This year, Elevance Health began covering doula care for members of some employer-sponsored health plans. Cynthia Brown, MD, medical director and clinical lead for women’s health at Elevance Health, joined the Becker’s Payer Issues podcast for an upcoming episode on her team’s push for doula coverage.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: For the first time, some Elevance Health-affiliated employer health plans will include doula services. Can you elaborate on that expansion? Originally, there were some Medicaid plans that had doulas for several years. How did that grow to these employer plans?
Dr. Cynthia Brown: As we saw maternal health complications rising nationally, we knew that we needed solutions that not only improved clinical outcomes, but strengthened the care experience for our pregnant women. When we looked across that evidence, doula care consistently surfaced as one of our most promising approaches.
Just to kind of level set, doulas are trained nonclinical people who provide emotional, physical and educational support during pregnancy, childbirth and the postpartum period. They are not clinicians. They don’t do deliveries. They really are a social support, and social support is one of the most consistent predictors of better health outcomes, and it’s one of the strongest protective factors across the entire prenatal period. When we have good support, we have less stress. [When] we have less stress, we have better mental and physical health.
Our Public Policy Institute conducted some research studies, and the results showed that women who had doula support were more likely to carry to full term. They had fewer [low] birth weight infants, they had reduced NICU admissions, they had less C-sections and then they had better postpartum mental health. All of these outcomes were meaningful from obviously a clinical perspective, but also for the member experience.
Typically, when we implement programs, we pilot them, and we usually pilot them in the groups where there’s the greatest need or we can make the most impact. We started in Medicaid, and our experience there showed that members receiving doula support navigate their pregnancy with better confidence, they have better understanding and emotional well-being, and they had better birthing outcomes.
Then we had to take the time to build the infrastructure that’s needed to really bring doulas into our network at scale. This meant things like establishing credentialing pathways, developing reimbursement models across all our states [and] partnering with doula organizations to grow the workforce that reflects the communities we serve. As a result, in 2025, members in select employer-sponsored health plans can now search for and select doulas, just like they would any other in-network provider. In the same way that you would look for a cardiologist that met your needs or a dermatologist, you can now search for a doula who addresses the needs of your whole family during pregnancy, delivery and the postpartum time.
Question: Racial disparities are particularly prevalent with maternal health outcomes. How can doulas address these gaps?
CB: We know that maternal health challenges affect women across all backgrounds and even women with higher income or advanced education can face poor experiences and outcomes simply because they don’t always feel heard and supported. For many families, doula care has been out of reach because it wasn’t traditionally covered by insurance. Expanding this access helps remove that barrier, and it gives more women the support that they deserve. Families who work with doulas often have smoother experiences.
They have less unnecessary interventions. They have more success with breastfeeding. They have better emotional well-being, and these benefits are even stronger and well noted in underserved communities, especially when families are paired with community-based doulas, who understand their culture, their language and their lived experience.
This shared understanding then builds trust. And when women feel safe and understood, they’re more likely to speak up about their needs and their concerns, and this is really the key to preventing complications. At the heart of it, doulas create a more personal, culturally aligned and supportive experience for all moms. And that’s really a pretty powerful way to address longstanding gaps in maternal healthcare.
Question: What sort of long-term savings can investments in doulas lead to for Elevance?
CB: It really starts with the member experience. When women feel supported, they engage earlier. They ask more questions of their providers. They are more likely to adhere to their care plan, and then they get help before these small issues turn into big complications. Mental health and substance use are two of the leading causes of postpartum maternal deaths in this country. Social support is one of the strongest protective factors across pregnancy and postpartum in its ability to reduce stress and to improve mental health, so doulas provide this, as well.
As I’ve said before, those who have doula care have reduced C-sections, they have less preterm births, they have less NICU admissions, and these are all events that have really significant cost. By having doulas involved, that’s creating meaningful, long-term value. Overall, what matters most is really that doulas are creating safer pregnancies, healthier babies and a more positive, empowering experience for moms.
Question: What final thoughts and advice do you have for other industry leaders as they focus on maternal health and consider expanding to include doula coverage?
CB: My advice for other industry leaders is to definitely consider doula coverage. You know, we advocate for doula care at Elevance Health because it works. We’ve done the research, we’ve run the pilot programs and it’s clear that doulas help women access the care that they need. The result is healthier, safer pregnancies and deliveries.
Pregnancy is such an incredibly vulnerable and stressful time for people, and members just want to feel heard, supported and guided, not just in the delivery room, but really throughout the entire journey. Doulas really help provide that continuous presence. By helping people navigate what can be a complicated healthcare system, it helps ease anxieties, it empowers them and it basically just improves outcomes. Expanding access to them is really one of the opportunities all of us have in this industry to elevate both the member experience and health outcomes for moms and babies.
