News & Updates

Evidence Shows Community Health Workers and Doulas Improve Maternal Health

May 27, 2020

Evidence Shows Community Health Workers and Doulas Improve Maternal Health

Washington, DC – Doulas and community health workers provide high-value care that is associated with improved maternal health outcomes. When doulas are present during birth, the risk of cesarean section is decreased by 39 percent. Additionally, employing community health workers (CHWs) in primary care reduced hospital stays by 65 percent and doubled the rate of patient satisfaction. Building upon the evidence that currently exists for community health worker services, applying the model to maternity care may have similar improved outcomes and reduced costs, particularly in the Medicaid population. 

The Institute for Medicaid Innovation (IMI), a non-profit, nonpartisan research and policy organization, has released its newest report, “Community-Based Maternal Support Services:  The Role of Doulas and Community Health Workers in Medicaid,” that analyzes the unique impact of community-based care on the Medicaid population. The community-based maternal model of care combines the specific pregnancy, labor, and postpartum expertise of doulas with the community and cultural connections of community health workers. Through a comprehensive environmental scan, IMI further identifies innovative ways organizations across the United States are working to eliminate maternal health disparities while also building community connections.

While community-based maternity care consistently results in positive health outcomes for mother and newborn, barriers to supporting this care remain. Presently, doula services are rarely covered by Medicaid, and as a result, community-based doula programs experience challenges in providing services to the Medicaid population. Variation in training and certification across states also contributes to barriers to care, as certification may be necessary to be eligible for Medicaid reimbursement.

In addition to identifying innovative community-based programs currently serving the Medicaid population, IMI has also highlighted a number of research, clinical, and policy opportunities to expand support for these initiatives. Opportunities include encouraging culturally concordant, community-based care that utilizes community-based workers in a self-empowering, financially sustainable way; exploring the impact of maternity community health workers; and exploring opportunities to increase access to community-based maternal support service providers.

Read and download the full report here.


About the Institute for Medicaid Innovation

The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit, nonpartisan research and policy organization that provides independent, nonpartisan information and analysis to inform Medicaid policy and improve the health of the nation.


Media Contact

Lydia Tonkonow