Press Release  MassHealth Announces Coverage of Doula Services

BOSTON — Today, MassHealth announced a new benefit allowing coverage of doula services for pregnant, birthing, and postpartum members. As part of the Healey-Driscoll administration’s efforts to address health disparities and advance health equity in Massachusetts, this coverage aims to expand access to doula care, which has been shown to improve several maternal and infant health outcomes. MassHealth covers about 40 percent of all births in Massachusetts. 

Doulas provide non-medical emotional, informational, and physical support to individuals and families during pregnancy, birth, and the postpartum period. Evidence shows that birthing people with doula care are less likely to have a c-section, preterm birth, or low birth weight infant, and more likely to report a positive birth experience, experience shorter labor, and to initiate breastfeeding. Doulas can also play an important role in reducing disparities and inequities for low-income families and families of color. 

Based on this evidence, MassHealth’s Chief Medical Officer has issued a standing recommendation for doula services for all pregnant and postpartum MassHealth members. 

“Our administration is committed to ensuring access to high-quality health care, including safe and equitable maternal care,” said Governor Maura Healey. “Covering doula services for MassHealth members is just one step in improving health equity and outcomes for all people across the state.”   

“It is essential that everyone has access to comprehensive, high-quality and inclusive maternal health care,” said Lieutenant Governor Kim Driscoll. “This new benefit is a part of our cross-agency work to reduce racial disparities in health care.”

“Making doula care accessible to MassHealth members is an important part of our efforts to improve maternal health and advance health equity in Massachusetts,” said Secretary of Health and Human Services Kate Walsh. “Findings from the Department of Public Health’s Review of Maternal Health Services earlier this year and from the Special Commission on Racial Inequities in Maternal Health in 2022 point to doula care as an important means of improving maternal and infant health outcomes, especially for people of color.” 

“MassHealth is committed to addressing maternal health disparities and doula services have been shown to improve outcomes for low-income families and families of color,” said Assistant Secretary for MassHealth Mike Levine. “Ensuring that members have access to the care they need during pregnancy and through the 12-month postpartum period is a critical component of our plan to meet this goal.” 

MassHealth doula coverage includes labor and delivery support and visits during pregnancy and postpartum. MassHealth’s typical reimbursement for doula care will be one of the highest of any state that covers doula services through Medicaid. 

As of December 8, 2023, doulas can apply to enroll as a MassHealth doula provider and receive payment for serving MassHealth members. Doulas can enroll if they get formal training or if they have demonstrated experience working as a doula. MassHealth encourages doulas from across the Commonwealth to apply. In the coming months, MassHealth will focus on building the network of MassHealth doula providers to meet the needs of its diverse members. MassHealth anticipates that members will be able to access doula services beginning in spring 2024. 

In addition to doula coverage, MassHealth continues to collaborate with the Department of Public Health and other state agencies and stakeholders across the Commonwealth to put into action the recommendations highlighted in the Healey-Driscoll administration’s recent maternal health report, including expanding midwifery models of care, addressing perinatal substance use disorder, and bolstering community-based supports during pregnancy and through the 12-month postpartum period. 

More information is available online for those looking to: 

• Learn more about applying to enroll as a MassHealth doula provider. 
• Learn more about coverage and resources for pregnant and postpartum members. 
• Learn more about state regulations on doula services, including:  
• 130 CMR 463.000: Doula Services 
• 101 CMR 319.00: Rates for Doula Services 

Statements of support: 

Rebecca Hart Holder, President of Reproductive Equity Now 

“Affordable and equitable doula care can be an essential tool to reduce racial health disparities and combat the Black maternal morbidity crisis. But often, insurmountable costs pose a major barrier to accessing doula care for many birthing people who may benefit the most. That’s why we’re thrilled that Massachusetts is taking steps to remove cost barriers and expand access to doula care for MassHealth membersby making it possible for doulas to now enroll as MassHealth providers. We now must continue to invest in doula workforce development to ensure doula care is available to all who want it.” 

Lora Pellegrini, President and CEO of the Massachusetts Association of Health Plans 

“MAHP and our member plans are committed to improving perinatal health outcomes for Massachusetts residents by increasing access to equitable, high-quality, evidence-based health care services and supports. We support MassHealth’s coverage of culturally competent doulas to connect birthing individuals and their families to resources in an effort to address unacceptable racial disparities.” 

Jessie Colbert, Executive Director, Mass. Postpartum Depression Fund 

“It’s exciting that the state has stepped up to cover doula care for MassHealth members – a service that will improve birth experiences and outcomes, as well as birth equity. Perinatal mental health is deeply impacted by birth experiences and social support before and after birth, so it’s the right thing to do on the mental health side, too. We’ll all need to work together to ensure doulas are supported and integrated into our maternal health system, and coverage is a great first step.” 

Emily Anesta, President, Bay State Birth Coalition 

“Doulas offer critical support for pregnancy, birth, and postpartum. Removing financial barriers and expanding access to doula services is an exciting opportunity to advance health equity in the Commonwealth.” 

Birth Equity & Justice Massachusetts Steering Committee 

“MassHealth coverage of doula services is an important step forward for Massachusetts. We are eager to see how the implementation of this tool serves doulas and their families.” 

Massachusetts Doula Coalition 

"We appreciate MassHealth's decision to cover doula services; doula care integration is an evidence-based practice that improves birth outcomes. We look forward to working with MassHealth to make this program work for MassHealth families and doulas."  

Massachusetts Law Reform Institute

“Massachusetts Law Reform Institute (MLRI) is pleased to see the Healey-Driscoll administration continue to expand benefits for pregnant and postpartum MassHealth members. Expanding access to doula services is an important step in addressing the maternal health crisis and its entrenched racial disparities. MLRI looks forward to working with MassHealth on the implementation of this critical program.” 

Dominique Lee, President and CEO of Planned Parenthood League of Massachusetts:

"Thank you to Governor Healey and Secretary Walsh for this important action. Doulas have been proven to improve health outcomes for birthing people, especially BIPOC patients, but the high cost often makes these services inaccessible to patients who would benefit from them the most. Allowing MassHealth patients to use their insurance to cover doula care is a huge step forward for reproductive health equity and birthing justice in Massachusetts."

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