Doulas who have been registered on the Traditional Healthcare Worker Registry can now have their services reimbursed by Medicaid. The registration process requires both an application and background check. This is a huge development for bringing doula services to every family that desires labor support. Oregon’s move to support doula services follows research that found that doula supported births had lower cesarean section and pre-term birth rates.

A study published early last year in the American Journal of Public Health connected birth doula services to both improved outcomes and lowered costs for Medicaid recipients.

Results: The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, odds of cesarean delivery were 40.9% lower for doula-supported births (adjusted odds ratio = 0.59; P<.001). Potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial, but depend on states’ reimbursement rates, birth volume, and current cesarean rates.

Conclusions: State Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.

Thanks to Eva Bild, DONA International Western Canada Regional Director for sharing this information!

Source: “Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries” Am J Public Health, Feb. 2013