Access to Doula Coverage: Medicaid coverage for Community Doula Care

Doula support is an evidence-based service that provides both short- and long-term positive impacts. Providing more access to doulas promotes more equitable, safer, less expensive births, and improves perinatal outcomes in the short- and long-term. Doula care 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 Vermont Doula Access Coalition 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.

Results: With strong support from both the Senate Health and Welfare and the House Health Care Committees, the Legislature passed S. 109, a bill that initiates the steps necessary to bring doula care for childbirth into the state’s Medicaid system. The Governor signed the bill, now known as Act 97, into law in early May.

The bill requires the state’s Office of Professional Regulation to work in consultation with stakeholders to determine the appropriate form of regulation for doulas, and the Department of Vermont Health Access to develop a Medicaid reimbursement plan. Both of these processes should be completed by the end of this year.

With these administrative steps underway, Medicaid coverage of doula services could potentially begin as soon as July 2025.

Lead Organization: Vermont Doula Access Coalition

Data and Talking Points

  • In Vermont, in 2021, there were 2,2021 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.