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Health and human services advocates acknowledge that doulas provide essential services to ensure mothers and babies are healthy from prenatal to postpartum. Another entity has recently shown its support for doulas. The American College of Obstetricians and Gynecologists (ACOG) released a statement providing recommendations to encourage obstetrician-gynecologists to collaborate with doulas and make them part of the health care team. The recommendations can be applicable in Ohio.
Obstetrician-gynecologists and doulas: 5 ideas for partnership
1. “Obstetrician-gynecologists should educate themselves about the doulas’ spectrum of practice and the benefits of their work.”
Physicians must know that there are many specializations within the doula field. Doulas provide emotional, physical, educational, and advocacy support not only during pregnancy and delivery, but also during postpartum and in the event a patient experiences a miscarriage. ACOG pointed out the many health benefits of patients who receive doula services such as fewer C-sections, birth and maternal complications, and higher breastfeeding rates.
Doulas can also help improve communication between marginalized patients and clinicians, thus trying to reduce community mistrust in the medical field. According to the Ohio Board of Nursing, there were 224 certified doulas in Ohio in 2025, expected to grow over time. To learn more about the different types of doulas, MedCity Doulas created a comprehensive list which shows that there are doulas who specialize in the various stages across the lifespan.
Doulas must be part of the care team, and not to be excluded during times of crisis such as natural disasters, pandemics, or escalating medical situations.
2. “Obstetrician-gynecologists should create synergistic, respectful teams that include doulas in ways that benefit patients and the workplace.”
ACOG recommends that clinicians should intentionally build collaborative relationships with doulas based on mutual respect, trust, and shared commitment to improve outcomes for every individual. Doulas must be part of the care team, and not to be excluded during times of crisis such as natural disasters, pandemics, or escalating medical situations.
If clinicians are interested in connecting with doulas in their communities, there are several online directories to consider:
- DoulaMatch.net: Provides a list of birth and postpartum doulas
- DONA International: Find a DONA Certified Doula Search Page
- Black Health: List of Black doulas in Ohio
Medical providers can also connect with doula-based organizations such as Birthing Beautiful Communities and Restoring our Own through Transformation (ROOTT).
3. “Obstetrician-gynecologists should educate patients about the various roles of a doula and should be aware of local resources to assist patients in identifying doulas and related community resources.”
Many health care workers and the general public still don’t know the benefits, roles, and services of doulas, and may even believe doulas are only for home births. ACOG noted a 2024 study which described how doula services are being underutilized by Black, Indigenous, and People of Color (BIPOC) populations due to a lack of knowledge of their roles and benefits.
To improve awareness about doulas, clinicians can provide information and resources to connect patients with doulas in communities. Some practical things clinicians can do to provide doula support to their patients include asking about their knowledge on doulas and share educational resources like:
- Using a Doula for Pain Relief (Evidence Based Birth, 2018)
- Hiring a Doula: A Guide for Parents (DONA International, 2022)
- Position Paper: The Birth Doula’s Role in Perinatal Care (DONA International, 2022)
- Evidence Based Birth Podcast: Doula (Evidence Based Birth, 2018)
4. “Obstetrician-gynecologists should be aware that there are various coverage and access options for doula support.”
Doulas are reimbursed and accessed through several pathways, including Medicaid, private insurance (only a couple of states privately insured doulas; Ohio isn’t one of them), grants, and hospital-based programs. However, doulas experience challenges when seeking reimbursement that obstetrician-gynecologists should note, such as low reimbursement rates or lack of education on how to get Medicaid reimbursement. This can cause some doulas to not accept Medicaid.
Still, some hospitals or employers hire doulas as part of the maternal care team at no additional expense to patients. Clinicians should understand how doulas get paid so they can effectively educate their patients if they desire a doula and explain their options.
5. “Obstetrician-gynecologists should advocate for and support research on partnerships with doulas and the roles of doulas in obstetric and gynecologic care.”
ACOG recommends the need for obstetrician-gynecologists to advocate for more research about doulas. Some topics of research include reimbursement models, maternal mental health (e.g., postpartum depression, self-esteem, mother-child interaction, etc.), and how they impact the lives of migrants, refugees, people with disabilities, and the incarcerated. They also noted that there is limited research on the connections between doulas and maternal morbidity.
Ohio clinicians should implement ACOG recommendations to work with doulas successfully
Obstetrician-gynecologists and other clinicians in Ohio should apply ACOG’s recommendations in their work to ensure doulas are part of the care team. This is especially important at a time where Ohio still suffers from high infant and maternal death rates and are disproportionally impacting people from vulnerable communities.
According to the Department of Children and Youth’s latest report on infant deaths in 2024, the state’s overall infant mortality rate is 6.6 deaths per 1,000 live births. Yet, non-Hispanic Black infants are almost two and a half times more likely to die before their first birthday compared to non-Hispanic white infants in our state. Our state fortunately allows doulas to seek Medicaid reimbursement, but they encounter hurdles such as the reimbursement process and technical issues submitting claims.
Obstetrician-gynecologists and other health care providers must step in to talk about their positive experiences working with doulas as part of their care teams to combat the myths and misinformation.
Legislative pushback
Another challenge they experience is pushback from legislators who question the legitimacy of doulas and whether the Medicaid reimbursement is worthwhile for them to utilize. Doulas in Ohio have been challenged to educate lawmakers about their work and correct misinformation and myths that could harm the stability of Medicaid reimbursement. Obstetrician-gynecologists and other health care providers must step in to talk about their positive experiences working with doulas as part of their care teams to combat the myths and misinformation. Several healthcare systems in Ohio are already partnering with doulas, demonstrating growing recognition of the important role doulas play in supporting pregnant and postpartum patients. Examples of provider-doula collaborations include:
- Mount Carmel Health System created Ohio's first hospital-based doula program
- Summa Health allows doula services in their facilities
- Cleveland Clinic’s Hillcrest Hospital offers doula support services in their low-intervention birthing suites.
Other healthcare systems partner with community-based doulas to provide continuous, culturally responsive support for pregnant and postpartum patients. These collaborative models can serve as examples for other healthcare organizations seeking to strengthen clinician-doula partnerships and advance policies that promote access to doula care.
Overall, obstetrician-gynecologists and other clinicians should advocate for the advancement of doulas so they can collaboratively have more patients access health services, reduce negative infant and maternal outcomes, and prove that doulas are still worthwhile to reimburse Medicaid.
