Cover: Advancing Equity in Maternal Health With Virtual Doula Care

Advancing Equity in Maternal Health With Virtual Doula Care

Published in: JAMA Health Forum, Volume 5, No. 1, e234833 (January 2024). DOI: 10.1001/jamahealthforum.2023.4833

Posted on Feb 19, 2024

by Molly Waymouth, Kortney Floyd James, Lori Uscher-Pines

Despite advancements in medical care, maternal morbidity rates are rising in the US, and Black birthing people disproportionately experience adverse outcomes, including maternal mortality. Policymakers have highlighted the importance of addressing the maternal health crisis and stark racial disparities. One potential strategy highlighted in the White House Blueprint for Addressing the Maternal Health Crisis is to increase access to doula care. Doulas are nonclinical professionals who offer physical, emotional, and informational support during pregnancy, delivery, and post partum. They also help parents navigate the health care system and mitigate the effects of racism by encouraging parents to self-advocate in interactions with health care professionals. Several systematic reviews have shown that doula support can reduce cesarean birth rates and premature deliveries and improve breastfeeding initiation and birth experiences. Recognizing these benefits, 12 states now provide coverage for doula services in their Medicaid programs. Although doulas have historically used telephone calls and text messaging to enhance communication, they generally worked with clients in person. However, many fully virtual and hybrid (in-person and virtual) doula services that use synchronous video visits have emerged in recent years. While virtual doula services were initially delivered out of necessity in response to the COVID-19 pandemic, the care model remains common. In this Viewpoint, we review the advantages and limitations of virtual doula services and discuss their potential to address the maternal health crisis.

Research conducted by

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.