Please wait while loading...


Addressing Maternal Health Disparities: Doula Access in Medicaid

September 2022
Full report

Women using doulas in Medicaid have fewer inpatient hospital admissions during pregnancy, are more likely to attend their postnatal visit, experience lower odds of cesarean delivery, have lower odds of postpartum depression or anxiety, and have lower overall costs compared to women not using doulas.

Several states reimburse for doula services for pregnant women enrolled in Medicaid. Doulas provide person-centered care to pregnant and postpartum women through information, education, and physical, social, and emotional support. Elevance Health examined the use of and outcomes from doula services offered by Elevance Health’s affiliated Medicaid managed care plans in three states: California, Florida, and New York.

The findings from this analysis suggest that doulas offer a personalized and effective approach for improving delivery of culturally competent maternal health care and mitigating birth inequities. State Medicaid programs should continue to consider reimbursing for doula services as part of their overall maternal health strategies.


  • The Role of Doulas
  • State Medicaid Programs’ Doula Models
  • Analysis and Results
  • Policy Options and Considerations

Related Public Policy Research

Partnering with Care Providers to Improve Maternal Health
May 2023
Maternal health disparities are worsening in the U.S., and care provider-focused initiatives are one strategy to improve maternal health outcomes, especially within Medicaid where women are at greater risk for morbidity and mortality.
Addressing Prenatal and Postpartum Coverage Gaps in Medicaid
November 2022
Medicaid is a critical source of insurance coverage for pregnant women. However, there are still gaps in coverage, due to delays in when pregnant women access Medicaid managed care benefits and how long after delivery they retain coverage.
Improving Birth Outcomes: The Centering Louisiana Project
December 2019
An evidence-based group prenatal care initiative in Louisiana achieved low rates of preterm births and low birthweight babies, and participants were highly satisfied with their experience.