New York State Department of Health Continues Support of Doula Services

Governor Hochul's State of the State Plan Includes Increases to Doula Services Across State

Report Highlights Positive Results from Doula Pilot Program Focus Groups in Erie County

ALBANY, N.Y. (January 30, 2024) – As part of a comprehensive effort to advocate for the safety and well-being of all pregnant people and eliminate health inequities, the New York State Department of Health continues to show its unwavering support of doula services. Governor Kathy Hochul in the 2024 State of the State address recently announced the details of her comprehensive plan to drastically reduce maternal mortality statewide and eliminate racial and ethnic disparities. The governor's proposal will allow the Commissioner of Health to issue a standing order to increase access to doula services and other initiatives to improve maternal mortality rates across New York State.

"Doula services improve birth outcomes and provide families with emotional support during pregnancy, delivery, and following birth," State Health Commissioner Dr. James McDonald said. "The State Health Department remains committed to addressing disparities in birth outcomes and providing resources and support, like doula services, to help ensure safe and healthy pregnancies and deliveries."

Last year, Governor Hochul expanded doula coverage for all Medicaid beneficiaries statewide and substantially increased doula reimbursement rates—critical steps toward addressing significant disparities in maternal and infant health outcomes. In June 2023, the Department also announced that New York Medicaid and Child Health Plus (CHPlus) will extend postpartum health coverage from 60 days to a full year following pregnancy.

Doula services help to reduce racial disparities in maternal health and improve overall health outcomes. Additionally, the Department recently released Doula Pilot Program: Findings from Focus Groups of Doulas and Clients in Erie County, a report that highlights findings from doula focus groups. Doulas reported the pilot program enabled them to expand their capacity to serve more Medicaid members and to reach clients who needed support in advocating for a childbirth experience that was responsive to their preferences.

Additionally, doulas emphasized the comprehensive support they provide during the perinatal period, including emotional support, advocacy, transportation assistance, translation, paperwork, guidance on nutrition and breastfeeding, and referrals to community resources, the report said. Doulas also delivered prenatal and postpartum care and established an ongoing connection to health care for the birthing individual and newborn.

The report showed clients expressed high satisfaction with the services provided by doulas. They valued the support, guidance, and advocacy doulas offered throughout their pregnancy, delivery, and postpartum periods.

Doulas played a fundamental role in helping clients navigate the health care system, ensuring their birth plans were respected, and offering emotional and physical support during labor and delivery, the report said. Clients new to the U.S. healthcare system or with limited English proficiency also appreciated the cultural understanding and language assistance provided by doulas.

The pilot program also raised awareness on the value of doulas among clients and clinicians. Doulas believed they had a positive impact on outcomes, including increased rates of vaginal births, cost savings for insurance companies, and improved support for diverse communities.

However, the report showed some barriers and challenges were identified, such as difficulties with billing some Medicaid Managed Care plans and the Medicaid rate of reimbursement relative to the range of services and supports provides. Since the pilot program, Medicaid has significantly increased the reimbursement rates in the permanent program implemented this year.

The report indicated the state will use the recommendations from the pilot program, with feedback from doulas and stakeholders, into the design and rollout of this new statewide Medicaid benefit. Additional information on the benefit development and a schedule of stakeholder meetings may be accessed here: New York State Medicaid Doula Services Benefit (

The Department remains committed to providing all people resources to ensure a safe birthing experience. More information on the Doula Pilot Program can be found here.