The doula Medicaid Project bridges the gap between evidence-based doula support and accessibility. Recently, news spread of Medi-Cal to double doula reimbursement rate. Project creators initially proposed one rate; however, they have now doubled their proposal.
The Doula Medicaid Project states, “The National Health Law Program’s Doula Medicaid Project seeks to improve health outcomes for pregnant Medicaid enrollees by ensuring that all pregnant individuals enrolled in Medicaid who want access to a doula will have one.”
While many community and Medicaid based doula programs exist, few remain sustainable. With reimbursement rates from Medicaid and insurance being significantly lower than private pay, it is difficult for many doulas to work with Medicaid programs long-term.
The news of Medi-Cal to double doula reimbursement is a sign change could be coming for public doula support.
If you are a California resident considering doula training, NOW is the time to get started! Becoming certified will allow you to take part in the new higher reimbursement rates.
Medi-Cal to Double Doula Rate – Medicaid Doula Project
Medi-Cal is the name for California’s state Medicaid program. Under a new proposed spending plan, Medi-Cal will cover doulas for low-income income residents at double the initial proposed rate.
Legislators initially proposed just $450 per birth. Being that many doulas provide 1-2 prenatal visits, continuous labor support (with labor support lasting 6-20 or more hours), and a postpartum visit, the rate is quite low.
California doulas gave harsh but realistic criticism for the low rate. Many responding they simply would not be able to accept Medi-Cal doula clients.
Answering the criticism, Gov. Gavin Newsom last month increased his proposal to $1,154, which is higher than in most other states. This proposal impresses some, while drawing concern from others.
California has a high cost of living. A doula can accept only a limited number of clients based on the amount of on-call time. Birth is unpredictable, limiting many doulas to just two, three, and occasionally four birth doula clients per month.
“I’m wildly unimpressed,” said Samsarah Morgan, a doula in Oakland who has been in the field for over 40 years. “That’s not a living wage for someone to do this work.”
However, the reimbursement in other states which offer doula services through Medicaid typically runs between $770 and $900. Impressively, Oregon this month joined Rhode Island in offering the highest rate, at $1,500 per birth.
Is This a Living Wage For Doulas?
A unique aspect of the International Doula Institute is our Complete Childbirth Professional certification program. We recognize the desire of meeting your community’s need for accessible doula support while maintaining your own need of a living wage.
Whether private or Medicaid clients, birth doulas remain limited in the number of birth clients they can accept each month. While Rhode Island, Oregon, and now California are offering over $1000 per birth, they remain high cost-of-living areas.
With our Complete Childbirth Professional certification program, we provide the skills to offer birth doula, postpartum doula, childbirth education, breastfeeding counseling, etc., services to area clients. When birth doulas combine on-call time with scheduled postpartum shifts, breastfeeding counseling, and childbirth education, it makes it possible to create a sustainable living wage.
It is also possible for doulas to take one or two Medicaid clients per month along with one to two private birth doula clients per month at a higher rate.
Why is Medi-Cal to Double Doula Reimbursement Good?
“We recognize the value of the work that doulas provide to mothers and infants, specifically, the intensity of the services and length of time doulas spend,” the state’s Department of Health Care Services wrote in a May 13 email to a group of doulas and researchers advising the department on the new program.
Birth doulas are essentially professional guides for families through pregnancy. And of course, they provide continuous support during labor. They also support through the postpartum period. Research shows doulas are associated with improved birth outcomes, such as reduced c-section rates, increased breastfeeding rates, and even fewer low birth weight babies.
While doulas are not the solution to the US’s poor maternal infant health statistics, they can play a role in improving them. Covering doula services at a decent rate is a vital part of creating accessibility. This needs to be done in a sustainable way. When we do not reimburse doulas well, we do not have enough doulas available.
At the International Doula Institute, we value accessibility in doula support. However, we equally value and understand the importance of paying doulas appropriately. That is why we ensure our programs provide exceptional training including business training.
Are you prepared to support families in your state? If you are a California resident interested in getting the new reimbursement rate soon, be sure to register now to certify. Become a Complete Childbirth Professional today! Prepare to earn a living wage. Best of all, you will make a difference in your community.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...