Legislation Filed in Delaware Would Require Medicaid to Cover Doulas Services


With the aim of reducing pregnancy-related complications and health disparities, particularly in Black women, lawmakers in Delaware have filed a bill that would require Medicaid to cover doula services provided to expectant parents beginning next year. House Majority Whip Melissa Minor-Brown is sponsoring House Bill 80, which would require that doula services be covered by Medicaid in Delaware by January 1, 2024. This follows on HB 343 from last year, which required officials to craft a plan for coverage of doula services by Medicaid providers.

Additional Information from the Delaware House of Representatives

“Doulas are specifically trained to provide personalized care for pregnant women throughout their pregnancy, during labor and postpartum. They are a vital part of the pregnancy process for a growing number of residents, especially Black women,” said Rep. Minor-Brown, who also is a nurse. 

“Black women made up one of every four women giving birth in Delaware between 2011 and 2018, but made up half of the mothers who died in childbirth. The Delaware Black infant mortality rate is three times higher than the white infant mortality rate. Those statistics should be alarming to everyone. Doulas are an important part of how we can address pregnancy-related mortality, and requiring Medicaid to provide this coverage will ensure that every parent who wants to use a doula will have access to one.” 

Under HB 80, all carriers would be required to cover doula services that include: 

  • Three prenatal visits, of up to 90 minutes. 
  • Three postpartum visits, of up to 90 minutes. 
  • Attendance through labor and birth. 

The bill also requires the state Division of Medicaid and Medical Assistance to establish a process for doulas to be certified and to enroll as participating providers, and to set a reimbursement rate for doula services “that supports a livable annual income for full-time practicing doulas.” 

“Doulas save lives – especially the lives of Black women,” said Sen. Marie Pinkney, HB 80’s lead Senate sponsor. “Every birthing person should be able to afford this lifesaving service, and I am grateful to the Delaware Division of Medicaid for taking steps to implement doula coverage for all Delawareans.” 

Reporting by the Maternal Mortality Review on infant and fetal death found that the most common accompanying issues were related to providing a family with support in making medical decisions impacting their care, easily accessing care, and effectively communicating with healthcare professionals. Doulas have been effective in providing that supportive bridge between parents and the medical community. 

HB 80 has been assigned to the House Health & Human Development Committee. 
Doulas are trained, non-clinical professionals who provide positive, nurturing environments before, during, and after birth and can provide care that is more informed of their patient’s experiences, values, or identities. They are more commonly utilized by expecting Black parents, who have a much higher rate of pregnancy-related mortality. Studies have shown that the use of a doula during pregnancy reduces maternal mortality and maternal complications.