Doula care is going mainstream across the US

A growing number of moms across the US are getting a second voice in the delivery room—and a second line item covered by Medicaid.

Over 30 states plus Washington, D.C., now reimburse doulas through Medicaid, or are in the process of implementing such coverage, up from just three states in 2019, per the National Health Law Program.

First things first: A doula is someone hired to offer emotional, physical, and informational support to expecting mothers through the birthing process (pregnancy, labor, and postpartum).

• Unlike midwives, doulas aren’t medical professionals, meaning they don’t perform tasks like checking blood pressure, doing cervical checks, or catching the baby.
• Instead, they offer nonmedical support like affirmations, helping with position changes in labor, and acting as advocates for patients’ desires in the hospital.

A survey conducted in 2006 found just 3% of US women got care from a doula during labor. But today, researchers estimate that figure has at least doubled.

Demand has grown alongside the evidence

Doula care is consistently linked to lower maternal anxiety, higher rates of breastfeeding initiation, and improved postpartum follow-up, according to a review of clinical trials published last month in JAMA Network Open. Other studies have found a link between doula care and fewer C-sections and preterm births.

Zoom out: Doula care is an outlier when it comes to Medicaid coverage of alternative healthcare options. Medicaid tends to prioritize treatments backed by strong clinical evidence, meaning options like acupuncture, herbal medicine, or massage therapy aren’t typically covered.