A recent study published in the American Journal of Public Health reveals that doula support substantially enhances maternal health outcomes for Medicaid enrollees. The research, conducted by Elevance Health, Inc., analyzed over one million pregnancies across nine U.S. states from 2014 to 2023.
The findings show that women receiving doula care were 47% less likely to undergo cesarean deliveries. This reduction was even more pronounced in counties with high infant mortality rates, where C-section rates dropped by 57% for doula-supported pregnancies.
Doulas, non-medical professionals who provide continuous support before, during, and after childbirth, were also associated with a 29% lower risk of preterm birth. Their role in patient advocacy and education appears to be a key factor in these improved outcomes.
The study highlighted another significant benefit: women with doula support were 46% more likely to attend postpartum checkups. This increased engagement with postnatal care is crucial for identifying and addressing potential complications early.
These results are particularly noteworthy given the recent expansion of Medicaid coverage for doula services. Following recommendations from the Surgeon General in 2020 and a White House initiative in 2022, several states have broadened access to doula care through Medicaid.
The research employed rigorous methods, including propensity score matching, to control for factors such as age, race, and socioeconomic status. This approach allowed for a focused analysis of 722 doula-supported pregnancies matched with an equal number of non-supported pregnancies.
While the study found no significant impact on emergency department visits, inpatient admissions, or postpartum depression rates, the overall findings suggest that expanding doula access could play a critical role in reducing health disparities and improving maternal outcomes, especially among high-risk populations served by Medicaid.
As states continue to expand their doula programs under Medicaid, this research provides compelling evidence for the potential of doula care to address persistent challenges in maternal health equity.
“Doula support found to be significant and impactful for Medicaid patient outcomes” (October 26, 2024)
