As part of the Department of Health Care Services’ (DHCS) ongoing commitment to engaging in innovative work to improve the maternal health care landscape, inclusive of offering a comprehensive suite of services and benefits aimed at promoting health equity and addressing disparities in maternal and infant health outcomes, Medi-Cal now covers doula services.
This new and important benefit, added by DHCS in January 2023, helps to ensure that birthing individuals have additional options to receive physical, emotional, and nonmedical support, prevent perinatal complications, and improve health outcomes for birthing individuals and their infants.
What Are Doula Services?
Doula services include personal support to birthing individuals and their families throughout pregnancy and one year postpartum. This includes emotional and physical support provided during pregnancy, labor, birth, and the postpartum period, as well as support during miscarriage and abortion.
Services include guidance; health navigation; evidence-based education for prenatal, postpartum, childbirth, and newborn/infant care; lactation support; development of a birth plan; and, if appropriate, connecting birthing individuals to community-based resources (e.g., breastfeeding classes or maternal support groups) or other providers.
Addressing Health Equity & Maternal Health Disparities
Doula services may be especially important for Black birthing individuals, who face disproportionately higher rates of maternal and infant mortality.
In the United States, Black people are three to four times more likely to die from pregnancy-related causes than White people. Additionally, Black infants are more than twice as likely to die in their first year of life compared to White infants.
Ultimately, Medi-Cal covered doula services are an important step in promoting greater health equity and reducing disparities in maternal health outcomes.
Why Medi-Cal Covers Doula Services?
Doulas provide person-centered, culturally sensitive care that supports the racial, ethnic, linguistic, and cultural diversity of Medi-Cal members, which not only help to address the unique and varied needs of Medi-Cal members, but also help to promote equity and reduce racial and ethnic disparities in maternal health outcomes.
Doula care is associated with positive birth outcomes, including a reduction in cesarean sections, epidural use, length of labor, low-birth weight, and premature deliveries. Additionally, the emotional support provided by doulas has been shown to help lower stress and anxiety during labor.
Accessing Doula Services
Doulas are available through Medi-Cal managed care plans (MCPs) and fee-for-service delivery systems. Doulas can offer personal support throughout pregnancy and one year postpartum, regardless of birth outcomes. To increase access to doula services and reduce barriers, DHCS issued a standing recommendation for doula services. This means that Medi-Cal members do not need to request a separate written referral to receive Medi-Cal-covered doula services, they can just go directly to a doula who accepts Medi-Cal patients and begin their journey with a doula who will support them throughout their pregnancy, labor, and postpartum period.
Comprehensive Care Coverage
Medi-Cal’s doula services include one initial 90-minute visit to establish care and support, eight additional visits combining prenatal and postpartum care tailored to individual needs, continuous support during labor and delivery, including in cases of stillbirth, miscarriage, or abortion, and up to two extended three-hour postpartum visits to ensure comprehensive postpartum care.
With an additional recommendation from a physician or other licensed practitioner, doulas can also provide up to nine additional postpartum visits to Medi-Cal members.
Real Stories, Real Impact
For many families, the support of a doula has been life-changing and significantly impacted their birth outcomes.
Mark and Jasmine, a young couple expecting their first child, were determined to have a positive birthing experience.
Mark recalls, “Having a doula was one of the best decisions we made. Our doula, Linda, was an advocate for us in the hospital, helping us understand our options and make informed decisions. When Jasmine went into labor, Linda’s presence transformed a fearful situation into an empowering experience. She offered comfort and emotional support that helped Jasmine stay strong and focused. After our baby was born, Linda’s continued support during the postpartum period was invaluable. She helped educate Jasmine about breastfeeding and provided us with resources that made our transition into parenthood smoother.”
Expanded Support Services
Medi-Cal extends its maternal coverage beyond doula services to include certified nurse midwives and licensed midwife services, delivering clinical care to birthing individuals and their newborns.
Additionally, DHCS is developing a comprehensive Birthing Care Pathway to guide Medi-Cal members from conception to 12 months post-birth. This project aims to reduce maternal morbidity and mortality disparities, particularly among Black, American Indian/Alaska Native (AI/AN), and Pacific Islander birthing individuals.
It also aims to enhance Medi-Cal’s care delivery policies for pregnant and postpartum individuals, standardize care processes across different settings, and encourage the adoption of these guidelines.
Investing in Health, Empowering Families
By integrating doulas into Medi-Cal, DHCS is helping to transform maternal and infant health care, ensuring that every Medi-Cal member has access to many options when it comes to choosing maternal care providers who are sensitive to cultural and language needs as well as individual preferences in terms of time, place, and manner of the birthing experience. DHCS’ commitment and ongoing investment in this space has already improved and will continue to improve health outcomes and foster long-term health and well-being for Medi-Cal members and their families across the state.
For more information and to find a doula near you, visit the Doula Directory at (https://www.dhcs.ca.gov/services/medi-cal/Documents/Doula-Directory.pdf) or the Medi-Cal Doula Services page at (www.dhcs.ca.gov/provgovpart/pages/Doula-Services.aspx).
This list represents doulas who have enrolled in Medi-Cal. Beneficiaries who enrolled in a Medi-Cal managed care plan can check with their managed care plan regarding doulas who provide services to their members.
In Los Angeles County, Medi-Cal recipients can contact the following managed care plans:
* L.A. Care Health Plan: 888-839-9909
* Health Net Community Solutions: 800-675-6110
* Kaiser Permanente: 855-839-7613
Empower your birth experience with Medi-Cal’s comprehensive doula services. Because every family deserves support, respect, and care.
