Doulas are trained professionals who provide emotional, physical, and informational support during the prenatal, labor and delivery, and postpartum periods of pregnancy. Doulas are shown to improve health outcomes for the pregnant person and their infant, including reducing high-risk pregnancies, low birthweight babies, and rates of cesarean sections, as well as increasing breastfeeding initiation rates.

With 42 percent of births in the U.S. financed by Medicaid and 64 percent of adult women in their reproductive years covered by Medicaid, states and managed care organizations (MCOs) have an opportunity to improve maternal care for women and birthing individuals. To provide doula care that is effective, person-centered, and equitable, it is important for Medicaid agencies to learn how to best recruit skilled doulas who reflect the identities and lived experiences of Medicaid members.

To become Medicaid providers, however, doulas face new challenges — such as training, credentialing, and contracting requirements, which can create barriers for expanding the doula workforce. This fact sheet, made possible through support from the California Health Care Foundation, outlines three strategies to guide state agencies and MCOs in helping doulas enroll as Medicaid providers, including: (1) engaging with doulas to inform benefit design and implementation; (2) ensuring appropriate training for doulas; and (3) providing resources and supports to overcome Medicaid participation barriers.