Doula support is an evidence-based policy that promotes more equitable, safer, less expensive births, and improves perinatal outcomes in the short- and long-term. Doula support is also correlated with improved infant-parent bonding and less postpartum depression and anxiety throughout the perinatal period.

The Alliance supports the efforts of the Doula Association of Vermont to secure policy changes that will enable Vermont families covered by Medicaid to access the support of a Community Doula, who can provide care and advocacy during the perinatal period that meets the self-determined needs of the birthing person. 

Lead Organization: Doula Association of Vermont

Data and Talking Points

• In Vermont, in 2021, there were 2,021 Medicaid births, about 38% of total births in the state.
• Currently all but four states are somewhere in process of proposing or implementing Medicaid coverage for birth doulas
• Doulas offer non-clinical, non-medical, human-to-human support. Doula care is emotional support.
• Studies show that doula care leads to a 30% reduced risk of labor induction, a 28% reduced risk of cesarean section, and a 14% reduced risk of a newborn admission to the NICU.

Session Results

Result: Bill Passage

Pre-session goal: Passage of legislation to enable Vermont families covered by Medicaid to access the support of a Community Doula, who can provide care and advocacy during the perinatal period that meets the self-determined needs of the birthing person.

Thanks to strong support from multiple committees, including Senate Health and Welfare and House Health Care, the Legislature passed S. 53, a bill that continues the multi-year process necessary to provide for Medicaid coverage for a new service. The bill has been signed by the Governor. It instructs the Office of Professional Regulation (OPR) to create the certification necessary for doulas who would like to access Medicaid funding, and the Department of Vermont Health Access to submit the necessary paperwork to federal regulators to include the services in the state’s Medicaid program.

The FY26 Budget includes the modest funding necessary to support OPR’s work. The funding to provide Medicaid coverage was not included in the Budget, as the coverage is not expected to begin until the start of FY27 (July ’26) at the earliest. Advocacy will continue on the issue in the next legislative session.