California is working to increase awareness and utilization of a Medi-Cal benefit that provides coverage for doula services, which have been available to eligible pregnant and postpartum individuals since . Despite the benefit’s existence for nearly three years, many Californians remain unaware they are eligible for this support.
The state’s efforts received a boost with its selection to join the Institute for Medicaid Innovation’s Doula Learning and Action Collaborative, a national initiative focused on expanding access to community-based doula care for families of color enrolled in Medicaid. This collaborative, launched in the fall of , brings together a diverse group of stakeholders – doula organizations, Medicaid leaders, managed care plans, and public health partners – to address systemic barriers and improve implementation of doula care.
Doulas are trained, nonclinical birth workers who provide continuous emotional, physical, and informational support during pregnancy, labor, birth, and the postpartum period. Unlike medical professionals, doulas do not provide clinical care, such as delivering babies or monitoring vital signs. Their role is centered on advocacy and empowering individuals and families to make informed decisions about their care.
Research consistently demonstrates the benefits of doula care, including improved birth outcomes, reduced rates of medical interventions, and increased patient satisfaction. These benefits are particularly pronounced for families of color, who often face disproportionately 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.
The collaborative aims to address several key challenges hindering access to doula care. Kairis Joy Chiaji, founder and director of the Children of the Sun Doula Project, highlighted the need for a multi-faceted approach. “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,” she explained.
Expanding awareness is a primary focus. Many potential beneficiaries are simply unaware of the Medi-Cal doula benefit. Efforts are underway to improve outreach and education to ensure eligible individuals know about the available support. Alongside awareness, increasing the number of qualified doulas and streamlining the process for them to become Medi-Cal providers is crucial. Finally, fostering understanding and collaboration between doulas and traditional clinical providers is essential to integrate doula care into the broader healthcare system.
L.A. Care Health Plan is actively contributing to these efforts. Kristin Schlater, Health Education Program Manager III at L.A. Care, has been appointed to the IMI National Doula Learning & Action Collaborative as a subject-matter expert. Her participation will provide valuable on-the-ground insights to improve the implementation and accessibility of the benefit across California.
The collaborative’s three-year plan focuses on several key areas: expanding awareness of the Medi-Cal doula benefit, increasing utilization rates, strengthening coordination between community organizations and healthcare systems, and collecting data to inform policy and improve implementation. This work directly supports L.A. Care’s broader goal of advancing health equity and improving outcomes for members throughout their lives, starting with prenatal care.
The California collaborative is co-led by Stevie Merino of Birthworkers of Color Collective and Kairis Joy Chiaji, with committed partners including Frontline Doulas, SisterWeb, United and Guided, NHeLP, Health Net, and L.A. Care. Merino emphasized the central role of community doulas in the success of these programs. “Community doulas are at the heart of this work. they are the reason these programs are effective,” she stated 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 underscored that the benefits of doula care extend beyond the birthing parent, positively impacting 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 acknowledge that California’s inclusion in the collaborative is a direct result of years of advocacy by community-based doulas and organizations dedicated to ensuring the Medi-Cal benefit effectively serves both families and providers. The ongoing work represents a significant step towards realizing the full potential of doula care to improve maternal and infant health outcomes across the state.
Individuals interested in learning more about doula services covered by Medi-Cal can find information on the Department of Health Care Services (DHCS) website.
