Did you know doula care has been covered by Medi-Cal since 2023?
Although the benefit has been available for nearly three years, many pregnant and postpartum Californians don’t know they are eligible for doula support through their Medi-Cal insurance coverage.
Now, California is taking a major step to try to change that.
The state has been selected to join the Institute for Medicaid Innovation’s Doula Learning and Action Collaborative, a national initiative to expand access to community-based doula care for Medicaid-enrolled families of color. The collaborative brings together doula organizations, Medicaid leaders, managed care plans, and public health partners to address systemic barriers and improve implementation.
Kairis Joy Chiaji, founder and director of the Children of the Sun Doula Project, said the state already has a strong benefit.
“Our goal in California is to increase access to it,” Chiaji said. “Do people know about it? Do they know how to get to doulas? Do doulas know how to become providers? Do clinical providers understand the value of what we do? All of those pieces have to work together.”
Doulas are trained, nonclinical birth workers who provide emotional, physical, and advocacy support during pregnancy, labor, birth, and the postpartum period. Research shows doula care is linked to better birth outcomes, fewer medical interventions, and higher patient satisfaction, especially for families of color who face higher risks during pregnancy and childbirth.
“The most important thing is that families utilize this benefit,”said Khefri Riley, co-founder and director of Frontline Doulas. “This collaborative helps raise the visibility of doula services, so Medi-Cal beneficiaries know the option exists and can choose to engage with a doula.”
The California collaborative is co-led by Stevie Merino of Birthworkers of Color Collective and Chiaji, with committed partners including Frontline Doulas, SisterWeb, United and Guided, NHeLP, LA Care, and Health Net.
Together, these organizations represent the cross-sector collaboration needed to ensure the Medi-Cal doula benefit succeeds.
“Community doulas are at the heart of this work; they are the reason these programs are effective,” Merino said in a news release. “This collaborative provides the space for us to work collectively across California, build on our state’s strong advocacy, and ensure that families have equitable access to the culturally affirming care they deserve.”
Chiaji emphasized that doula care benefits not only birthing parents but entire families and communities.
“It’s not just about having the benefit on paper. It’s about making sure families can actually access it in a way that works for them.”
State leaders say California’s selection reflects years of advocacy by community-based doulas and organizations pushing for a Medi-Cal benefit that works for families and providers.
“California was selected because we already had a Medicaid doula program in place and because community-based organizations were deeply involved in shaping it,” said Andrea Howard, a Medicaid program manager with Birthworkers of Color Collective. “There was strong advocacy to ensure the benefit was accessible and that reimbursement rates reflected a livable wage.”
Even so, Howard said California still does not have enough doulas to meet demand, and the system can be hard to navigate.
“Doulas have to go through an approval process and then contract with managed care plans,” Howard said. “That’s new for many people, and it can be challenging to understand contracts and expectations.”
Raising awareness among families and providers is now a central focus of California’s work with the Institute for Medicaid Innovation.
“Families need to know this benefit exists, and providers need to be sharing that information,” Howard said. “Visibility is a huge piece of this.”
Over the next three years, the California Doula Learning and Action Collaborative will work to increase visibility of the Medi-Cal doula benefit among families, providers, and the health care system.
The collaborative also will increase use of the benefit so more families can access vital pregnancy, birth, and postpartum support. It will strengthen collaboration across community-based organizations, managed care plans, and public health partners to address barriers and find solutions. The group will gather and share data to inform policy, improve implementation, and facilitate nationwide learning.
“We need protection, support, and advocacy,” Riley said. “Doula care is evidence-based, dynamic, and rooted in community. Making sure families know they can access it is the first step.”