Doula Frequently Asked Questions Sheet - Medi-Cal Members
The Department of Health Care Services (DHCS) covers doula services in both managed care and fee-for-service delivery systems for pregnant and postpartum individuals. Services include nonmedical support for prenatal and postpartum visits, and during labor and delivery, miscarriage, and abortion.
Obtaining Doula Services
1. What are doulas?
- Doulas are birth workers who provide person-centered, culturally competent care that supports the racial, ethnic, linguistic, and cultural diversity of beneficiaries while adhering to evidence-based best practices. Doula services are aimed at preventing perinatal complications and improving health outcomes for birthing parents and infants.
2. What kind of services do doulas provide?
- Doulas offer various types of support during the perinatal period, including during pregnancy; labor and delivery, miscarriage and abortion; and one year postpartum. Doulas provide guidance; health navigation; evidence-based education for prenatal, postpartum, childbirth, and newborn/infant care; lactation support; development of a birth plan; and linkages to community-based resources.
3. Are there advantages to having a doula?
- Yes. 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).
4. Who is eligible to receive doula services?
- Medi-Cal members who are pregnant or were pregnant within the past year and either would benefit by having a doula or request a doula are eligible for services.
5. I already gave birth to my child but would like doula services for postpartum support. Am I able to obtain a doula just for the postpartum period?
- Yes. If the member did not have a doula while pregnant, they may use the initial visit and all eight visits during the postpartum period, and up to nine additional postpartum visits with a second written recommendation.
6. How long is the postpartum period for doula services?
- For Medi-Cal, the postpartum period is up to one year after pregnancy. This allows members to receive doulas services up to one year after pregnancy.
7. Are doula services available for miscarriage, still birth, or abortion?
- Yes, doula services are available to support individuals during and after pregnancies that end in miscarriage, still birth, or abortion.
8. Am I able to receive postpartum services from a doula if my pregnancy ended in miscarriage, still birth, or abortion?
- Yes, postpartum doula services are available to support an individual regardless of how a pregnancy ended for up to one year after pregnancy.
9. How do I find a doula?
- Enrolled doulas are listed in the doula directory by county. The directory also contains their contact information, specializations, language(s) spoken, and preferred pronouns. Members with fee-for-service Medi-Cal (who are not assigned to a managed care health plan) may contact any doula listed in the directory to see if they accept fee-for-service Medi-Cal and are accepting new members.
- Individuals enrolled in a Medi-Cal managed care plan (for example, Molina, Blue Shield, LA Care Health Plan, etc.) should contact their MCP to assist them in securing doula services. MCP point of contacts for doula services can be found at Managed Care Plan Contact List for Doulas and Members (PDF). MCP point of contacts for general information can be found at Medi-Cal Managed Care Health Plan Directory.
10. Can I receive doula services from more than one doula?
- Yes, more than one doula may provide services during a member’s pregnancy and postpartum period. However, the maximum approved number of visits that a member may receive is based on the member’s pregnancy.
11. Are there any limitations on where doulas can provide services?
- No, Medi-Cal does not limit where doulas may provide services.
12. May doulas provide services by telehealth?
- Yes. Doula may provide all services via telehealth, including by telephone. Services must meet federal requirements for privacy.
Recommendation requirements
13. Are there any requirements to receiving doula services?
- Since doula services are considered a preventive benefit, federal law requires that they be recommended by a physician or other licensed practitioner of the healing arts.
- To increase access to services, DHCS issued a standing recommendation for doula services by the DHCS Medical Director, Dr. Karen Mark. This means that a Medi-Cal member who is pregnant or was pregnant within the past year does not have to find a licensed provider to write a recommendation for services.
- In addition, the 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 the DHCS Medi-Cal Doula Services Recommendation form.
14. Who can recommend doula services?
- Doula services must be recommended by a physician or other licensed practitioner of the healing arts within their scope of practice under state law. The recommending provider does not need to be enrolled in Medi-Cal or be a network provider with the member’s managed care plan.
15. What services are authorized by the standing recommendation?
- The standing recommendation allows the member to receive the following services by a doula:
- One initial 90-minute visit.
- Up to eight additional visits that may be provided in any combination of prenatal and postpartum visits, as determined by the member and doula.
- Support during labor and delivery, abortion, and miscarriage.
- Up to two extended three-hour postpartum visits after the end of a pregnancy.
- Members can also receive up to nine additional visits during the postpartum with a second written recommendation in their medical record or via the Medi- Cal Doula Recommendation form. The standing recommendation does not authorize these additional postpartum visits.
16. Where can I get more information or provide feedback?
