Doula support was associated with lower rates of preterm birth and may be a cost-effective benefit for Medicaid programs.

Background

Preterm birth and cesarean delivery are common, costly outcomes that disproportionately affect Medicaid programs and beneficiaries. Doulas provide non-medical maternal support before, during, and after childbirth. This study compared 1,935 Medicaid-funded births supported by a community-based doula program with 65,147 Medicaid-funded births in a regional comparison group.

Findings

Women who received doula support had 22% lower odds of preterm birth than women in the comparison group and lower cesarean delivery rates among full-term births. Cost modeling suggested that Medicaid coverage of doula support could be cost-saving or cost-effective, with savings from fewer preterm birth and cesarean deliveries, potentially offsetting doula support benefit reimbursement of approximately $1,000.

Program/Policy Takeaways

Medicaid coverage of doula services may improve birth outcomes while potentially reducing costs associated with preterm birth and cesarean delivery. Policymakers exploring Medicaid coverage of doula services can apply this study, within the context that the data is from 2012, to inform estimates of cost savings and demonstrate the value for doula coverage.