California Doula Push Shifts Focus Due to COVID-19 Pandemic

California Doula Push Shifts Focus Due to COVID-19 Pandemic

Assembly’s COVID-19 Emergency Response Ends Doula Bill

Sacramento, CA – A push to create a Medi-Cal pilot program for doula care in California is the latest victim of the global COVID-19 pandemic. Introduced by Assemblymember Eloise Gómez Reyes, AB 2258 aimed to lower maternal and infant mortality rates in California by creating a three-year Medi-Cal pilot program to provide doula care for pregnant and postpartum people in the 14 California counties with the highest birth disparities. 


Studies have shown that doula care can help reduce rates of cesarean births, reduce the incidence of preterm births, and increase breastfeeding rates. Doula care can also 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. 


The doula pilot bill collapsed as legislative energy was poured into responding to the COVID-19 pandemic. The bill’s sponsors and supporters mourned the end of the bill and noted the sad irony that the racial health disparities the bill aimed to address are only being exacerbated by COVID-19. 


“The research is there, and we know that doula care is greatly associated with better birthing outcomes, higher rates of breastfeeding, and numerous early childhood benefits. It is so important that we provide access to resources that prevent maternal and infant morbidity, rather than trying to solve the problems after they have already occurred. This is especially important for our communities with the highest burden of birth disparities,” said Assemblymember Eloise Gómez Reyes. “But with all of the state’s finances and health departments tied up with direct COVID-19 relief, we have to pause and pivot to find the best ways to provide essential maternal health resources to our most vulnerable communities. I am happy to work with such a passionate and active group of advocates who will continue to fight for maternal health and reproductive rights. I will continue to support them because the fight is not over.”

An amazing group of doulas, policy advocates, agency staff, public health professionals, and other stakeholders came together over the past twelve months to support the collective brainstorming and discussion which ultimately became AB 2258

Amy Chen, Senior Attorney at the National Health Law Program, echoed Reyes’ sentiments and vowed to continue pushing for greater access to doula care in California. “An amazing group of doulas, policy advocates, agency staff, public health professionals, and other stakeholders came together over the past twelve months to support the collective brainstorming and discussion which ultimately became AB 2258,” said Chen. “While the bill will not continue this legislative session, I know this group of advocates will continue to advocate for ways to improve maternal health outcomes and reduce health disparities, especially for Black pregnant and postpartum people.”


“The Economic impact of Coronavirus COVID-19 has robbed us of AB 2258 for 2020. But we have not lost the opportunity to partner with California’s best hearts and minds to end birth disparities,” said Kairis Chiaji, Board Secretary and National Trainer at the Birthing Project USA. “Black mothers and babies deserve every resource. We will continue this fight for birth equity. We remain confident that the solution lies in birthing families being supported from within their communities, as the medical standard of care.”


 “Although AB 2258 may not have a path forward at this moment, doula coverage is still needed to improve birth outcomes for Black mothers and babies, particularly those served by our Medi-Cal program. We cannot settle for a return to normal as we recover from the pandemic,” added Jen Flory of the Western Center on Law & Poverty. We must continue to demand greater equity in all facets of our health care system by shifting resources to the communities that need it most.”


The South Los Angeles/South Bay African American Infant & Maternal Mortality Community Action Team (CAT), another supporter of the bill, was direct in their assessment of the current situation. “Public health emergencies such as COVID-19 have the potential to exacerbate the disparities that Black mothers and babies experience in health care, outcomes, and experiences. Literature documenting improved outcomes shows that doulas are key members of the Village that support safe and joyous pregnancies and births. This makes the information, care, and advocacy provided by doulas during mother and child’s most vulnerable moments even more essential, and broad access to this care even more urgent during this challenging time. The delay of AB 2258 brings costs to families and the health system that can and should be avoided. We have been energized by the broad support for AB 2258 from legislators, families, and community stakeholders. We will continue our collaboration with champions for moms and babies across the state to increase access to doula care. Our mothers and infants deserve the right to survive and thrive.”


The doula bill’s sponsors remain committed to expanding access to doula care in the Golden State. Still, they worry that the economic fallout of the pandemic will lead to significant cuts to programs aimed at addressing health care inequities in the state. They acknowledge that passage of Medi-Cal coverage for doula care may be an uphill battle as California emerges from the coronavirus crisis. The group is now shifting focus to find other creative ways to expand access to doula care and continue to support pregnant and postpartum people amid the COVID-19 crisis.


The bill was co-sponsored by the following advocacy organizations: Birthing Project USABlack Women for Wellness Action ProjectNational Health Law ProgramNorth State Doula ProgramSouth Los Angeles/South Bay African American Infant &Maternal Mortality Community Action Team, and the Western Center on Law & Poverty.

To learn more about AB 2258 and the fate of doula care in California, or for additional comment from Amy Chen, please contact NHeLP’s Director of Communications, Andy DiAntonio, at [email protected] or 703.615.0786. Amy Chen is also the author of an upcoming report on doula care in Medicaid. Learn more here:

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