How Doulas Improve Health for New Mothers and Babies

Doula support during and after pregnancy does more than enrich the birth experience. It increases the likelihood that new mothers will get the care they need after giving birth and is a promising strategy to close gaps in maternal health.

Doulas have assisted with childbirth in many cultures for thousands of years. Today, they are professionally trained, non-clinical providers who offer physical and emotional support throughout pregnancy, labor, delivery, and the postpartum period. The personalized care they provide empowers pregnant people as they navigate the complex health care system and provides vital resources for improving the health of mothers and babies, particularly in underserved communities.

In a new study, April Falconi and colleagues analyzed insurance claims from 722 pairs of Medicaid enrollees and compared maternal health outcomes for those with and without doula support. They found that pregnant women supported by a doula were 46% more likely to attend a postpartum appointment than those without. At postpartum visits, health care professionals assess mothers for infections, mental health challenges, and chronic conditions that can worsen after birth. Women with doulas also had 47% fewer C-sections and 29% fewer preterm births.

The health benefits of doula support reported in this study were consistent for both Black and White women receiving Medicaid. This is important, as Black women in the U.S. suffer more than twice as many severe maternal health complications as White women, even when factors like income or health care access are equal. Many reproductive justice initiatives stress the role of doulas in helping to reduce these disparities.

Currently, 18 states and Washington, D.C. cover doula services through Medicaid, but doulas attend less than 1% of the births covered by Medicaid. With a growing body of research showing the benefits of doula care, expanding coverage in more states could lead to better health for mothers and babies.