MEMPHIS, TENN. — UnitedHealthcare and Tennessee Medicaid launched a pilot program in Memphis in 2026 providing free doula services to Medicaid members through Naturally Nurtured Birth Services.

Doulas provide physical and emotional support before, during and after birth. More than 30 states now reimburse doulas through Medicaid or are implementing such coverage, up from 14 in late 2022, according to the National Health Law Program.

Shaquoiya Stewart, a 35-year-old single mother of four with six-month-old twin sons, receives care through Tennessee Medicaid. "I felt safe. It didn't feel like I was just by myself," Stewart said about her experience with doula support. "She was like my homegirl," she said.

Research comparing socially disadvantaged mothers found that those who used doulas were four times less likely to have babies with low birth weight and two times less likely to have a birth complication. Mothers who used doulas were also more likely to start breastfeeding.

A study published last year found that Medicaid recipients with doulas had a 47% lower risk of C-sections and a 29% lower risk of preterm birth. The same study found that these recipients were 46% more likely to attend a postpartum checkup.

Without insurance, doula care costs can exceed $2,000. Private health insurers have begun to include doula care benefits in their plans.

"I see doulas becoming more and more integrated and accepted by all within the health care system," said Dr. Margaret-Mary Wilson, chief medical officer at UnitedHealth Group.

There are no mandatory licensure requirements for doulas, though states have qualification standards for doulas to receive Medicaid payments. Many doulas seek certification from private entities. According to a Childbirth Connection survey, 3% of women in the U.S. received care from a doula during labor in 2006, a percentage that has increased since then.