Doulas have proven to be a significant and impactful source of support for Medicaid patients, according to recent research conducted by US health care insurance provider Elevance Health, Inc. The study found that Medicaid enrollees who received doula care were 47% less likely to undergo cesarean deliveries, 29% less likely to experience preterm birth, and 46% more likely to attend postpartum checkups compared to those without a doula.
Doulas are trained professionals who offer continuous physical, emotional, and informational support to women before, during, and after childbirth. While they are not medical providers and do not offer medical advice, doulas play a crucial role in providing education, guidance, and patient advocacy. This includes helping women set up birthing plans, preparing essential items for the delivery day, explaining options and answering questions, and communicating the mother’s decisions to the doctor.
Previous research has linked doula care to lower rates of cesarean deliveries, birth complications, and postpartum depression. In response to these findings, the Surgeon General recommended coverage for doula services in 2020 to improve access to quality maternity care. This was followed by a White House initiative in 2022 aimed at addressing maternal health disparities.
The study titled “Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014–2023” analyzed Medicaid claims data from over one million pregnancies across nine U.S. states. The research focused on women aged 15 to 49 enrolled in Medicaid-affiliated health plans and compared outcomes between those with doula support and those without.
The findings revealed that doula care was associated with reductions in maternal health risks, a lower risk of preterm birth, and a significant decrease in cesarean deliveries in counties with high infant mortality rates. While there were no significant differences in emergency department visits, inpatient admissions, or postpartum depression/anxiety, the study highlighted the positive impact of doulas on maternal health outcomes.
The study suggested that the expansion of doula programs under Medicaid, particularly following Medicaid expansions in several states, has led to improved maternal outcomes. As doula care becomes more accessible to high-risk populations, such as those covered by Medicaid, there is potential for reducing cesarean delivery rates and enhancing overall maternal health.
In conclusion, the research underscores the importance of doula support in improving maternal health and health equity among Medicaid enrollees. By providing non-clinical support during pregnancy and childbirth, doulas have the potential to play a critical role in enhancing maternal outcomes and reducing health disparities in vulnerable populations.
