Doula Initiative

The Massachusetts Department of Public Health (DPH) aims to improve the health of pregnant and postpartum people, caregivers, and families by making Doulas available to those who want them. Recognizing that Black, Indigenous, and People of Color (BIPOC) experience disproportionally poor health and birth outcomes, the purpose of the Doula Initiative is to eliminate health inequities and promote positive outcomes and experiences for all birthing families.

Table of Contents

What is a Doula?

A Doula is a trained professional who provides educational, emotional, and physical support to pregnant and birthing people and families before, during, and after birth based on culturally competent, evidence-based practices.

Doulas may help reduce some health inequities women of color, especially Black women, experience. Doula care has been linked to improved birth outcomes including fewer cesarean births, fewer preterm births, and fewer low birthweight infants. It can also save on cost. By including Doulas in the system of care, we hope to strengthen and expand the Doula workforce and explore ways to reimburse Doula services.

Doula Initiative Vision Statement

All Massachusetts pregnant and birthing people, caregivers, and families have access to high quality, affordable Doula services as part of a compassionate, respectful health care system.

Doula Initiative Purpose

The Doula Initiative seeks to support and expand a strong Doula-led workforce. It could include the development of a certification process, enhance ongoing professional development opportunities, and establish sustainable financing. In addition, the Initiative seeks to ensure high-quality and accessible Doula services for Massachusetts pregnant and birthing people and their families and to support the work of Doulas across the Commonwealth.

Currently, Doulas are not licensed or certified by Massachusetts and there is no national or statewide accrediting body for Doulas. 

Certification of Doulas would help to: 

  • Provide a statewide system for Doula credentialing
  • Ensure quality of care
  • Allow people to select Doulas who have been vetted by the state
  • Enable broader insurance coverage of Doula care

Doula Initiative Team

The Doula Initiative Team seeks to align efforts, identify strategic priorities, and promote collaboration to support and expand the doula profession across the Commonwealth.

Doula Initiative Leadership

  • Adriana Jean Louis, MPH, Maternal Health Coordinator
  • Maia Raynor, Maternal and Child Health Program and Policy Manager

Doula Initiative Internal Advisory Group Participants

  • Beth Buxton, LCSW, Director of Maternal & Infant Health Initiatives
  • Roxanne Hoke-Chandler, MS, Early Childhood Systems Coordinator for Family Engagement & Training
  • Hafsatou Diop, MD, Director, MCH Research and Analysis Division (DPAG)
  • Rachel Colchamiro, Director, Nutrition Division (DPAG)
  • Stephanie Doyle, Deputy Director of Strategy and Implementation (DPAG)
  • Margi Coggins, CNM, MCH Clinical Coordinator (DPAG)
  • Christine Silva, MPH, Director of MA Home Visiting Initiative (MIECHV)
  • Larisa Mendez-Peñate, MEd, Assistant Director of Pregnancy, Infancy and Early Childhood (DPIE)

Doula Partner Advisory Group Participants (DPAG)

  • Stephanie Crawford, Independent Doula
  • Erika Laquer, Doula
  • Lorenza Holt, MA Doula Association
  • Joanne Dorgilus, Registered Dietician, Doula
  • Viveka Prakash-Zawisza, MassHealth
  • Dona Rodrigues, CNM, Director of Birth Sisters Program
  • Josefa Scherer, Baystate Doula Program
  • Joyce Clark, MA Doula Association
  • James Wang, MA Chapter ACOG
  • Amy Goh, CNM, Director, American Association of Birth Centers (AABC)
  • Alexandra Levie, Massachusetts Hospital Association
  • Pat Noga, Massachusetts Hospital Association
  • Ellen Tolan, WIC Breastfeeding Coordinator
  • Cara Brooks Safon, PhD Candidate at Boston University School of Public Health
  • Darline Turner, MA Coalition of Black Birthworkers
  • Sarah Krinksy, MassHealth, Senior Manager of Perinatal and Maternal Health Policy
  • Virginia Ahearn, CPM, UMass School of Public Health Student
  • Perpetual Honor, PhD Candidate at UMass Boston, Doula
  • Jacqueline Ewuoso, Betsy Lehman Center

Doula Initiative Activities

Funding

In June 2021, DPH allocated Title V of the Social Security Act (Maternal and Child Health Block Grant) funding to hire 1 FTE for a Maternal Health Coordinator. This position was filled in November 2021 and this role is dedicated half time to the Doula Initiative and half time to the Maternal Mortality Review Initiative. 

Cross-Agency Collaboration

In July 2021, DPH began conceptualizing how Doulas could be certified through DPH with sustainable financing. This included an environmental scan of national and international Doula training programs and free and low-cost trainings for Doulas, as well as key informant interviews with other states with Doula programs. Furthermore, as key collaborators from its inception, MassHealth continues to partner with DPH in working towards shared goals in establishing essential elements for providing high-quality doula services to Massachusetts families.   In addition, DPH reached out to both the Betsy Lehman Center and the Health Policy Commission to learn more about their Doula work.

Internal Collaboration

In January 2022, DPH convened an internal Doula Advisory Team to support the process of establishing a state Doula certification pathway.  Membership includes the Bureau of Community Health & Prevention Community Health Worker Office, and several subject matter experts within the Bureau of Family Health & Nutrition (BFHN).  Priorities identified included hosting a Doula Listening Session and the establishment of a Doula Partner Advisory Group (DPAG) to ensure the voices of Doulas were included in all aspects of DPH planning for Doula certification. 

BFHN scheduled a DPH Doula Listening Session for Wednesday March 9, 2022.  The purpose of the DPH Doula Listening Session was to:

  • Introduce DPH Doula Initiative Team members to the Doula community
  • Ensure DPH transparency by providing an overview of DPH activities conducted specific to the DPH Doula Initiative
  • Provide a forum for Doulas to share their thoughts about DPH kicking off a Doula Initiative
  • Collect feedback from the Doula community and advocates that will help guide future decision making
  • Acknowledge the value that Doulas bring to the perinatal field

Contact MassHealth about Doula Services Program

If you are a doula with questions about MassHealth’s Doula Services Program, please visit MassHealth Doula Services Program: Information for Doulas website. You can also contact the MassHealth provider support team at (800) 841-2900, TTD/TTY: 711 or provider@masshealthquestions.com.

If you are a MassHealth member with questions about MassHealth’s Doula Services Program, please call the MassHealth Customer Service Center at (800) 841-2900 or TDD/TTY: 711. You can also find information for pregnant MassHealth members at www.mass.gov/masshealthpregnancy.

Contact Doula Initiative

Any questions related to the MA Department of Public Health's Doula Initiative and efforts including but not limited to credentialing, hospital integration, workforce development, and other related topics should be directed to doulainitiative@mass.gov.

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