Advancing Perinatal Health Equity Through Medicaid Coverage of Doulas

Kristin Younger
Woman in labor with husband and doula

Each year, thousands of birthing people, particularly those in the Black, Native American/Alaska Native, and Hispanic communities, experience negative, often avoidable, outcomes during and after childbirth that result in significant consequences to their health and well-being.

Support for this work was provided by the AIR Equity Initiative.

Given that Medicaid finances nearly half of births in the U.S., there is significant opportunity for the program to help advance perinatal health equity. Doula care potentially provides a way to address inequities while generating savings to state Medicaid programs. Health policy researchers from AIR investigated policy considerations for states offering or considering Medicaid coverage of doulas.

This brief reviews findings from the literature on the successes and challenges of Medicaid doula coverage implementation; synthesizes insights on Medicaid doula coverage considerations from interviews with doula certification and advocacy organizations; and identifies strategies and recommendations to improve the implementation of doula coverage.