State and Federal Legislative Proposals Relating to Doula Care

Executive Summary

Dhara Patel, an intern at the National Health Law Program, and Amy Chen, a senior attorney, provide a summary of major state and federal legislation introduced or enacted within the past 10 years that included funding for doula services, which is patient-centered care that is vital to combatting the maternal mortality crisis.

“Pregnancy-related deaths are on the rise in the United States. This is particularly the case for Black women, who are three to four times more likely than non-Hispanic white women to die while pregnant or within a year of childbirth,” Patel and Chen write. “Some advocates are now pushing to help improve maternal health outcomes by expanding access to doula care. Doulas are birth companions trained to provide emotional and other nonmedical support to women before, during, and after childbirth. Research has correlated doula care with higher breastfeeding initiation rates, fewer cesarean sections, and fewer low-birth weight babies. Doulas have also demonstrated the ability to reduce the harmful effects of racism by providing culturally appropriate, patient-centered care. These potential benefits led Minnesota and Oregon in 2014 to provide Medicaid coverage for doula services. Other state and federal legislators are now following suit by introducing bills that incorporate doulas and doula care to reduce health disparities and infant and maternal mortality and morbidity.”