Addressing Maternal Health Disparities: Doula Access in Medicaid
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.
Related Public Policy Research
Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014‒2023
Doula support among Medicaid enrollees was associated with a 47% lower risk of cesarean delivery, a 29% lower risk of preterm birth risks, and a 46% higher likelihood of attending a postpartum checkup, suggesting significant maternal health benefits.
Doula Access Through Medicaid Managed Care Improves Maternal Health
Doulas serve as an effective strategy to address disparities in maternal health. This evaluation provides evidence that women with doula care experience reduced risk of maternal morbidity, compared to women without doula care.
Later Medicaid Health Plan Enrollment Suggests Higher Infant Birth Costs
Timely enrollment in Medicaid managed care is crucial for individuals who are pregnant, allowing them to access prenatal care earlier in their pregnancy. Timely enrollment can also lead to improved birth outcomes and lower infant birth costs.