At Naturally Nurtured Birth Services in Memphis, afternoons are spent doing the unflashy work that can make or break a new parent’s recovery. Doulas call and text new mothers, check on warning signs, help line up groceries, and nudge exhausted families toward postpartum appointments. What once was an out-of-pocket luxury is now free for many TennCare enrollees through a local pilot that matches community doulas with Medicaid members. In neighborhoods with high maternal and infant risk, that steady presence can mean earlier detection of trouble and faster access to medical care.
Pilot brings doulas onto Medicaid in Memphis
As reported by the Chicago Tribune, Naturally Nurtured is part of a Tennessee Medicaid pilot, run by UnitedHealthcare, that pays doulas for prenatal, labor, and postpartum visits and folds in extras like breastfeeding kits and home visits. The effort is aimed squarely at stubborn disparities in the area. Advocates note that Black mothers in Shelby County face higher maternal and infant risks than their white counterparts.
For TennCare recipient Shaquoiya Stewart, who worked with a doula through the pilot, the support felt tangible. “I felt safe. It didn't feel like I was just by myself,” she told the AP.
Research backs the push
A national analysis of Medicaid claims found that enrollees who used doulas had a 47% lower risk of cesarean delivery, a 29% lower risk of preterm birth and were 46% more likely to attend postpartum checkups, according to the American Journal of Public Health. Earlier research focused on socially disadvantaged mothers found that doula-assisted births were four times less likely to be low birth weight and twice as likely to avoid other birth complications, according to a study in the Journal of Perinatal Education. Those kinds of outcomes sit at the heart of arguments from clinicians and policymakers that doula care can be a cost-effective way to improve births.
States and insurers are expanding coverage
Coverage is catching on. Policy tracking and reporting show that more than 30 states now reimburse, or are in the process of reimbursing, doulas through Medicaid, a sharp rise from just a handful several years ago. That state momentum has pushed private insurers and employers to test their own benefits and partnerships to build the workforce and reach more birthing people, according to KFF Health News.
Employer benefits and scaling efforts
UnitedHealth Group recently announced a Doula Support benefit for eligible employer-sponsored plans and projected that millions of members could gain access as the program expands through 2026 and into 2027, according to UnitedHealth Group. Insurers say that folding doulas into care teams can reduce costly complications and boost patient satisfaction. Actually making that work at scale, however, depends on building networks of trained doulas and smoothing out billing and paperwork.
Workforce and payment hurdles
Advocates caution that low reimbursement, credentialing requirements and administrative red tape still keep many doulas from signing up for Medicaid programs, and states are still debating how to set sustainable rates, according to guidance from the National Health Law Program. Minnesota’s approach is often cited as a workable model. Under its Medicaid program, the state allows up to 18 doula sessions without prior authorization, as documented by the Minnesota Department of Human Services.
Without insurance coverage, doula care can run more than $2,000, a price that insurers and state pilots hope to stop from blocking access.
In Memphis, the pilot amounts to a real-world test of whether formal coverage, layered on top of neighborhood relationships, can produce measurable gains. For doulas like Shanille Bowens, the early signs are grounded in small but telling shifts: fewer missed postpartum appointments, more breastfeeding help and mothers who say they felt genuinely supported during a vulnerable stretch of their lives.
