In a groundbreaking move to combat rising maternal deaths, Missouri’s Medicaid program began covering doula services statewide Oct. 2. The policy change was driven by the Center for Advancing Health Services, Policy & Economics Research (CAHSPER) at Washington University in St. Louis’ Institute for Public Health and other community health leaders who called for innovative solutions to address Missouri’s high maternal mortality rate.
This temporary, emergency expansion of coverage aims to improve maternal health outcomes, especially for low-income and minority populations. A permanent rule is expected to be finalized within six months.
“This isn’t just a health-care issue — it’s about addressing social and racial disparities that have existed for generations,” said Abigail R. Barker, PhD, CAHSPER’s associate director for policy partnerships. “By expanding doula care through Medicaid, we’re building a system where every woman — regardless of income or background — has the support she needs to thrive.”
The comprehensive program provides pregnant and postpartum women with health literacy and nutrition education, referrals to community resources, guidance on birth planning and non-medical support during labor, while respecting personal and cultural needs. Postpartum care includes education on well-woman care, family planning, mental health screening, parenting skills and breastfeeding support.
A 2022 policy brief co-authored by CAHSPER and community doula leaders was instrumental in Missouri’s decision to expand doula services under Medicaid. It highlighted the critical role doulas play in supporting maternal health, particularly in high-risk pregnancies, and called for immediate action to expand access to these vital services.