The Washington State Health Care Authority launched a new birth doula benefit for Apple Health (Medicaid) on Jan. 1. Birth doulas in Washington can now get reimbursed for services provided to Apple Health clients. The benefit launch follows a joint statewide recommendation for doula services from HCA and the Department of Health.

Birth doulas are trained, nonclinical professionals who provide emotional, physical and informational support to pregnant, birthing and post-pregnancy people and their families. There is strong evidence that birth doula services are associated with improved perinatal and birth outcomes, including: decreased unnecessary c-sections and other medical interventions; decreased preterm delivery; increased breastfeeding rates; increased patient satisfaction with care; and improved infant well-being at birth.

Evidence supports doula services are associated with greater positive impacts for Black, Indigenous and other people of color. “Birth doulas provide culturally responsive, compassionate care that empowers families during one of the most important times of their lives,” said Dr. Judy Zerzan-Thul, HCA’s medical director. “By implementing this benefit, we’re taking a step toward advancing health equity and improving pregnancy care across the state.”

Apple Health covers more than 40% of annual births in Washington, including care during and after pregnancy. The Washington state Legislature approved a maximum reimbursement of $3,500 per doula per client, the highest reimbursement rate in the country.

To be reimbursed by Apple Health, doulas must complete DOH’s birth doula certification. Since launching in October 2023, the program has certified 106 birth doulas.