Turning Evidence Into Action: Affiliated Health Plans Introduce Expanded Access to Doula Care
- Elevance Health-affiliated commercial and Medicaid health plans have expanded access to doula care in 2025, offering it as a covered benefit to improve maternal health outcomes.
- Research and pilot programs found that doula care leads to better outcomes, including fewer preterm births, lower cesarean rates, reduced NICU admissions, and improved maternal mental health.
Ensuring people receive evidence-based healthcare is one of the ways health plans work to improve overall health outcomes. This year for the first time, members of some Elevance Health-affiliated commercial health plans can access doula services as part of their plan to help them prepare for the birth of a baby. Doula care has been available in several government-sponsored plans since 2018, and this year availability was expanded further. In the same way that members can search for care providers from cardiologists to dermatologists, they can also search for a doula who can address the needs of the whole family during pregnancy, delivery and the postpartum period.
“We advocate for doula care because it works,” said Dr. Cynthia Brown, Elevance Health medical director and clinical lead for women’s health. “We’ve conducted research and run pilot programs. It’s clear that doulas help women access additional health services and the result is healthier, safer pregnancies and deliveries.”
Several years of thorough research, careful planning and partnership development with doula organizations helped make this possible.
Doulas Help Improve Health Outcomes
As maternal health complication rates began to climb in the United States, Elevance Health and its affiliated plans explored approaches and treatments that could reverse this trend. Doula care emerged as one of the most promising options.
A 2022 study from the Elevance Health Public Policy Institute (PPI) compared women who received doula services in three states (California, Florida, New York) to women who did not receive doula services. The study showed that women using doulas were significantly more likely to have a full-term or post-term birth (as opposed to a preterm birth), were less likely to have babies of low birth weight or requiring a neonatal intensive care unit (NICU) admission, had significantly lower odds of cesarean (C-section) delivery, and significantly lower odds of postpartum depression or postpartum anxiety.
It’s clear that doulas help women access additional health services and the result is healthier, safer pregnancies and deliveries.”
Medical Director and Clinical Lead for Women’s Health at Elevance Health
Additionally, a follow-up PPI study in February 2024—which examined the effects of doula services in nine states—found that women who received doula care services demonstrated better health outcomes than women who did not use doula services. This was despite the fact that women in the study who received doula care were more likely to have a pregnancy complication, which reflects how the doula program focused outreach efforts to women with more pregnancy risks.
In addition to the research, we established pilot programs to further examine the effect from doula services offered by our affiliated Medicaid plans. The results matched the research data; women using doulas experienced better maternal health outcomes.
"We set out to look beyond traditional medical care," Brown said. "We considered whether doulas, who aren't typically seen as healthcare workers, could support our members' overall health and well-being. With more people using doulas and more states considering adding this benefit, we focused on exploring doulas' impact on maternal health outcomes and creating a robust and compassionate doula care program."
Boosting Access to and Awareness of Doula Services
While the evidence showed doulas were improving outcomes for women and their babies, their skills and contributions were not widely known or understood. Elevance Health-affiliated health plans partnered with community-based organizations in 18 states to train and certify hundreds of doulas.
Additionally, the Elevance Health Foundation awarded more than $30 million in grants starting in 2021 to programs focused on improving maternal and child health. Many of these grants leverage doula care to improve maternal health outcomes in under-resourced communities or support expansion of the doula workforce.
“The local organizations have a deep understanding of their communities, and we collaborated closely with them to inspire community members to become doulas,” Brown said. “This, in turn, helps the community become more at ease with doulas and appreciate their value.”
Bringing Doula Care into the Care Provider Network
Improving access to doula care meant partnering with a national doula organization to streamline credentialing and reimbursement systems, which vary by state.
“Several pieces came together to make it possible to bring doulas into our care provider networks,” Brown said. “Health plans, doula care organizations, clinical entities, and payment systems all signed up to make the program possible.”
Members of Elevance Health-affiliated Medicaid plans have access to doulas in ten states in 2025, and more than a dozen employer-sponsored plans offer the benefit in 2025. In addition, access to doula care became part of Elevance Health’s own employee benefits package in 2025.
“Doulas beautifully complement the exceptional care physicians and midwives provide during pregnancy, delivery and the postpartum period,” Brown said. “With their essential focus on the many and important social factors that affect the health of mothers and babies, doulas help to enhance the overall care experience and improve outcomes.”
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