If you are pregnant and want to hire a doula, this health care option might be cost-prohibitive for some. Typically, expectant mothers can either get free doula services if living in a low-income community where doulas are paid through donations and grants. Some expectant mothers can pay for a doula out of pocket, outright or through payment plans, and others have health insurance that will provide reimbursements for doula care. United Healthcare, in fact, launched doula support this year, where women will be reimbursed for doula services that occur during pregnancy, birth, and postpartum. The amount of the reimbursement is based on every member’s plan. Additionally, some states’ Blue Cross Blue Shield member plans cover doula support based on county, particularly in rural counties. 

Evidence has increasingly shown that doula support can improve birth outcomes, increase patient satisfaction, and reduce unnecessary medical interventions. As a result, several states and insurers are exploring reimbursement models for doula care as part of maternal health reform.

To be sure, reimbursement is not an option for lower socioeconomic women who mostly rely on Medicaid for doula services. As of this writing, over 30 states offer Medicaid reimbursement to doulas or are close to Medicaid-reimbursement doula care being officially on the books. This is important as forty percent of all births nationwide are covered under Medicaid. The National Health Law Program provides an outstanding interactive map that shows where your state is as far as Medicaid-reimbursement doula care. Medicaid reimbursement plans are a win-win for both parties, as low-income expectant mothers can receive doula care in addition to other prenatal care, and certified doulas can earn a living.

We recently ran into a promising free maternal health app, Malama, that was created to help address inequities and high-risk pregnancies for women who are insured by Medicaid. Live now in three states, California, Colorado, and Texas, the Malama app connects expectant mothers with doulas who can provide in-person or virtual care and connect expectant mothers to social services like meals and transport. The app also allows expectant mothers to track their health data and receive culturally relevant pregnancy and nutrition information. A people and AI-powered app, Malama, seeks to expand to other states this year due to a new round of funding. The Malama app provides resources to moms, from connecting them with free diapers and affordable housing to legal services and health education. Additionally, Malama’s services are in-network with plans like the aforementioned United Healthcare, Aetna, and Kaiser Permanente, among other health plans.

As the year goes on, more states will likely get on board to provide Medicaid-reimbursement doula services as maternal health data continues to show that the United States has the highest maternal mortality of all high-income countries. They know they also need to get with the program.