Doula programs are a promising approach to strengthen maternal health and improve the childbirth experience, particularly for Medicaid members and other populations experiencing disparities in birth outcomes. Doulas are trained, non-medical professionals who offer physical, emotional, and informational support during pregnancy, birth, and the postpartum period. They provide labor support and education on pregnancy and childbirth, help their clients navigate the health care system, connect clients to services, and advocate for clients’ preferences with providers.

Policymakers, Medicaid programs, health systems, and providers are increasingly integrating doulas into care models as a strategy to address persistent maternal health challenges and improve birth outcomes. Growing evidence indicates that doula care is associated with lowered rates of cesarean delivery and preterm birth, increased breastfeeding initiation, and greater engagement in postpartum care. Evidence also suggests benefits for maternal well-being, including reduced anxiety and improved care experiences. Evaluations point to potential cost-savings associated with reductions in high-risk births.

Doula programs can also help address gaps in continuity, support, and access to care, and may be especially impactful for populations experiencing disparities in maternal health outcomes, including women of color, individuals living in rural areas or maternity care deserts, and those in under-resourced communities.

As of early 2026, 26 states and the District of Columbia cover doulas under Medicaid, with additional states actively developing programs. With Medicaid covering over 40 percent of U.S. births, state Medicaid programs are a key lever for expanding access to doula services. Successful implementation hinges on aligning policy design with community needs and supporting a sustainable doula workforce.

Policymakers, health systems, maternal care providers, and health plans can use this Evidence-to-Action Collection to understand the evidence behind doula programs, learn about effective implementation strategies, and identify opportunities to improve maternal health outcomes and reduce disparities.

Explore the Collection to learn about:

Evidence

Case Examples

Implementation Tools

Policy Considerations