improves Health Outcomes, Reduces Racial Disparities and Cuts Cost | Alexis Robles-Fradet and Mara Greenwald | National Health Law Program | 2022/08 | U.S. | Benefits; Cost/Benefit; Health Equity/Disparities |
Medi-Cal Coverage for Doula Care Requires Sustainable and Equitable Reimbursement to be Successful | Amy Chen and Allison Berquist | National Health Law Program | 2022/05 | U.S. | Reimbursement |
Medicaid Coverage for Doula Care: 2021 State Roundup | Alexis Robles-Fradet | National Health Law Program | 2021/12 | U.S. | |
Medicaid Coverage for Doula Care: State Implementation Efforts | Alexis Robles-Fradet | National Health Law Program | 2021/12 | U.S. | |
Issue Brief: A Guide to Proposed and Enacted Legislation for Medicaid Coverage for Doula Care | Alexis Robles-Fradet | National Health Law Program | 2019/08 | U.S. | |
Women are Dying in Childbirth: Doulas are Part of the Solution | Alexis Robles-Fradet | National Health Law Program | 2019/08 | U.S. | Benefits; Maternal Mortality |
Legislative Proposals Addressing Maternal Mortality | Daniel Young | National Health Law Program | 2019/08 | U.S. | Maternal Mortality; Health Equity/Disparities |
Guest interview for Good Birth For All Podcast about Medicaid coverage of doula care | Amy Chen | Good Birth for All Network | 2019/02 | U.S. | Benefits; Workforce; Reimbursement |
2017-2018 Federal Legislative Proposals Relating to Maternal and Infant Health and Mortality | Amy Chen, Dhara Patel, and Nicole Strombom | National Health Law Program | 2019/01 | U.S. | Maternal Mortality; Health Equity/Disparities |
The Doula Difference: State and Federal Bills Aim at Reducing Maternal Health Disparities through Doula Services | Dhara Patel | National Health Law Program | 2019/03 | U.S. | Benefits; Maternal Mortality; Health Equity/Disparities |
State and Federal Legislative Proposals Relating to Doula Care | Amy Chen and Dhara Patel | National Health Law Program | 2019/02 | U.S. | |
Routes to Success for Medicaid Coverage of Doula Care | Amy Chen | National Health Law Program; California Preterm Birth Initiative | 2018/12 | U.S. | Benefits; Workforce; Reimbursement |
Raising the Bar for Maternal Health Equity and Excellence | National Partnership for Women & Families | 2023/03 | U.S. | Workforce; Hospital/Med Providers | |
Changing the Narrative: The Doula Medicaid Reimbursement Storybook | HealthConnect One | 2023/04 | U.S. | Workforce; Reimbursement | |
Getting Doulas Paid Policy Brief: Advancing Community-Based Doula Models In Medicaid Reimbursement Conversations | HealthConnect One; SisterWeb; BirthMatters; Accompany Doula Care; Ancient Song Doula Services | 2023/02 | U.S. | Workforce; Reimbursement | |
Birth Worker Burnout: Exploring Integrative Approaches to Nurturing a Healthy Doula Workforce | Mama Glow Foundation | 2023/01 | U.S. | Workforce | |
Doula Care and Maternal Health: An Evidence Review | Kathleen Knocke, Andre Chappel, Sarah Sugar, Nancy De Lew, Benjamin D. Sommers | Assistant Secretary for Planning and Education | 2022/12 | U.S. | Benefits; Workforce; Health Equity/Disparities |
Covering Doula Services Under Medicaid: Design and Implementation Considerations for Promoting Access and Health Equity | Priti Khanal, Anna Benyo, Karla Silverman, Alexandra Maul | Center for Health Care Strategies | 2022/12 | U.S.; MD; NJ; OR; RI; VA; DC | Benefits; Workforce; Reimbursement |
“Our Communities Hold the Solutions”: The Importance of Full-Spectrum Doulas to Reproductive Health and Justice | National Partnership for Women & Families | 2022/10 | U.S. | Benefits | |
Improving Our Maternity Care Now Through Doula Support | National Partnership for Women & Families; HealthConnect One; Tewa Women United; National Health Law Program | 2022/09 | U.S. | Benefits; Maternal Mortality | |
It Takes A Village: Pathways for Achieving Access to Doula Services for Medicaid Enrollees | Sarah Hart | Georgetown Journal on Poverty Law & Policy | 2022/06 | U.S. | |
Community Doula Research Project Learnings | UC Berkeley Sexual Health and Reproductive Equity Program | 2022/04 | U.S. | Workforce |
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The State of Doula Care | The Washington Post | 2021/03 | U.S.; MN; OR | Benefits; Workforce; Reimbursement; Maternal Mortality | |
Improving Our Maternity Care Now: Four Care Models Decisionmakers Must Implement for Healthier Moms and Babies | Carol Sakala, Sinsi Hernández-Cancio, Sarah Coombs, Ndome Essoka, Erin Mackay | National Partnership for Women & Families | 2020/09 | U.S. | Maternal Mortality; Health Equity/Disparities |
Four State Strategies to Employ Doulas to Improve Maternal Health and Birth Outcomes in Medicaid | Taylor Platt, Neva Kaye | The National Academy for State Health Policy | 2020/07 | U.S.; IN; MN; NE; OR | Benefits; Cost/Benefit |
Community-Based Doulas and Midwives: Key to Addressing the U.S. Maternal Health Crisis | Nora Ellmann | Center for American Progress | 2020/04 | U.S. | Benefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality |
Expanding Access to Doula Care: Birth Equity & Economic Justice in New Mexico | Tewa Women United | 2020/03 | NM | Benefits; Workforce; Reimbursement; Health Equity/Disparities |
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Creating Policy for Equitable Doula Access | HealthConnect One | 2019/10 | U.S. | Benefits; Workforce; Reimbursement; Maternal Mortality |
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Summary of Doula Town Halls and Doula Survey in Massachusetts | March of Dimes | 2019/05 | MA | Benefits; Cost/Benefit; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality |
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Eliminating Racial Disparities in Maternal and Infant Mortality: A Comprehensive Policy Blueprint | Jamila Taylor, Cristina Novoa, Katie Hamm, and Shilpa Phadke | Center for American Progress | 2019/05 | U.S. | Maternal Mortality; Health Equity/Disparities |
Tackling Maternal Health Disparities: A Look at Four Local Organizations with Innovative Approaches | National Partnership for Women & Families | 2019/04 | U.S.; FL; DC; NM; TX | Maternal 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 Counts | 2019/03 | U.S.; NY | Benefits; Cost/Benefit; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities |
Toolkit for Advancing the Human Right to Safe and Respectful Maternal Health Care | Black Mamas Matter Alliance | 2016/06 | U.S. | Maternal Mortality; Health Equity/Disparities |
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Sustainable Funding for Doula Programs | HealthConnect One | 2017/06 | U.S. | Workforce; Reimbursement | |
Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health | National Partnership for Women & Families; Childbirth Connection; Choices in Childbirth | 2016/01 | U.S. | Benefits; Cost/Benefit; Health Equity/Disparities |
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Doulas in Medicaid: Case Study Findings | MACPAC (Medicaid and CHIP Payment and Access Commission) | 2023/11 | U.S.; FL; MN; NJ; OR; RI | Workforce; Reimbursement | |
Key Learnings from the Doula and Perinatal Community Health Worker in Medicaid Learning Series | Every Mother Counts; Institute for Medicaid Innovation | 2023/10 | U.S. | Workforce; Hospital/Med Providers; Reimbursement | |
Healthy Babies and Parents: How States Can Leverage Doulas to Improve Outcomes | The Prenatal-to-3 Policy Impact Center | 2023/10 | U.S. | Benefits; Workforce; Reimbursement | |
Doulas as Reproductive Justice Actors in the Climate Crisis | Human Rights Watch, et al. | Human Rights Watch | 2023/11 | U.S. | Benefits; Workforce; Maternal Mortality; Health Equity/Disparities |
Hear Her Campaign American Indian and Alaska Native (AIAN) People | Office of Minority Health; CDC (Centers for Disease Control and Prevention) | 2022/11 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Black Women’s Maternal Health Solutions: A Multifaceted Approach to Addressing Persistent and Dire Health Inequities | National Partnership for Women & Families | 2023/11 | U.S. | Maternal Mortality; Health Equity/Disparities | |
March of Dimes Annual State Report Cards | March of Dimes | 2023/11 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Advancing Maternal Health with Data Equity | Association of State and Territorial Health Officials | 2023/10 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Building a New Way Forward: The White House Blueprint for Addressing the Maternal Health Crisis | Maternal Health Learning and Innovation Center; The Reilly Group; Postpartum Support International’s Mind the Gap | 2023/09 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Advancing Healthy Births - An Equity Plan for Michigan Families & Communities for 2024-2028 | Michigan Department of Health and Human Services | 2023/10 | MI | Health Equity/Disparities | |
Building Your Perinatal Care Team | RH Impact | 2023/11 | U.S. | Workforce; Hospital/Med Providers |
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The California Black Birth Justice Agenda: Unifying the Vision for Systemic Change | California Coalition for Black Birth Justice | 2023/10 | CA | Workforce; Maternal Mortality; Health Equity/Disparities | |
The Connecticut Doula Integration Toolkit | Primary Maternity Care | 2023/08 | CT | Workforce; Hospital/Med Providers |
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Coverage of Community-Based Doula Care: A Summary of Initial Stakeholder Convenings with Kansas Doulas | Kansas Birth Justice Society | 2023/09 | KS | Workforce; Reimbursement |
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Next Steps for Doula Services in New York State: Medicaid Benefit Design and Reimbursement | Senator Samra G. Brouk | New York State Senator Samra Brouk | 2023/07 | NY | Benefits; Workforce; Reimbursement; Maternal Mortality |
Centering Black Mothers in California | California Department of Public Health | 2023/09 | CA | Maternal Mortality; Health Equity/Disparities | |
Summary: “An extra layer my best self”: Healthcare provider perspectives on doula care | Reed, R., et al. | SisterWeb | 2023/06 | U.S.; CA | Workforce; Hospital/Med Providers |
Aligning Pregnancy-Related Medicaid Coverage Extensions and Medicaid Doula Coverage to Improve Maternal Health | Natasha Rappazzo and Amy Chen | National Health Law Program | 2023/08 | U.S. | Benefits; Maternal Mortality |
Utilizing Doula Care to Support Substance Use Disorder in the Postpartum Period | Maria Gabriela Ruiz, Ramya Dronamraju | The Association of State and Territorial Health Officials | 2023/06 | U.S. | Benefits; Maternal Mortality; Health Equity/Disparities |
Opportunities to Advance Medicaid Coverage for Doula Support | Afton Bloom | 2023/08 | U.S. | Benefits; Workforce; Hospital/Med Providers; Reimbursement | |
Medical Billing Must-Have Tools | Kadria March | Post & Claim | 2023/08 | U.S. | |
Tackling The Maternal And Infant Health Crisis: A Governor’s Playbook | The National Governors Association | 2023/07 | U.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 Agencies | Centers for Medicare & Medicaid Services | 2023/08 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity | March of Dimes | 2023/08 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Fact Sheet: Black Women, Birthing People, and Maternal Mental Health | The Maternal Mental Health Leadership Alliance | 2023/07 | U.S. | Maternal Mortality; Health Equity/Disparities | |
New Jersey Doula Toolkit | New Jersey Doula Learning Collaborative | 2022/10 | NJ | Workforce |
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Maternal and Child Health Data Hub | Healthy Mothers, Healthy Babies Coalition of Georgia | 2023/08 | GA | Maternal Mortality; Health Equity/Disparities | |
Champion Dyad Initiative (CDI) | SisterWeb | 2023/08 | CA | Hospital/Med Providers |
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Tricare Childbirth and Breastfeeding Demonstration Survey Results | The Military Birth Resource Network & Postpartum Coalition | 2023/08 | U.S. | Benefits; Workforce; Reimbursement | |
How the Federal Government Can Make Funding Accessible to Maternal Health Community-Based Organizations | The Century Foundation | 2023/07 | U.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 Jersey | 2023/03 | U.S. | Workforce | |
Community-Based Doulas: A Proven Solution to Improve Perinatal Outcomes | Prenatal-to-3 Policy Impact Center | 2023/04 | U.S. | Benefits |
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HHS Celebrates the Role of Doulas in Improving Maternal Health Outcomes | The Department of Health and Human Services | 2023/05 | U.S. | Benefits; Workforce; Maternal Mortality; Health Equity/Disparities | |
Re-Imagining Policy: In Pursuit of Black Reproductive Justice: 2023 Black Reproductive Justice Policy Agenda | In Our Own Voice: National Black Women’s Reproductive Justice Agenda; Interfaith Voices for Reproductive Justice; SisterLove, Inc | 2023/06 | U.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 care | Reiley Reed, et al. | UC Berkeley Sexual Health and Reproductive Equity Program | 2023/06 | U.S.; CA | Workforce; Hospital/Med Providers |
Expanding and Diversifying the Doula Workforce: Challenges and Opportunities of Increasing Insurance Coverage | Mathilde Roux | The U.S. Department of Labor | 2023/05 | U.S. | Workforce; Reimbursement |
Facing high death rates, Black expectant parents seek out Black doulas | Justin Wm, Moyer | The Washington Post | 2023/05 | U.S. | Benefits; Maternal Mortality |
Medicaid Doula Pilot Findings and Looking Forward | Healthy Mothers, Healthy Babies Coalition of Georgia | 2023/05 | GA | Benefits; Workforce; Health Equity/Disparities | |
Black Mamas Matter: In Policy and Practice | Black Mamas Matter Alliance | 2023/04 | U.S. | Workforce; Maternal Mortality; Health Equity/Disparities | |
Understanding Barriers and Facilitators to Payer Investment in Doula Care | Cassondra Marshall, Ashley Nguyen, Clara Yang, Anu Manchikanti Gómez | UC Berkeley Sexual Health and Reproductive Equity Program | 2023/05 | CA | Benefits; Workforce; Reimbursement; Health Equity/Disparities |
Giving Birth in America: Arkansas Screening and Advocacy Guide | Every Mother Counts | 2023/07 | AR | Maternal Mortality; Health Equity/Disparities | |
What, When, and How Long? Doula Time Use in a Community Doula Program in San Francisco, California | Arcara J, Cuentos A, Abdallah O, Armstead M, Jackson A, Marshall C, Gomez AM | 2023/03 | U.S.; CA | Workforce; Reimbursement | |
Private Insurance Coverage of Doula Care: A Growing Movement to Expand Access | Amy Chen and Kate Rohde | National Health Law Program | 2023/03 | U.S. | Benefits |
Doula Medicaid Training and Certification Requirements: Summary of Current State Approaches and Recommendations for Improvement | Amy Chen and Kate Rohde | National Health Law Program | 2023/03 | U.S. | Workforce |
Identifying and Understanding Ways to Address the Impact of Racism on Patient Safety in Health Care Settings | Lucy B. Schulson, Angela D. Thomas, Jeannette Tsuei, Jason Michel Etchegaray | RAND Corporation; MedStar | 2023/03 | U.S. | Health Equity/Disparities |
Bonnie Boswell Reports: Saving Moms | Bonnie Boswell | PBS | 2023/02 | U.S. | Maternal Mortality; Health Equity/Disparities |
EnRICH webinar: Partnering with Community Doulas in Research: Agenda Setting and Program Evaluations | Health Resources & Services Administration | 2023/02 | U.S. | Workforce | |
EnRICH webinar: Medicaid Coverage of Doula Services | Health Resources & Services Administration | 2023/09 | U.S.; CA; MA | Benefits; Cost/Benefit; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities | |
EnRICH webinar: Impact of Community Doulas on Reducing Health Disparities in Maternal and Child Health Populations | Health Resources & Services Administration | 2022/10 | U.S. | Benefits; Cost/Benefit; Maternal Mortality; Health Equity/Disparities | |
Doulas Work on the Front Lines of the Climate Crisis | Hannah Docter-Loeb | Yes! Magazine | 2022/12 | U.S.; FL | Benefits; Workforce; Maternal Mortality; Health Equity/Disparities |
Is This the Answer to Reducing the Black Maternal Mortality Rate? | Sam Delgado, Libby Rainey | More Perfect Union | 2023/02 | U.S. | Benefits; Health Equity/Disparities |
Advocating for Birthworkers in Colorado | Elephant Circle; Soul 2 Soul Sisters | 2022/12 | CO | Benefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality; Health Equity/Disparities | |
Birth Worker Burnout: Exploring Integrative Approaches to Nurturing a Healthy Doula Workforce | Mama Glow Foundation | 2022/10 | U.S. | Workforce; Hospital/Med Providers; Reimbursement | |
‘I Don’t Want to Die’: Fighting Maternal Mortality Among Black Women | Erica K Green | The New York Times | 2023/01 | MO | Benefits; Maternal Mortality |
Doula Care and Maternal Health: An Evidence Review | Kathleen Knocke, Andre Chappel, Sarah Sugar, Nancy De Lew, Benjamin D. Sommers | Assistant Secretary for Planning and Education | 2022/12 | U.S. | Benefits; Workforce; Reimbursement |
2019 State Doula Bills | Alexis Robles-Fradet | National Health Law Program | 2019/12 | U.S. | |
2020 State Doula Bills | Alexis Robles-Fradet | National Health Law Program | 2020/12 | U.S. | |
2021 State Doula Bills | Alexis Robles-Fradet | National Health Law Program | 2021/12 | U.S. | |
2019 Federal Doula Bills | Alexis Robles-Fradet | National Health Law Program | 2019/12 | U.S. | |
2020 Federal Doula Bills | Alexis Robles-Fradet | National Health Law Program | 2020/12 | U.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, J | The Journal of Perinatal Education | 2014/03 | U.S. | Benefits; Workforce; Hospital/Med Providers |
Impact of doulas on healthy birth outcomes | Gruber, K. J., Cupito, S. H., & Dobson, C. F. | The Journal of Perinatal Education | 2013/12 | U.S. | Benefits |
Continuous support for women during childbirth | Bohren, M.A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. | Cochrane Database of Systematic Reviews | 2017/07 | U.S. | Benefits |
Perceptions and experiences of labour companionship: a qualitative evidence synthesis | Bohren, M. A., Berger, B. O., Munthe‐Kaas, H., & Tunçalp, Ö. | Cochrane Database of Systematic Reviews | 2019/03 | U.S. | Benefits |
Continuous support for women during childbirth | Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. | Cochrane Database of Systematic Reviews | 2013/07 | U.S. | Benefits |
Continuous emotional support during labor in a US hospital: a randomized controlled trial | Kennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C. | JAMA | 1991/05 | U.S. | Benefits |
Disrupting the pathways of social determinants of health: doula support during pregnancy and childbirth | Kozhimannil, K. B., Vogelsang, C. A., Hardeman, R. R., & Prasad, S. | The Journal of the American Board of Family Medicine | 2016/05 | U.S. | Benefits |
Use of nonmedical methods of labor induction and pain management among US women | Kozhimannil, K. B., Johnson, P. J., Attanasio, L. B., Gjerdingen, D. K., & McGovern, P. M. | BIRTH | 2013/12 | U.S. | Benefits |
Potential benefits of increased access to doula support during childbirth | Kozhimannil, K. B., Attanasio, L. B., Jou, J., Joarnt, L. K., Johnson, P. J., & Gjerdingen, D. K. | The American Journal of Managed Care | 2017/08 | U.S. | Benefits |
A hospital-based doula program and childbirth outcomes in an urban, multicultural setting | Mottl-Santiago, J., Walker, C., Ewan, J., Vragovic, O., Winder, S., & Stubblefield, P. | Maternal and Child Health Journal | 2007/07 | U.S. | Benefits |
Outcomes of care for 1,892 doula-supported adolescent births in the United States: The DONA international data project, 2000 to 2013 | Everson, C. L., Cheyney, M., & Bovbjerg, M. L. | The Journal of Perinatal Education | 2018/06 | U.S. | Benefits |
Improving birth and breastfeeding outcomes among low resource women in Alabama by including doulas in the interprofessional birth care team | Thurston, L. A. F., Abrams, D., Dreher, A., Ostrowski, S. R., & Wright, J. C. | Journal of Interprofessional Education & Practice | 2019/07 | U.S.; AL | Benefits |
The Cost‐Effectiveness of Professional Doula Care for a Woman's First Two Births: A Decision Analysis Model | Greiner, K. S., et al. | Journal of Midwifery & Women's Health | 2019/07 | U.S. | Benefits; Cost/Benefit |
Coverage for doula services: how state Medicaid programs can address concerns about maternity care costs and quality | Kozhimannil, K. B., & Hardeman, R. R. | BIRTH | 2017/07 | U.S. | Benefits; Cost/Benefit |
Modeling the cost‐effectiveness of doula care associated with reductions in preterm birth and cesarean delivery | Kozhimannil, K. B., et al. | BIRTH | 2016/03 | U.S. | Benefits; Cost/Benefit |
Potential benefits of increased access to doula support during childbirth | Kozhimannil, K. B., Attanasio, L. B., Jou, J., Joarnt, L. K., Johnson, P. J., & Gjerdingen, D. K. | The American Journal of Managed Care | 2017/08 | U.S. | Benefits |
Doula care, birth outcomes, and costs among Medicaid beneficiaries | Kozhimannil, K. B., Hardeman, R. R., Attanasio, L. B., Blauer-Peterson, C., & O’brien, M. | American Journal of Public Health | 2013/04 | U.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 Journal | 2013/04 | U.S.; WI | Benefits; Cost/Benefit |
Supporting birthing people and supporting doulas: the impact of the COVID-19 pandemic on a Community-Based Doula Organization in San Francisco | Nguyen A, Arteaga S, Mystic M-I, Cuentos A, Armstead M, Arcara J, Jackson AV, Marshall C, Gomez AM | Health Equity | 2023/06 | U.S.; CA | Benefits; 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 care | Reed R*, Nguyen A, Armstead M, Cuentos A, Mystic M, Arcara J, Jackson AV, Marshall C, Gomez AM | SSM - Qualitative Research in Health | 2023/06 | U.S.; CA | Benefits; 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 Birth | 2023/05 | U.S.; CA | Benefits; 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 Evaluation | Marshall C, Arteaga S, Arcara J, Cuentos A, Armstead M, Jackson A, Gómez AM. | Maternal and Child Health Journal | 2022/01 | U.S.; CA | Workforce; Hospital/Med Providers |
“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care | Gómez AM, Arteaga S, Arcara J, Cuentos A, Armstead M, Mehra R, Logan RG, Jackson AV, Marshall CJ | International Journal of Environmental Research and Public Health | 2021/10 | U.S.; CA | Workforce; Reimbursement |
Partnering with Community Doulas to Improve Maternal and Infant Health Equity in California: Findings from the Community Doula Research Project | Marshall C, et al. | UC Berkeley Sexual Health and Reproductive Equity Program | 2022/07 | U.S.; CA | Benefits; 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 Georgia | Elizabeth A. Mosley, et al. | Perspectives on Sexual and Reproductive Health | 2023/08 | U.S.; GA | Workforce; 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 Pandemic | Daria Turner, et al. | Sexual and Reproductive Health Matters | 2022/11 | U.S.; GA | Workforce; Hospital/Med Providers |
“I can be pro-abortion and pro-birth”: Opportunities and Challenges for Full Spectrum Care Among Doulas in Georgia | Lindsey A, Narasimhan S, Sayyad A, Turner D and Mosley EA | Frontiers in Global Women's Health | 2023/01 | U.S.; GA | Benefits; Workforce; Health Equity/Disparities |
“We Really are Seeing Racism in the Hospitals”: Racial Identity, Racism, and Doula Care for Diverse Populations in Georgia | Sayyad A, et al. | PLoS ONE | 2023/06 | U.S.; GA | Benefits; Workforce; Health Equity/Disparities |
Evidence and guidelines for trauma-informed doula care | Elizabeth A. Mosley, Rhonda K. Lanning | Midwifery | 2020/04 | U.S.; GA | Benefits; Workforce |
Report to the General Assembly | Manisha Juthani | Connecticut Department of Public Health | 2021/02 | CT | Workforce |
Expanding doula support services in Massachusetts | The Betsy Lehman Center for Patient Safety | 2022/01 | MA | Benefits; Workforce; Reimbursement | |
Policy recommendations that support community-based doula sustainability | Michigan Community-Based Doula Summit | Black Mothers' Breastfeeding Association | 2022/04 | MI | Workforce; Reimbursement |
SWOT Analysis | Michigan Community-Based Doula Summit | Black Mothers' Breastfeeding Association | 2022/03 | MI | Workforce; 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 Hardeman | Interim Report to the Minnesota Department of Human Services | 2015/07 | MN | Workforce; Hospital/Med Providers; Reimbursement |
Doula Series Footnotes | Ashley Nguyen, Rachel Ryan, & Sarah Lipo | 2021/03 | U.S.; MN; OR | Benefits; Workforce; Hospital/Med Providers; Reimbursement; Maternal Mortality; Health Equity/Disparities | |
Tennessee Doulas: Practical and Policy Recommendations | Elena Ferguson, Heather Allison | Healthy and Free Tennessee | 2022/10 | TN | Workforce; Hospital/Med Providers; Reimbursement |
Report of the Virginia Medicaid Benefit for Community Doula Services Work Group | 2020/12 | VA | Benefits; Workforce; Reimbursement | ||
Methods to secure doula reimbursement approval from CMS | Washington State Health Care Authority | 2020/12 | WA | Benefits; Workforce | |
Washington State Medicaid reimbursement: Survey of Birth Doulas | Ashley Nguyen | 2020/07 | WA | Workforce; Reimbursement | |
Next Steps for Doula Services in New York State: Medicaid Benefit Design and Reimbursement | Senator Samra G. Brouk | 2023/07 | NY | Benefits; Workforce; Reimbursement; Maternal Mortality; Health Equity/Disparities | |
Leveraging Medicaid Policy to Advance Doula Care | Sashoy Patterson, Taylor Williams, Angie Snyder | Maternal Health Learning and Innovation Center | 2023/12 | U.S. | Benefits; Workforce; Reimbursement; Health Equity/Disparities |
White House Blueprint for Addressing the Maternal Health Crisis | Biden-Harris Administration | 2022/06 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Maternity Care Action Plan | Centers for Medicare & Medicaid Services | 2022/07 | U.S. | Maternal Mortality; Health Equity/Disparities | |
Letter for hospitals on the benefits of doula care, including Toolkit for Integrating Doulas into the Birth Care Team | Pooja Mittal | Health Net | 2023/06 | CA | Benefits; Workforce; Hospital/Med Providers |
Template: Doula Observation Agreement with Community Health System | Shantay Davies-Balch | Black Wellness & Prosperity Center | 2023/09 | CA | Workforce; Hospital/Med Providers |
Roadmap to Doula Care for Medicaid Clients | Oregon Doula Association | 2015/01 | U.S.; OR | Workforce | |
A Cost-Benefit Analysis of Doula Care from a Public Health Framework | Ariel Eastburn, Erin Hubbard, and Ashley Mitchell | Bixby Center for Global Reproductive Health | 2024/01 | U.S. | Benefits; Cost/Benefit |
Memo: For-Profit Companies’ Involvement in Doula Care (available by request to [email protected]) | José Rodríguez | National Health Law Program | 2023/07 | U.S. | Workforce |
Memo: Theories of Liability for Doula Actions (available by request to [email protected]) | National Health Law Program | 2024/01 | U.S. | Workforce | |
Medi-Cal Birthworker Resource Hub | Diversity Uplifts, Inc. | 2024/01 | CA | Workforce | |
Medi-Cal Doula Benefit Enrollment: Resource Guide | Frontline Doulas | 2023/06 | CA | Workforce | |
Medi-Cal Doula Benefit Enrollment: FAQ | Frontline Doulas | 2023/06 | CA | Workforce | |
Association Between Doula Use on a Digital Health Platform and Birth Outcomes | Smriti Karwa, et al. | Obstetrics & Gynecology | 2024/02 | U.S. | Benefits; Hospital/Med Providers |
Doula Pilot Program: Findings from Focus Groups of Doulas and Clients in Buffalo | New York State Department of Health | 2023/09 | NY | Benefits; Workforce | |
A Blueprint for Improving Maternal and Infant Health Outcomes Under Medicaid | Institute for Medicaid Innovation | 2024/01 | U.S. | Workforce; Health Equity/Disparities; Hospital/Med providers | |
Building Capacity for Research on Community Doula Care: A Stakeholder-Engaged Process in California | Marshall C, et al | 2024/01 | U.S.; CA | Workforce; Health Equity/Disparities | |
Doulas and the Birthing Journey | Elizabeth Montgomery | Arkansas Center for Health Improvement | 2024/01 | AR | Benefits |
Medicaid Reimbursement Guide for the Doula Services Benefit | New York Coalition for Doula Access | 2024/02 | NY | Workforce; Reimbursement | |
Doula Access Through Medicaid Managed Care Improves Maternal Health | Elevance Health | 2024/02 | U.S. | Benefits; Workforce | |
Realizing the Transformational Potential of Maternity Care Payment Reform Analysis and Recommendations | Carol Sakala and Megan Burns | National Partnership for Women & Families | 2024/02 | U.S. | Workforce; Reimbursement; Health Equity/Disparities |
Doula Medicaid Project: February 2024 State Roundup | Amy Chen | National Health Law Program | 2024/02 | U.S. | Reimbursement |
NHeLP’s Framing and Language in the Doula Medicaid Project | Michelle Yiu | National Health Law Program | 2024/03 | U.S. | Workforce |
Meet the Team
Meet the Legal and Policy Experts working on NHeLP’s Doula Medicaid Project:
![Amy Chen](https://healthlaw.org/wp-content/uploads/2015/08/Amy-Chen-revAP-scaled-e1709005232270.jpg)
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](https://healthlaw.org/wp-content/uploads/2017/09/Alexis-Robles-Fradet-revAP-scaled-e1709005043280.jpg)
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…