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By: Nathaniel J. Greene, Community & Culture Reporter

As California continues to lead the way in healthcare innovation, the state’s Medicaid program, Medi-Cal, is taking significant steps to improve maternal health outcomes. By integrating doula services into its maternal health offerings, Medi-Cal aims to address and reduce the racial and ethnic disparities that have long plagued birth outcomes for Black, American Indian, Latino, and Asian American and Pacific Islander parents and infants.

On June 4, 2024, Ethnic Media Services hosted a pivotal briefing that spotlighted the ongoing transformation of Medi-Cal, California’s Medicaid program. The briefing featured insights from Erica Holmes, Chief of the Benefits Division at the Department of Health Care Services (DHCS), alongside experienced doula providers Kairis Chiaji and Khefri Riley.

The Importance of Doula Services

Doulas are trained professionals who provide continuous physical, emotional, and informational support to birthing individuals before, during, and after childbirth. Their role is crucial in ensuring a positive birthing experience and improving overall birth outcomes. Research has shown that doula support can lead to fewer C-sections, reduced use of epidurals, fewer premature births, and a decrease in low birthweight infants. Moreover, doulas play a significant role in reducing the length of labor, lowering anxiety levels, and enhancing the overall satisfaction of the birthing process.

Holmes emphasizes, “Doula care is essential to closing racial and ethnic disparities in birth outcomes. Doulas provide physical, emotional, and informational support to patients before, during, and after childbirth.”

Addressing Disparities in Maternal Health

The expansion of doula services under Medi-Cal is particularly significant in addressing the disparities faced by marginalized communities. Black, American Indian, Latino, and Asian American and Pacific Islander parents and infants have historically experienced higher rates of adverse birth outcomes. Doulas, who often come from the communities they serve, are uniquely positioned to provide culturally competent care that meets the specific needs of these populations.

Chiaji, a seasoned doula provider, highlights the practical impact of doula services: “California has taken doula care to a level of practical usefulness, being willing to learn what doulas do and making it a part of the standard of care.”

In addition to doula services, Medi-Cal’s maternal health expansion includes a birthing care pathway from conception through 12 months postpartum, and parent-child dyadic care. This holistic approach ensures that both the birthing individual and the child receive coordinated care throughout the critical first year of life. These services address not only physical health but also mental health and health-related social needs, providing a comprehensive support system for new parents.

Holmes further explains, “Medi-Cal’s transformation is about providing high-quality maternal health services and supports, addressing physical health, mental health, and health-related social needs.”

Doulas serve as advocates and allies for birthing individuals, particularly in navigating the complexities of the healthcare system. They help families develop birth plans, provide breastfeeding support, and offer guidance on newborn care. This support is especially crucial in the postpartum period, where many families face challenges that can impact both maternal and infant health.

Riley, co-founder and director of Frontline Doulas, underscores the importance of community-centered care: “We create innovative, culturally competent, solution-oriented programs to address the maternal and infant mortality crisis. Doulas are here to become a part of the team, the collaborative care team, to contribute to positive outcomes.”

The inclusion of doula services in Medi-Cal represents a collaborative effort between the DHCS and community health advocates. This partnership aims to ensure that all Medi-Cal members have access to the supportive, personalized care that doulas provide. The creation of a doula directory, listing doulas by county, specialties, language spoken, and ethnicity, is one example of how Medi-Cal is working to make these services accessible to all who need them.

“The doula directory is a resource where Medi-Cal members can find doulas who accept Medi-Cal and provide culturally competent care,” notes Holmes.

As Medi-Cal continues to expand its maternal health services, the integration of doula care stands out as a transformative step toward better health outcomes for mothers and babies across California. By addressing the unique needs of diverse communities and providing comprehensive support throughout the birthing process, Medi-Cal is setting a new standard for maternal health care. The impact of this initiative is profound, offering hope and support to families and helping to ensure that every birthing individual has the opportunity for a healthy, empowered birthing experience.