A bill that would establish a doula certification program is making its way through the state Senate. Sponsored by Sen. Martine Gulick, D-Chittenden-Central, S.53 would create a certification process and provide Medicaid coverage for community-based doula services, starting in July 2026.
A doula according to the bill’s language is “a nonclinical, nonmedical individual who provides direct emotional and physical support and educational and informational services to birthing individuals before, during, and after labor and childbirth.”
Doulas also offer a consistent relationship and are advocates for perinatal women. Sarah Teel, a doula herself, and a member of the Doula Association of Vermont and the research director for Voices for Vermont’s Children, said that doula care covered by Medicaid would emphasize community building. The idea is to have doulas “embedded in the community,” she said, and to build trust as they work with the whole family leading up to the birth.
Pregnancy has the potential to be isolating. One out of seven women experience depression during pregnancy or up to a year after giving birth, according to the National Center for Biotechnology Information.
Teel said the proposed plan developed by the Vermont Department of Health Access could potentially cover up to $2,100 dollars for doula care per client. The money could be divided up as the patient chooses to cover prenatal visits, labor and delivery support, and postnatal support.
Teel pointed to research that shows an association between doula care and fewer cesarean sections, less use of the labor-inducing drug Pitocin, fewer newborns admitted to special care nurseries, less pain relief medication, and an increased chance of a spontaneous vaginal birth.
Asked about the most powerful experience she has had as a doula, Teel said it was “Someone experiencing something [labor and giving birth] that is very, very difficult but coming out of it and saying ‘that was OK. That wasn’t traumatic.’”
Jaimie Martin, the co-director of the Doula Association of Vermont, is not a doula herself, but represents the client perspective. Martin wrote in an email to The Bridge that she comes from — and has not escaped — generational poverty.
She shared the harrowing birth story of her fourth child, which involved medical complications and was compounded by her inability to advocate for herself and her child. She contrasted the story to her last birth, also difficult, but during which she had doula support thanks to The Doula Project. With the help of grant funding, The Doula Project, when possible, provides doula support to Medicaid recipients in and around Washington County.
“My doula inspired me to advocate for myself and was there to advocate on my behalf whenever the medical establishment that I was up against was not readily respecting my rights as a patient,” wrote Martin. “For me, having a doula meant safety. It meant being respected and treated like a human being who mattered.”
Martin wrote that she joined the Doula Association of Vermont “because we all matter, and those of us who do not live lives of privilege have been denied access to receiving care that truly reflects this.”
Read the story on VTDigger here: Doula certification and Medicaid coverage advance in Senate.