Doulas play a vital role in providing emotional, physical, and informational support and guidance during the prenatal, birth, and postpartum period. These non-clinically trained professionals are particularly well-suited to support Black, American Indian, and Alaska Native birthing individuals who face higher maternal morbidity and mortality rates than white individuals, irrespective of income. Doulas can help address these inequities by improving maternity and postpartum care.

This brief, developed by the Center for Health Care Strategies (CHCS), with support from MACPAC, explores how state Medicaid programs are implementing coverage of doula services. Through a literature review and interviews with stakeholders in five states — Florida, Minnesota, New Jersey, Oregon, and Rhode Island — CHCS identified important factors for delivering doula services through Medicaid and also examined whether states included doulas and Medicaid members in designing programs. The brief outlines the challenges of integrating this non-clinical service into Medicaid, and the necessary support doulas need to aid Medicaid members.