Medi-Cal

Department of Health Care Services

 
 

Doula Services as a

Medi-Cal Benefit

The Department of Health Care Services (DHCS) added doula services as a covered benefit on January 1, 2023. Doula services are available in fee-for-service and through managed care plans (MCPs). Services include personal support to individuals and families throughout pregnancy and one year postpartum. This includes emotional and physical support provided during pregnancy, labor, birth, and the postpartum period, as well as support for and after miscarriage and abortion.

DHCS added doulas as a Medi-Cal benefit to help prevent perinatal complications and improve health outcomes for birthing parents and infants. According to a recent review by Sobczak and colleagues (2023) doula care was associated with positive delivery outcomes including a reduction in caesarean sections, epidural use, length of labor, low-birthweight and premature deliveries. Additionally, the emotional support provided by doulas lowered stress and anxiety during the labor period. 

Studies examining the impact of continuous support by doulas report increased empowerment and autonomy during birth, high overall satisfaction with the birthing process, and improved breastfeeding success and duration (Sobczak et al., 2023).  ​

As a preventive benefit, doula services require a written recommendation from a physician or other licensed practitioner of the healing arts. To increase access to services, DHCS issued a standing recommendation for doula services from the DHCS Medical Director, Karen Mark, MD, PhD, that fulfills the requirement for a recommendation for an individual who is pregnant or was pregnant within the past year.  ​

The initial recommendation authorizes the following:

  • One initial visit.

  • Up to eight additional visits that may be provided in any combination of prenatal and postpartum visits.

  • Support during labor and delivery (including labor and delivery resulting in a stillbirth), abortion or miscarriage.

  • Up to two extended three-hour postpartum visits after the end of a pregnancy.

An additional recommendation from a physician or other licensed practitioner of the healing arts acting within their scope of practice is required for up to nine additional postpartum visits. This recommendation can be noted in the member's medical record by the recommending licensed provider, or a member can ask a licensed provider to complete a Standard form, such as the DHCS Medi-Cal Doula Services Recommendation form. The standing recommendation from DHCS cannot be used for additional postpartum visits. For more information regarding recommendations, please see the Frequently Asked Questions for Medi-Cal Members​ and Frequently Asked Questions for Doulas​​.